Flipping the ICF: Exploring the Interplay of Theory and the Lived Experience to Reconsider Physical Activity in Community-Dwelling People With Multiple Sclerosis.
Andrea Marjorie Stennett, Lorraine H De Souza, Meriel Norris
PMID 36188838WHAT IT FOUND
People with MS prioritized daily routines like self-care and family roles to maintain identity and independence.
Physiotherapists focused on physical performance and overlooked these personal and contextual drivers. This mismatch explains why standard exercise advice often fails to sustain engagement.
Key findings
01People with MS prioritized unstructured activities focused on maintaining everyday function, such as self-care and family roles, over traditional exercise.
02Physiotherapists gave greater weighting to body structure and function domains, focusing on physical performance rather than the participation and personal factors valued by patients.
03Contextual factors like energy demands and personal choice dictated engagement in physical activity for people with MS, a perspective largely missed by professionals who viewed patients as inactive.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The paper synthesizes previous studies, so it relies on the rigor and generalizability of those original datasets. The findings are specific to community-dwelling people with MS in the UK and may not apply to other populations or healthcare systems. The sample sizes for the qualitative components (16 patients, 14 physiotherapists) are small, limiting the breadth of perspectives captured.
Declared interests
The authors declare no commercial or financial conflicts of interest.
The easy way to misread this
Do not interpret this as evidence that a specific intervention improves outcomes. This is a theoretical analysis of perspectives, not a trial of a treatment. The value lies in understanding why engagement fails, not in proving that a new method works.