“How Come You Sent Me the Canadian One?” Application and Uptake of the Canadian Physical Activity Guidelines for Adults With Multiple Sclerosis in the United States

in Adapted Physical Activity Quarterly

Click name to view affiliation

Whitney N. Neal University of Alabama at Birmingham

Search for other papers by Whitney N. Neal in
Current site
Google Scholar
PubMed Close
*
,
Emma Richardson University of Alabama at Birmingham

Search for other papers by Emma Richardson in
Current site
Google Scholar
PubMed Close
*
, and
Robert W. Motl University of Alabama at Birmingham

Search for other papers by Robert W. Motl in
Current site
Google Scholar
PubMed Close
*
DOI:
https://doi.org/10.1123/apaq.2020-0136
Keywords:
exercise; health promotion; neuroscience; qualitative inquiry
First Published Online:
09 Apr 2021
In Print:
Volume 38: Issue 3
Page Range:
413–434
Restricted access

The uptake and benefits of the Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis (PAGs) have been validated, but there is limited understanding regarding the knowledge, needs, and preferences of people with multiple sclerosis (MS) for implementing the PAGs outside of clinical research. The authors conducted online, semistructured interviews with 40 persons with MS from across the United States seeking information on awareness of and potential approaches for increasing the uptake of the PAGs. They identified first impressions and potential approaches for increasing the uptake of the PAGs through inductive, semantic thematic analysis. Participants perceived the PAGs as a good introduction for structured exercise but desired more information on how to meet the PAGs. Participants further believed that modifying the PAGs for inclusivity and applying a multifaceted approach for dissemination and implementation may increase uptake of exercise behavior. Physical activity research in MS should include both analyzing the effects of exercise and the unique challenges faced by persons with MS in putting the PAGs into practice.

The authors are with the Dept. of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.

Motl (robmotl@uab.edu) is corresponding author.
  • Collapse
  • Expand

Adapted Physical Activity Quarterly

Cover Adapted Physical Activity Quarterly

  • Adamson, B.C., Learmonth, Y.C., Kinnett-Hopkins, D., Bohri, M., & Motl, R.W. (2016). Feasibility study design and methods for Project GEMS: Guidelines for exercise in multiple sclerosis. Contemporary Clinical Trials, 47, 32–39. PubMed ID: 26655434

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143–164. PubMed ID: 15090118

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Benedict, R.H., Cox, D., Thompson, L.L., Foley, F., Weinstock-Guttman, B., & Munschauer, F. (2004). Reliable screening for neuropsychological impairment in multiple sclerosis. Multiple Sclerosis, 10(6), 675–678. PubMed ID: 15584493

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Bernard, H.R. (2017). Research methods in anthropology: Qualitative and quantitative approaches (4th ed.). Rowman & Littlefield.

  • Berteaux, D. (1981). From the life-history approach to the transformation of sociological practice. In D. Bertaux (Ed.), Biography and society: The life history approach in the social sciences (pp. 29–45). Sage.

    • Search Google Scholar
    • Export Citation

  • Bertrand, C., & Bourdeau, L. (2010). Research interviews by Skype: A new data collection method. Proceedings of the 9th European Conference on Research Methodology for Business and Management Studies, Madrid, Spain.

    • Search Google Scholar
    • Export Citation

  • Browne, P., Chandraratna, D., Angood, C., Tremlett, H., Baker, C., Taylor, B.V., & Thompson, A.J. (2014). Atlas of multiple sclerosis 2013: A growing global problem with widespread inequity. Neurology, 83(11), 1022–1024. PubMed ID: 25200713

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Burke, S. (2016). 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 (1st ed., pp. 330–339). Taylor & Francis Group.

    • Search Google Scholar
    • Export Citation

  • Burnard, P. (1991). A method of analysing interview transcripts in qualitative research. Nurse Education Today, 11(6), 461–466. PubMed ID: 1775125

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Burnard, P. (1996). Teaching the analysis of textual data: An experiential approach. Nurse Education Today, 16(4), 278–281. PubMed ID: 8936234

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Burr, V. (2015). Social constructionism (3rd ed.). Routledge.

  • Canning, K.L., & Hicks, A.L. (2020). Benefits of adhering to the Canadian physical activity guidelines for adults with multiple sclerosis beyond aerobic fitness and strength. International Journal of MS Care, 22(1), 15–21. PubMed ID: 32123524

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Caspersen, C.J., Powell, K.E., & Christenson, G.M. (1985). Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Reports, 100(2), 126–131. PubMed ID: 3920711

    • Search Google Scholar
    • Export Citation

  • Clarke, V., Braun, 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. 191–205). Taylor & Francis Group.

    • Search Google Scholar
    • Export Citation

  • Creswell, J.W., & Poth, C.N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage Publications.

    • Search Google Scholar
    • Export Citation

  • Dalgas, U., Langeskov-Christensen, M., Stenager, E., Riemenschneider, M., & Hvid, L.G. (2019). Exercise as medicine in multiple sclerosis—Time for a paradigm shift: Preventive, symptomatic, and disease-modifying aspects and perspectives. Current Neurology and Neuroscience Reports, 19(11), 88. PubMed ID: 31720862

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Fifolt, M., Richardson, E.V., Barstow, E., & Motl, R.W. (2020). Exercise behaviors of persons with multiple sclerosis through the stepwise implementation lens of social cognitive theory. Disability and Rehabilitation, 42(7), 948–956. PubMed ID: 30512979

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Fischer, F., Lange, K., Klose, K., Greiner, W., & Kraemer, A. (2016). Barriers and strategies in guideline implementation—A scoping review. Healthcare, 4(3), 36. PubMed ID: 27417624

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hanna, P. (2012). Using internet technologies (such as Skype) as a research medium: A research note. Qualitative Research, 12(2), 239–242.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hemmer, B., Nessler, S., Zhou, D., Kieseier, B., & Hartung, H.-P. (2006). Immunopathogenesis and immunotherapy of multiple sclerosis. Nature Clinical Practice Neurology, 2(4), 201–211. PubMed ID: 16932551

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Janghorban, R., Roudsari, R.L., & Taghipour, A. (2014). Skype interviewing: The new generation of online synchronous interview in qualitative research. International Journal of Qualitative Studies on Health and Well-Being, 9(1), 24152. PubMed ID: 24746247

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Kinnett-Hopkins, D., Learmonth, Y., Hubbard, E., Pilutti, L., Roberts, S., Fanning, J., … Motl, R. (2019). The interpretation of physical activity, exercise, and sedentary behaviours by persons with multiple sclerosis. Disability and Rehabilitation, 41(2), 166–171. PubMed ID: 29111839

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Kuzel, A.J. (1992). Sampling in qualitative inquiry. In B.F. Crabtree & W.L. Miller (Eds.), Doing qualitative research (pp. 31–44). Sage Publications.

    • Search Google Scholar
    • Export Citation

  • Latimer-Cheung, A.E., Martin Ginis, K.A., Hicks, A.L., Motl, R.W., Pilutti, L.A., Duggan, M., … Smith, K.M. (2013). Development of evidence-informed physical activity guidelines for adults with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 94(9), 1829–1836.e7. PubMed ID: 23770262

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Latimer-Cheung, A.E., Pilutti, L.A., Hicks, A.L., Martin Ginis, K.A., Fenuta, A.M., MacKibbon, K.A., & Motl, R.W. (2013). Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: A systematic review to inform guideline development. Archives of Physical Medicine and Rehabilitation, 94(9), 1800–1828.e3. PubMed ID: 23669008

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Lavis, J.N., Robertson, D., Woodside, J.M., McLeod, C.B., & Abelson, J. (2003). How can research organizations more effectively transfer research knowledge to decision makers? The Milbank Quarterly, 81(2), 221–248. PubMed ID: 12841049

    • Crossref
    • 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. (2017). 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), 1001–1010. PubMed ID: 28915343

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Learmonth, Y.C., Adamson, B.C., Kinnett-Hopkins, D., Bohri, M., & Motl, R.W. (2017). Results of a feasibility randomised controlled study of the guidelines for exercise in multiple sclerosis project. Contemporary Clinical Trials, 54, 84–97. PubMed ID: 27916699

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Learmonth, Y.C., & Motl, R.W. (2016). Physical activity and exercise training in multiple sclerosis: A review and content analysis of qualitative research identifying perceived determinants and consequences. Disability and Rehabilitation, 38(13), 1227–1242. PubMed ID: 26314587

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Marrie, R.A., Yu, N., Blanchard, J., Leung, S., & Elliott, L. (2010). The rising prevalence and changing age distribution of multiple sclerosis in Manitoba. Neurology, 74(6), 465–471. PubMed ID: 20071664

    • Crossref
    • Search Google Scholar
    • Export Citation

  • McAuley, E., Wójcicki, T.R., Gothe, N.P., Mailey, E.L., Szabo, A.N., Fanning, J., … Mullen, S.P. (2013). Effects of a DVD-delivered exercise intervention on physical function in older adults. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 68(9), 1076–1082. PubMed ID: 23401566

    • Crossref
    • Search Google Scholar
    • Export Citation

  • McAuley, E., Wójcicki, T.R., Learmonth, Y.C., Roberts, S.A., Hubbard, E.A., Kinnett-Hopkins, D., … Motl, R.W. (2015). Effects of a DVD-delivered exercise intervention on physical function in older adults with multiple sclerosis: A pilot randomized controlled trial. Multiple Sclerosis Journal—Experimental, Translational and Clinical, 1, 2055217315584838. PubMed ID: 28607692

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Minden, S.L., Frankel, D., Hadden, L.S., Srinath, K.P., & Perloff, J.N. (2004). Disability in elderly people with multiple sclerosis: An analysis of baseline data from the Sonya Slifka Longitudinal Multiple Sclerosis Study. NeuroRehabilitation, 19(1), 55–67. PubMed ID: 14988588

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Morse, J.M. (1994). Designing funded qualitative research. In N.K. Denzin & Y.S. Lincoln (Eds.), Handbook of qualitative research (pp. 220–235). Sage Publications.

    • Search Google Scholar
    • Export Citation

  • Motl, R.W., Backus, D., Neal, W.N., Cutter, G., Palmer, L., McBurney, R., … Ng, A. (2019). Rationale and design of the STEP for MS trial: Comparative effectiveness of supervised versus telerehabilitation exercise programs for multiple sclerosis. Contemporary Clinical Trials, 81, 110–122. PubMed ID: 31022481

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Motl, R.W., McAuley, E., & Snook, E.M. (2005). Physical activity and multiple sclerosis: A meta-analysis. Multiple Sclerosis, 11(4), 459–463. PubMed ID: 16042230

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Motl, R.W., & Pilutti, L.A. (2012). The benefits of exercise training in multiple sclerosis. Nature Reviews Neurology, 8(9), 487. PubMed ID: 22825702

    • Crossref
    • 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), 848–856.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Papathomas, A. (2016). From cardinal to marginal … and back? In B. Smith & A.C. Sparkes (Eds.), Routledge handbook of qualitative research in sport and exercise (pp. 37–48). Routledge.

    • Search Google Scholar
    • Export Citation

  • Richardson, E.V., Barstow, E., & Motl, R.W. (2020). Exercise experiences among persons with multiple sclerosis living in the southeast of the United States. Disability and Rehabilitation. Advance online publication.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Richardson, E.V., Fifolt, M., Barstow, E.A., Silveira, S.L., Sikes, E.M., & Motl, R.W. (2020). The priorities of neurologists for exercise promotion in comprehensive multiple sclerosis care. Multiple Sclerosis and Related Disorders, 38, 101482. PubMed ID: 31707216

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Robinson, O.C. (2014). Sampling in interview-based qualitative research: A theoretical and practical guide. Qualitative Research in Psychology, 11(1), 25–41.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Schüler, J., Wolff, W., & Dettmers, C. (2019). Exercise in multiple sclerosis: Knowing is not enough—The crucial role of intention formation and intention realization. Neurology and Therapy, 8(1), 5–11. PubMed ID: 30980257

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sebastião, E., McAuley, E., Shigematsu, R., Adamson, B.C., Bollaert, R.E., & Motl, R.W. (2018). Home-based, square-stepping exercise program among older adults with multiple sclerosis: Results of a feasibility randomized controlled study. Contemporary Clinical Trials, 73, 136–144. PubMed ID: 30243811

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Silveira, S.L., Richardson, E.V., & Motl, R.W. (2020). Social cognitive theory as a guide for exercise engagement in persons with multiple sclerosis who use wheelchairs for mobility. Health Education Research, 35(4), 270–282. PubMed ID: 32535626

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Smith, B., & Caddick, N. (2012). Qualitative methods in sport: A concise overview for guiding social scientific sport research. Asia Pacific Journal of Sport and Social Science, 1(1), 60–73.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sparkes, A.C., & Smith, B. (2013). Qualitative research methods in sport, exercise and health: From process to product (1st ed.). Routledge.

    • Search Google Scholar
    • Export Citation

  • Stamatakis, E., Straker, L., Hamer, M., & Gebel, K. (2019). The 2018 Physical Activity Guidelines for Americans: What’s new? Implications for clinicians and the public. Journal of Orthopaedic & Sports Physical Therapy, 49(7), 487–490. PubMed ID: 31258047

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sweet, S.N., Perrier, M.-J., Podzyhun, C., & Latimer-Cheung, A.E. (2013). Identifying physical activity information needs and preferred methods of delivery of people with multiple sclerosis. Disability and Rehabilitation, 35(24), 2056–2063. PubMed ID: 23763468

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Synnot, A., Hill, S., Summers, M., & Taylor, M. (2014). Comparing face-to-face and online qualitative research with people with multiple sclerosis. Qualitative Health Research, 24(3), 431–438. PubMed ID: 24572010

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Trapp, B.D., & Nave, K.-A. (2008). Multiple sclerosis: An immune or neurodegenerative disorder? Annual Review of Neuroscience, 31(1), 247–269. PubMed ID: 18558855

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Wallin, M.T., Culpepper, W.J., Campbell, J.D., Nelson, L.M., Langer-Gould, A., Marrie, R.A., … Tremlett, H. (2019). The prevalence of MS in the United States: A population-based estimate using health claims data. Neurology, 92(10), e1029–e1040. PubMed ID: 30770430

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2550 1238 190
Full Text Views 44 15 1
PDF Downloads 46 12 1