Physical Activity and Exercise Training in Multiple Sclerosis: A Quality Review and Content Analysis of Perceived Determinants and Consequences

Background: There is a corpus of quantitative research that has been systematically summarised documenting the determinants and consequences of physical activity and exercise training in persons with multiple sclerosis (MS). The existing qualitative research has not been systematically reviewed, but such an endeavor is critical for establishing the breadth and importance of determinants and consequences of physical activity and exercise that are based on the views of MS patients.

Objectives: We adopted methodology based on theoretical frameworks for undertaking a systematic review and content analysis of qualitative research examining determinants and consequences of physical activity and exercise participation in MS.

Methods: Electronic databases and article reference lists were searched to identify qualitative studies of exercise and physical activity in MS. Content analysis of the determinants and consequences of physical activity and exercise was undertaken using an inductive analysis guided by the Physical Activity for people with Disabilities (PAD) framework and Social Cognitive Theory (SCT), respectively.  

Results: We reviewed 19 articles. The determinants of physical activity and exercise included environmental (e.g., minimal professional support) and personal (e.g., fatigue) barriers as well as environmental (e.g., peer support) and personal (e.g., self-management) facilitators. The most common presumably modifiable barriers and facilitators were social exclusion and peer support, respectively. The consequences of physical activity and exercise included adverse physical (e.g., increased fatigue) and self-evaluative (e.g., loss of control) outcomes as well as benefits in physical (e.g., maintenance of physical function), social (e.g., increased participation in social activities) and self-evaluative (e.g., self-management and control) outcomes. Of the consequences, self-management and control was the most common benefit reported by people with MS.

Conclusions: Such results will inform future quantitative research on the determinants and consequences of physical activity and exercise in those with MS and can be adopted for developing clinical recommendations and interventions for physical activity and exercise in MS.