Qualitative Exploration of a Tele-exercise Program to Inform the Design of Adaptive Intervention Strategies for Adults With Multiple Sclerosis

Objective

(1) To examine the experiences and perceptions of people with multiple sclerosis (MS) who previously completed a 3-month tele-exercise program; (2) to identify modifiable factors regarding the program components and implementation procedures that could be used to develop an adaptive tele-exercise intervention.

Design

A qualitative study using a semistructured interview guide.

Setting

An extension of a comparative effectiveness trial delivered for 761 people with MS between 2016 and 2021. Interviews were conducted over Zoom or phone.

Participants

Twenty-two adults with MS who completed the 3-month program (age range, 24-67y, 86% women, 73% Caucasian, 68% relapsing-remitting MS). Participants presented a wide range of mobility disabilities, ranging from no mobility limitation to wheelchair or scooter (n=22).

Interventions

Not applicable.

Main Outcome Measures

Thematic analysis of the transcribed interview led to the identification of desirable components and delivery mechanisms of the tele-exercise program.

Results

Our analysis indicated the importance of individualized and ongoing modification of exercise program content to accommodate changes in participants’ functional abilities and health status. Participants reported an ideal timepoint of human support, preferably every 3 weeks, via phone or videoconference calls to capture the intervention modification needs (eg, exercise position, intensity, and clarification of exercise instruction). We further identified desirable components for behavioral modifications, such as inclusion of an exercise companion and self-monitoring tool and postintervention resources for sustaining exercise participation during follow-up periods.

Conclusions

The findings of this study offer insights into tailoring future adaptive tele-exercise intervention designs aimed at promoting engaging and sustainable exercise participation in people with MS.