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

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.