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People with multiple sclerosis experience barriers to physical activity. Thought processes are interwoven with garnering motivation to overcome these barriers. This study investigated in-depth the role of positive thinking in physical activity motivation of two women and two men with multiple sclerosis. Participants thought aloud while completing standardised measures of physical activity, stages of change and self-efficacy, and in response to planned and spontaneous questions. Four themes were formulated using inductive thematic analysis: thoughts about purpose, self-efficacy, the past and reinforcement through positive thinking. These findings have implications for physical activity theories and delivering appropriate physical activity interventions to the multiple sclerosis community., (© The Author(s) 2015.)

Researchers have suggested that men with multiple sclerosis (MS) experience lower self-efficacy than women with MS and have linked women's self-efficacy with a sense of perceived control over symptoms and activities. Self-efficacy—the belief in one's own ability to achieve an outcome—has also been linked to engagement in healthy behaviors such as exercise. We sampled men with MS to better understand how MS-related fatigue influences exercise participation. Guided by the interpretive description method, we interviewed 18 men about their fatigue and exercise experiences. One overarching theme and three subthemes were developed through multiple readings, author comparisons, and participant reflections. The men described a process of goal readjustment with regard to exercise that helped them stay engaged in meaningful physical activity despite fatigue. Health care professionals might consider introducing goal readjustment strategies to help men with MS-related fatigue retain perceived control over exercise engagement and achieve greater self-efficacy., (© The Author(s) 2014.)

This study describes the experiences of four groups of healthcare providers who facilitate exercise interventions for people with multiple sclerosis (MS)-related fatigue. Fatigue is a complex symptom frequently experienced by people with MS, yet it is poorly understood by clinicians and clinical researchers. Historically, clinicians have recommended less physical activity in order to limit fatigue; however, recent experimental studies suggest that regular exercise provides health benefits with little increase in fatigue. We used interpretive description methodology to guide data collection and analysis. Four groups of healthcare providers participated in either focus group discussions or individual interviews. Transcripts were analyzed for key meanings. Healthcare providers described their perceptions of the "nature of fatigue" and how this raised "professional challenges," specifically "barriers to implementation" of interventions, "stirring conflict" among interdisciplinary members, and "modifying roles." The nature of fatigue and professional challenges influenced clinician practice by "demanding creativity" with regard to exercise prescription and advice. Healthcare providers are encouraged to consider strategies of active listening and careful observation when providing individualized exercise programs for people with MS-related fatigue. In addition, recognition and understanding of the complex nature of fatigue by the interdisciplinary team might facilitate more positive exercise experiences for this population.

We currently know little about how dog-walking contributes to health and wellbeing of adults living with long-term health conditions. Guided by a conceptual framework of “therapeutic mobilities,” we accompanied 13 adults with diverse long-term health conditions on their usual dog-walk. We captured conversations about health and wellbeing through audio-recordings. Interactions with environment, other humans, and between humans and dogs were captured via video-recordings. We provided each participant with a transcript and video-recording of the dogwalk-along interview and met all participants again for a further seated interview. Guided by participants, we developed a series of themes: a special relationship, motivation (an obligation of love), social isolation and connections, and the dog-walk recipe. From these themes, we developed a model of inter-linked and fluid “therapeutic spaces” through which dogwalking can enhance or diminish wellbeing in people with long-term health conditions. Humans with long-term health conditions develop close relationships with their dogs. This “obligation of love” takes humans in to the Dog-walk space where gentle encounters and pleasant sensations enhance human wellbeing. Further research will identify ways in which people with long-term health conditions might further access dog-walking therapeutic spaces, thereby enhancing therapeutic encounters with other humans, dogs, and the environment. [ABSTRACT FROM AUTHOR]

Background Exercise has been recognized as important in the management of rheumatoid arthritis (RA). Walking is a low-cost and low-impact activity, requiring little supervision. It requires no specialist training, is suited to a variety of environments and is inherently a clinically meaningful measure of independence. The aim of the present study was to determine whether a designed walking programme for people with RA successfully facilitated regular physical activity in participants, without detriment to pain levels. Methods Thirty-three people with RA were recruited from Dunedin Hospital rheumatology outpatient clinics and enrolled in a walking randomized controlled trial (RCT) feasibility study. Participants were randomly allocated to the walking intervention ( n = 11) or control ( n = 22) groups. Control participants received a nutrition education session, and the walking intervention group received instructions on a walking route with three loops, to be completed 3-4 times per week. The walking route shape was designed so that the length of the walk could be tailored by participants. Both groups were assessed at baseline and six weeks later. The primary outcome measures were feasibility, acceptability and safety. The principal secondary outcome was change in walking speed after the intervention. Additional outcome measures were a step-up test, activity limitations (on the Health Assessment Questionnaire), global well-being (on the European Quality of Life Questionnaire), self-efficacy for managing arthritis symptoms, self-efficacy for physical activity, daily pedometer readings and a daily visual analogue scale for pain. Results Participants successfully completed the walk for the suggested frequency, indicating feasibility and acceptability. There were no reported adverse effects of participation and the walking intervention group did not have higher daily pain levels than the control group, indicating safety. The walking intervention group showed a pattern of improvements in self-efficacy and global well-being; no changes in these outcomes were noted in the control group. No outcome measure showed statistically significant between-group differences. Conclusions Walking appears to be a feasible, acceptable and safe intervention for people with RA. These findings inform the design and power requirements of larger trials of structured walking interventions. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]