Physical activity to delay accumulating disabilities in people with multiple sclerosis: an integrative review

Background: In multiple sclerosis, increased cardiorespiratory fitness from physical activity has been shown to reduce damage to the brain and help delay the accumulation of disability. However, fewer than 20% of people with multiple sclerosis engage in and continue sufficient physical activity to derive health benefits. Aims: To establish a comprehensive understanding of knowledge on enablers and barriers to physical activity for people with multiple sclerosis, identify why so few partake in physical activity and build on this knowledge to inform clinical practice. Methods: Secondary research, in the form of an integrative review. The Capability-Opportunity-Motivation-Behaviour model was used as a theoretical framework to organise the review. Thematic analysis was used to structure data analysis and synthesis. Results: Common enablers of physical activity were reduction in symptoms, lower disability, suitable accessible facilities, support networks, commitment to regular exercise and professional support. Fears over safety, fatigue, lack of time, cost, unsuitable facilities, professionals’ knowledge and professional support were barriers. Consultations, symptom management, early engagement, acceptance and rehabilitation were overarching themes. Conclusions: Professional support was the most significant enabler of physical activity. An emphasis on patient capabilities, opportunities and motivation as part of consultations and tailored to individual needs, as well as the development of a formal pathway for promoting physical activity or appropriate clinical tools, could translate into increased physical activity.