Centre for Trials Research, Cardiff University, Cardiff, UK
Centre for Trials Research, Cardiff University, Cardiff, UK.
BMJ Open. 2021 Mar 16;11(3):e045378. doi: 10.1136/bmjopen-2020-045378.
People with progressive multiple sclerosis (PwPMS) report that they recognise the benefits of activity on their physical and psychological health but need support to achieve their physical activity goals. We aimed to systematically develop a theoretically informed intervention that would enable PwPMS to more readily engage in regular physical activity.
We used an intervention mapping approach to inform intervention development.
We conducted semistructured interviews with PwPMS and their families/carers and physiotherapists recruited from secondary care settings.
Fourteen PwPMS with an Expanded Disability Status Scale score of between 6 and 8 and 7 of their families/carers and 13 physiotherapists and 1 physiotherapy technician participated.
Interview data suggested that the development of supportive coaching relationships with physiotherapists could promote the ability of PwPMS to achieve a desirable and achievable physical activity plan. These interview data informed the prototype 'Lifestyle Exercise and Activity Package for Multiple Sclerosis' (LEAP-MS) consisting of a secure multiuser web-based platform (with an education and activity suite, interactive components enabling selection of exercises, goal setting and activity logging), up to six flexible face-to-face or web-based physiotherapy coaching sessions and remote support via an embedded web-based messaging function that all together draw on specific theory-based methods to achieve physical activity behaviour change, namely active learning, reinforcement, modelling, feedback, facilitation, goal setting and guided practice. Implementation is within a multiuser platform accessible to participants, trained physiotherapists and researchers.
We have followed an inclusive, systematic and transparent process to develop the LEAP-MS intervention that enables detailed description of components, context and guiding principles to inform ongoing evaluation. Importantly, PwPMS expressed the need for autonomy in developing physical activity plans. This has been achieved through the embedding of self-management principles in the design and delivery of the LEAP-MS intervention.
进展性多发性硬化症（PwPMS）患者报告称，他们认识到活动对其身心健康的益处，但需要支持来实现其身体活动目标。我们旨在系统地开发一种基于理论的干预措施，使 PwPMS 更轻松地进行定期身体活动。
我们使用干预映射方法为干预措施的制定提供信息。
我们从二级保健机构招募了 PwPMS 及其家属/照顾者和物理治疗师，进行了半结构式访谈。
14 名 PwPMS 患者的扩展残疾状况量表评分在 6 到 8 之间，他们的 7 名家属/照顾者和 13 名物理治疗师和 1 名物理治疗技术人员参与了研究。
访谈数据表明，与物理治疗师建立支持性的辅导关系可以提高 PwPMS 实现理想和可行的身体活动计划的能力。这些访谈数据为原型“多发性硬化症生活方式运动和活动包（LEAP-MS）”提供了信息，该原型包括一个安全的多用户基于网络的平台（具有教育和活动套件、可互动的组件，可选择练习、设定目标和记录活动）、最多六次灵活的面对面或基于网络的物理治疗辅导课程以及通过嵌入式基于网络的消息传递功能提供远程支持，所有这些都借鉴了特定的基于理论的方法来实现身体活动行为的改变，即主动学习、强化、建模、反馈、促进、设定目标和指导实践。实施范围在参与者、经过培训的物理治疗师和研究人员都可使用的多用户平台内。
我们遵循了一个包容、系统和透明的过程来开发 LEAP-MS 干预措施，从而能够详细描述组件、背景和指导原则，为正在进行的评估提供信息。重要的是，PwPMS 表示在制定身体活动计划方面需要自主权。这通过将自我管理原则嵌入到 LEAP-MS 干预措施的设计和实施中得以实现。
