Rachel Dennett



Background The benefits of exercise and physical activity for people with multiple sclerosis are well recognised, as are the challenges faced by many in adhering to these activities over the long term. Adherence is considered by some to be the single most important modifiable factor affecting outcome. With years lived with disability increasing and healthcare resources limited, the need to develop and implement effective and acceptable interventions and support people with adherence to physical activity is pressing. Aim This integrative summary presents work from three related areas regarding exercise and physical activity in people with multiple sclerosis. The body of work represents a systematic and rigorous approach to the topic and comprises outputs from three streams of work: 1) Web-based intervention studies; a systematic review and a qualitative study exploring the participant’s experience. 2) Evaluation of a home-based standing frame programme; a randomised controlled trial evaluating the clinical and cost-effectiveness, a qualitative study exploring experiences of using the standing frame, and production of a series of four short films to present these experiences using both images and the voices of the people involved. 3) A systematic review of adherence to exercise interventions in people with multiple sclerosis that presents recommendations regarding trial design in this area. The Behaviour Change Wheel is used as a “reflection framework” to facilitate integration of my current work and consider areas for future study. The reflection process has helped highlight important ‘threads’ that bring my work together and has informed the development of two concepts that provide a fresh perspective in this field. Conclusion This summary draws together work from a variety of studies encompassing original research and systematic reviews, which demonstrate the creation and interpretation of new knowledge in the field of physical activity in people with multiple sclerosis.

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