The priorities of neurologists for exercise promotion in comprehensive multiple sclerosis care

• Published in: Multiple sclerosis and related disorders 2020-02, Vol.38, p.101482-101482, Article 101482
• Main Authors: Richardson, Emma V., Fifolt, Matthew, Barstow, Elizabeth A., Silveira, Stephanie L., Sikes, E. Morghen, Motl, Robert W.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Attitude of Health Personnel; Comprehensive care; Cross-Sectional Studies; Exercise; Female; Health Promotion; Humans; Male; Middle Aged; Multiple Sclerosis - rehabilitation; Multiple Sclerosis - therapy; Neurologist; Neurologists; Physician-Patient Relations; Therapeutics
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2019.101482

•Exercise is an essential strategy for improving symptoms of MS.•Neurologists are under resourced to provide this information.•We addressed gaps in knowledge and practice in the paper.•Time, training and insurance constraints were barriers to exercise promotion.•Exercise guidelines, resources and a team approach facilitate exercise promotion. Fewer than 20% of persons with multiple sclerosis (MS) engage in sufficient amounts of exercise for experiencing health and wellness benefits. Neurologists have a powerful and influential relationship among patients, highlighting the potential for the patient-provider interaction to be a gateway for promoting exercise behavior. Neurologists, however, are under-supported and under-resourced for promoting exercise in comprehensive MS care. The purpose of this study was to determine the priorities of neurologists for exercise promotion among patients in comprehensive MS care and, where possible, provide suggestions for how each priority may be addressed in practice. Priority areas were identified through deductive content analysis of 20 semi-structured interviews with practicing neurologists. Seven priority areas were identified regarding promotion of exercise among patients in comprehensive MS care. These included 1). How do I fit exercise promotion into a patient's appointment? 2). What resources should I give my patients about exercise? 3). What are the benefits of exercise for people with MS? 4). What training can I do to be better informed about exercise? 5). What are the prescriptions/guidelines for exercise among persons with MS? 6). What kind of services can I rely on to support me in promoting and supporting exercise behavior? 7). How do I negotiate reimbursement and insurance restrictions when I promote exercise? This research sets an agenda regarding approaches for exercise promotion among patients with MS through interactions with neurologists in comprehensive care settings.