Evaluation of a Conceptual Model to Guide Health Care Providers in Promoting Exercise Among Persons With Multiple Sclerosis

in Adapted Physical Activity Quarterly

Click name to view affiliation

Emma V. RichardsonUniversity of Alabama at Birmingham

Search for other papers by Emma V. Richardson in
Current site
Google Scholar
PubMed
Close
*
,
Sarah BlaylockUniversity of Alabama at Birmingham

Search for other papers by Sarah Blaylock in
Current site
Google Scholar
PubMed
Close
*
,
Elizabeth BarstowUniversity of Alabama at Birmingham

Search for other papers by Elizabeth Barstow in
Current site
Google Scholar
PubMed
Close
*
,
Matthew FifoltUniversity of Alabama at Birmingham

Search for other papers by Matthew Fifolt in
Current site
Google Scholar
PubMed
Close
*
, and
Robert W. MotlUniversity of Alabama at Birmingham

Search for other papers by Robert W. Motl in
Current site
Google Scholar
PubMed
Close
*
Restricted access

Fewer than 20% of persons with multiple sclerosis (MS) engage in enough exercise to manage MS symptoms and improve function. To address this problem, the authors developed a conceptual model to promote exercise among persons with MS through the patient–provider interaction within health care settings. The current qualitative study evaluated and refined the conceptual model based on 32 semistructured interviews involving persons with MS. The data were subject to inductive, semantic thematic analysis. Participants highlighted that the conceptual model was a necessary addition to current MS care and noted multiple strengths regarding its design (e.g., structure) and content (e.g., patient–provider interaction). Furthermore participants noted areas of the conceptual model that could be improved (e.g., less focus on neurologists as exercise promoters). This comprehensive evaluation yielded a refined conceptual model for exercise promotion in MS through the patient–provider interaction.

Richardson, Blaylock, and Motl are with the Dept. of Physical Therapy; Barstow, the Dept. of Occupational Therapy; and Fifolt, the Dept. of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL.

Richardson (emrich@uab.edu) is corresponding author.

Supplementary Materials

    • Supplementary Material (PDF 146 KB)
  • Collapse
  • Expand
  • Adamson, B.C., Ensari, I., & Motl, R.W. (2015). Effect of exercise on depressive symptoms in adults with neurologic disorders: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 96(7), 13291338. PubMed ID: 25596001 doi:10.1016/j.apmr.2015.01.005

    • Search Google Scholar
    • Export Citation
  • Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143164. PubMed ID: 15090118 doi:10.1177/1090198104263660

    • Search Google Scholar
    • Export Citation
  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77101. doi:10.1191/1478088706qp063oa

    • Search Google Scholar
    • Export Citation
  • Braun, V., Clarke, V., & Weate, P. (2016). Using thematic analysis in sport and exercise research. In B. Smith & A.C. Sparkes (Eds.), Routledge handbook of qualitative research in sport and exercise (pp. 191205). London, UK: Routledge.

    • Search Google Scholar
    • Export Citation
  • Brewer, J.D., & Sparkes, A.C. (2011). Young people living with parental bereavement: Insights from an ethnographic study of a UK childhood bereavement service. Social Science & Medicine, 72(2), 283290. PubMed ID: 21146275 doi:10.1016/j.socscimed.2010.10.032

    • Search Google Scholar
    • Export Citation
  • Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. The American Psychologist, 32(7), 513531. doi:10.1037/0003-066X.32.7.513

    • Search Google Scholar
    • Export Citation
  • Burke, S. (2016). Rethinking ‘validity’and ‘trustworthiness’ in qualitative inquiry: How might we judge the quality of qualitative research in sport and exercise sciences. In B. Smith & A.C. Sparkes (Eds.), Routledge handbook of qualitative research in sport and exercise (pp. 330339). London, UK: Routledge.

    • Search Google Scholar
    • Export Citation
  • Burr, V. (2015). Social constructionism. London, UK: Routledge.

  • Deci E.L., & Ryan R.M. (Eds.). (2002). Handbook of self-determination research. Rochester, NY: University of Rochester Press.

  • Ellis, T., & Motl, R.W. (2013). Physical activity behavior change in persons with neurologic disorders: Overview and examples from Parkinson disease and multiple sclerosis. Journal of Neurologic Physical Therapy, 37(2), 8590. PubMed ID: 23632452 doi:10.1097/NPT.0b013e31829157c0

    • Search Google Scholar
    • Export Citation
  • Escolar-Reina, P., Medina-Mirapeix, F., Gascón-Cánovas, J.J., Montilla-Herrador, J., Jimeno-Serrano, F.J., de Oliveira Sousa, S.L., . . . Lomas-Vega, R. (2010). How do care-provider and home exercise program characteristics affect patient adherence in chronic neck and back pain: A qualitative study. BMC Health Services Research, 10(1), 60. PubMed ID: 20219095 doi:10.1186/1472-6963-10-60

    • Search Google Scholar
    • Export Citation
  • Godin, G. (2011). The Godin-Shephard leisure-time physical activity questionnaire. The Health & Fitness Journal of Canada, 4 ,1822.

  • Hohol, M.J., Orav, E.J., & Weiner, H.L. (1995). Disease Steps in multiple sclerosis: A simple approach to evaluate disease progression. Neurology, 45 ,251255. PubMed ID: 7854521 doi:10.1212/WNL.45.2.251

    • Search Google Scholar
    • Export Citation
  • Kroll, T., Jones, G.C., Kehn, M., & Neri, M.T. (2006). Barriers and strategies affecting the utilisation of primary preventive services for people with physical disabilities: A qualitative inquiry. Health & Social Care in the Community, 14(4), 284293. PubMed ID: 16787479 doi:10.1111/j.1365-2524.2006.00613.x

    • Search Google Scholar
    • Export Citation
  • Learmonth, Y.C., Adamson, B.C., Balto, J.M., Chiu, C.Y., Molina-Guzman, I.M., Finlayson, M., . . . Motl, R.W. (2017a). Identifying preferred format and source of exercise information in persons with multiple sclerosis that can be delivered by health-care providers. Health Expectations, 20(5), 10011010. PubMed ID: 28915343 doi:10.1111/hex.12541

    • Search Google Scholar
    • Export Citation
  • Learmonth, Y.C., Adamson, B.C., Balto, J.M., Chiu, C.Y., Molina-Guzman, I., Finlayson, M., … Motl, R.W. (2017b). Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: A qualitative study. Health Expectations, 20(4), 574583. PubMed ID: 27436592 doi:10.1111/hex.12482

    • Search Google Scholar
    • Export Citation
  • Learmonth, Y.C., Adamson, B.C., Balto, J.M., Chiu, C.Y., Molina-Guzman, I.M., Finlayson, M., . . . Motl, R.W. (2018). Investigating the needs and wants of healthcare providers for promoting exercise in persons with multiple sclerosis: A qualitative study. Disability and Rehabilitation, 40(18), 21722180. PubMed ID: 28524732 doi:10.1080/09638288.2017.1327989

    • Search Google Scholar
    • Export Citation
  • Letts, L., Ginis, K.A., Faulkner, G., Colquhoun, H., Levac, D., & Gorczynski, P. (2011). Preferred methods and messengers for delivering physical activity information to people with spinal cord injury: A focus group study. Rehabilitation Psychology, 56(2), 128137. PubMed ID: 21574732 doi:10.1037/a0023624

    • Search Google Scholar
    • Export Citation
  • Maddigan, S.L., Majumdar, S.R., & Johnson, J.A. (2005). Understanding the complex associations between patient–provider relationships, self-care behaviours, and health-related quality of life in Type 2 diabetes: A structural equation modeling approach. Quality of Life Research, 14(6), 14891500. PubMed ID: 16110929 doi:10.1007/s11136-005-0586-z

    • Search Google Scholar
    • Export Citation
  • Motl, R.W., Barstow, E.A., Blaylock, S., Richardson, E.V., Learmonth, Y.C., & Fifolt, M. (2018). Promotion of exercise in multiple sclerosis through health care providers. Exercise and Sport Sciences Review, 46(2), 105111. doi:10.1249/JES.0000000000000140

    • Search Google Scholar
    • Export Citation
  • Motl, R.W., McAuley, E., Sandroff, B.M., & Hubbard, E.A. (2015). Descriptive epidemiology of physical activity rates in multiple sclerosis. Acta Neurologica Scandinavica, 131(6), 422425. PubMed ID: 25598210 doi:10.1111/ane.12352

    • Search Google Scholar
    • Export Citation
  • Motl, R.W., Mowry, E.M., Ehde, D.M., LaRocca, N.G., Smith, K.E., Costello, K., . . . McCully, K.K. (2018). Wellness and multiple sclerosis: The National MS Society establishes a Wellness Research Working Group and research priorities. Multiple Sclerosis Journal, 24(3), 262267. PubMed ID: 28080254 doi:10.1177/1352458516687404

    • Search Google Scholar
    • Export Citation
  • Motl, R.W., & Pilutti, L.A. (2016). Is physical exercise a multiple sclerosis disease modifying treatment. Expert Review of Neurotherapies, 16(8), 951960. PubMed ID: 27219279 doi:10.1080/14737175.2016.1193008

    • Search Google Scholar
    • Export Citation
  • Motl, R.W., Sandroff, B.M., Kwakkel, G., Dalgas, U., Feinstein, A., Heesen, C., . . . Thompson, A.J. (2017). Exercise in patients with multiple sclerosis. The Lancet Neurology, 16(10), 848856. PubMed ID: 28920890 doi:10.1016/S1474-4422(17)30281-8

    • Search Google Scholar
    • Export Citation
  • Paltamaa, J., Sjögren, T., Peurala, S.H., & Heinonen, A. (2012). Effects of physiotherapy interventions on balance in multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials. Journal of Rehabilitation Medicine, 44(10), 811823. PubMed ID: 22990349 doi:10.2340/16501977-1047

    • Search Google Scholar
    • Export Citation
  • Papathomas, A. (2016). Narrative inquiry: From cardinal to marginal . . . and back? In B. Smith & A.C. Sparkes (Eds.), Routledge handbook or qualitative research in sport and exercise (pp. 3748). London, UK: Routledge.

    • Search Google Scholar
    • Export Citation
  • Partington, E., Partington, S., Fishwick, L., & Allin, L. (2005). Mid-life nuances and negotiations: Narrative maps and the social construction of mid-life in sport and physical activity. Sport, Education and Society, 10(1), 8599. doi:10.1080/135733205200098820

    • Search Google Scholar
    • Export Citation
  • Pearson, M., Dieberg, G., & Smart, N. (2015). Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 96(7), 13391348.e7. PubMed ID: 25712347 doi:10.1016/j.apmr.2015.02.011

    • Search Google Scholar
    • Export Citation
  • Phoenix, C., & Sparkes, A.C. (2006). Young athletic bodies and narrative maps of aging. Journal of Aging Studies, 20(2), 107121. doi:10.1016/j.jaging.2005.06.002

    • Search Google Scholar
    • Export Citation
  • Pilutti, L.A., Dlugonski, D., Sandroff, B.M., Klaren, R., & Motl, R.W. (2014). Randomized controlled trial of a behavioral intervention targeting symptoms and physical activity in multiple sclerosis. Multiple Sclerosis Journal, 20(5), 594601. PubMed ID: 24009162 doi:10.1177/1352458513503391

    • Search Google Scholar
    • Export Citation
  • Pilutti, L.A., Greenlee, T.A., Motl, R.W., Nickrent, M.S., & Petruzzello, S.J. (2013). Effects of exercise training on fatigue in multiple sclerosis: A meta-analysis. Psychosomatic Medicine, 75 ,575580. PubMed ID: 23788693 doi:10.1097/PSY.0b013e31829b4525

    • Search Google Scholar
    • Export Citation
  • Platta, M.E., Ensari, I., Motl, R.W., & Pilutti, L.A. (2016). Effect of exercise training on fitness in multiple sclerosis: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 97(9), 15641572. PubMed ID: 26896750 doi:10.1016/j.apmr.2016.01.023

    • Search Google Scholar
    • Export Citation
  • Pollner, M., & Stein, J. (1996). Narrative mapping of social worlds: The voice of experience in Alcoholics Anonymous. Symbolic Interaction, 19(3), 203223. doi:10.1525/si.1996.19.3.203

    • Search Google Scholar
    • Export Citation
  • Richardson, E.V., Smith, B., & Papathomas, A. (2017). Crossing boundaries: The perceived impact of disabled fitness instructors in the gym. Psychology of Sport and Exercise, 29 ,8492. doi:10.1016/j.psychsport.2016.12.006

    • Search Google Scholar
    • Export Citation
  • Sandroff, B.M., Motl, R.W., Scudder, M.R., & DeLuca, J. (2016). Systematic, evidence-based review of exercise, physical activity, and physical fitness effects on cognition in persons with multiple sclerosis. Neuropsychology Review, 26(3), 271294. PubMed ID: 27447980 doi:10.1007/s11065-016-9324-2

    • Search Google Scholar
    • Export Citation
  • Smith, B. (2018). Generalizability in qualitative research: Misunderstandings, opportunities and recommendations for the sport and exercise sciences. Qualitative Research in Sport, Exercise and Health, 10(1), 137149. doi:10.1080/2159676X.2017.1393221

    • Search Google Scholar
    • Export Citation
  • Smith, B., & Sparkes, A. (2016). Interviews: Qualitative interviewing in the sport and exercise sciences. In B. Smith & A.C. Sparkes (Eds.), Routledge handbook or qualitative research in sport and exercise (pp. 3748). London, UK: Routledge.

    • Search Google Scholar
    • Export Citation
  • Smith, B., Tomasone, J.R., Latimer-Cheung, A.E., & Martin Ginis, K.A. (2015). Narrative as a knowledge translation tool for facilitating impact: Translating physical activity knowledge to disabled people and health professionals. Health Psychology, 34(4), 303313. PubMed ID: 25133831 doi:10.1037/hea0000113

    • Search Google Scholar
    • Export Citation
  • Sparkes, A.C., & Smith, B. (2014). Qualitative research methods in sport, exercise and health: From process to product. London, UK: Routledge.

    • Search Google Scholar
    • Export Citation
  • Weiler, R., Murray, A., & Joy, E. (2013). Do all health care professionals have a responsibility to prescribe and promote regular physical activity: Or let us carry on doing nothing. Current Sports Medicine Reports, 12(4), 272275. PubMed ID: 23851415 doi:10.1249/JSR.0b013e31829a74ea

    • Search Google Scholar
    • Export Citation
  • Wens, I., Eijnde, B.O., & Hansen, D. (2016). Muscular, cardiac, ventilatory and metabolic dysfunction in patients with multiple sclerosis: Implications for screening, clinical care and resistance exercise therapy, a scoping review. Journal of Neurological Science, 367 ,107121. PubMed ID: 27423572 doi:10.1016/j.jns.2016.05.050

    • Search Google Scholar
    • Export Citation
  • White, S.M., Wójcicki, T.R., & McAuley, E. (2011). Social cognitive influences on physical activity behavior in middle-aged and older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 67(1), 1826. PubMed ID: 21743038 doi:10.1093/geronb/gbr064

    • Search Google Scholar
    • Export Citation
  • Williams, T.L., Smith, B., & Papathomas, A. (2018). Physical activity promotion for people with spinal cord injury: physiotherapists’ beliefs and actions. Disability and Rehabilitation, 40(1), 5261.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2218 860 200
Full Text Views 50 14 1
PDF Downloads 27 9 1