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Old 07-02-2019, 02:05 PM
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Default Qualitative Inquiry of an Exercise Program for MSers Who Use Wheelchairs for Mobility

Qualitative Inquiry of an Exercise Program for Persons with Multiple Sclerosis Who Use Wheelchairs for Mobility

Abstract

Background: The majority of research on exercise programs for people with multiple sclerosis (MS) has included samples who are generally ambulatory with no or minimal assistance. To date, there are fewer exercise programs that have been developed for people with MS who use a wheelchair for the majority of the day. This is surprising as over 30% of persons with MS use a wheelchair for mobility on a daily basis, and this segment of the MS population requires appropriate exercise programs for rehabilitation and symptom management.

Objectives: This qualitative study explored the “what, when, where, who and why” of an exercise program for persons with MS who use wheelchairs. Such research will inform “how” exercise programs can be delivered for persons with MS who use wheelchairs for mobility.

Methods: We conducted semi-structured interviews with 20 persons with MS from across the United States who reported using wheelchairs for mobility for at least 50% of the day. The interviews were conducted using video conferencing technology and focused on preferences for an ideal exercise program. We analyzed data abductively using thematic analysis.

Results: Participants expressed interest in a comprehensive exercise program that including strength training, aerobic activity, and flexibility and stretching (what). The frequency and duration of exercise generally ranged between 2 times per week and daily for between 15 and 60 minutes (when). The most common location for exercise included the home with personal equipment or Internet resources (where). The exercise program should include individual, one-on-one sessions with a trainer/coach, and group programs online (who). The common barriers were time, weather, cost, caregiver burden, fatigue, facility accessibility, and transportation, whereas the common facilitators included social support from family, caregivers, and health care providers, enjoyment, and MS-specific programs and groups. Barriers and facilitators help to explain preferences and guide a social-cognitive theory informed exercise program (why). Participant descriptions of ideal exercise programs fit within Bandura’s threefold implementation model for guiding health promotion and disease prevention interventions (how).

Conclusions: Such data will inform future research on the creation of a social cognitive theory-based exercise program that addresses the needs of persons with MS who are wheelchair users across levels of Bandura’s threefold implementation model.

Authors
Stephanie L Silveira
University of Alabama at Birmingham
Emma V Richardson
UAB
Robert W Motl
University of Alabama at Birmingham
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