Evaluating healthcare professional-led physical activity promotion interventions for individuals with multiple sclerosis: a scoping review

Identification and evaluation of the full range of components within complex interventions is critical to explaining their impact and informing clinical decision-making. Our aim is to identify physical activity promotion interventions suitable for implementation by healthcare professionals among individuals with multiple sclerosis, and to determine whether they meet current best-practice recommendations. We searched nine databases from inception up to May 2025. Articles were eligible if they included adults (≥18 years) with diagnosis of multiple sclerosis, evaluated interventions incorporating strategies to promote physical activity, reported outcomes of participation or its predictors, and identified healthcare professionals as deliverers. We identified 28 distinct interventions. Interventions showed limited alignment with existing recommendations regarding use of behavioural strategies, diversity of deliverers, theoretical underpinning, adherence to physical activity guidelines, range of activity options, and follow-up assessment. In contrast, alignment was stronger for duration and frequency of involvement, multimodal delivery, and inclusion of behaviour support components. While healthcare professional-led interventions represent a promising approach to promoting physical activity among individuals with multiple sclerosis, our component-level analysis reveals inconsistent alignment with best-practice recommendations, potentially undermining intervention impact. By clarifying where current interventions diverge from recommendations, we offer a framework to strengthen the design of future interventions. Healthcare professional-led physical activity promotion is a promising approach to increasing physical activity among individuals with multiple sclerosis, but clinicians often report a need for practical tools and strategies to support effective practice. Interventions to support clinicians in this endeavour are often complex, yet evaluation thus far has failed to capture the full range of components, treating them instead as unified packages. This component-level analysis shows that the characteristics and components of current interventions vary in their alignment with best-practice recommendations, potentially limiting effectiveness in achieving physical activity behaviour change. Future interventions must make greater use of behavioural strategies and person-centred design, focus on long-term outcomes, and diversify the professionals involved, theoretical frameworks used, and types of physical activity promoted.