A Qualitative Analysis of Focus Groups on a Community-Based Pro Bono Exercise and Lifestyle Modification Education Program for Individuals With Disability due to Multiple Sclerosis and Stroke

The aim of this study was to identify perceived logistical, behavioral, and practical barriers to regular exercise participation in individuals with disability due to stroke and multiple sclerosis, as well as potential solutions. Focus group interviews were conducted as part of a mixed-methods prospective observational study evaluating a multi-site, pro bono, community-based exercise and lifestyle modification program. Twelve participants engaged in one of three focus groups, and data analysis was conducted using a modified grounded theory approach. Five themes were identified through thematic analysis: fear of exercising and need for safety when implementing an exercise program; personal experiences of physical and mental health and wellness; importance of social support and sense of community foster accountability and camaraderie; role of self-efficacy in daily life participation and resilience; and accessibility of fitness centers. Key factors were identified that influence exercise participation among individuals with disability due to neurological diagnosis. Overall, strong motivation to enhance overall health and wellbeing was observed; however, safety concerns and accessibility were barriers to participation. Social support and a sense of community were identified as critical factors to foster accountability and engagement. Despite existing barriers, building self-efficacy and resilience emerged as powerful enablers of long-term participation in exercise.