EDITED BY
Jacqui H Morris,
University of Dundee, United Kingdom
REVIEWED BY
Nicola Saywell,
Auckland University of Technology,
New Zealand
Verna Stavric,
Auckland University of Technology,
New Zealand
*CORRESPONDENCE
Stine Susanne Haakonsen Dahl
stine.s.dahl@nord.no
RECEIVED 27 September 2023
ACCEPTED 06 March 2024
PUBLISHED 18 March 2024
CITATION
Dahl SSH, Arntzen EC and Normann B (2024)
The meaningfulness ofexploring one’s own
limits through interactions and enjoyment in
outdoor high-intensity physiotherapy for
people with multiple sclerosis: a qualitative
study.
Front. Rehabil. Sci. 5:1303094.
doi: 10.3389/fresc.2024.1303094
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© 2024 Dahl, Arntzen and Normann. This is an
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The meaningfulness ofexploring
one’s own limitsthrough
interactions and enjoyment
in outdoor high-intensity
physiotherapy for people
with multiple sclerosis: a
qualitative study
Stine Susanne Haakonsen Dahl
1*, Ellen Christin Arntzen
1
and
Britt Normann
1,2
1Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway,2Department of Physiotherapy,
Nordland Hospital Trust, Bodø, Norway
Background and purpose:Physical activity (PA) is often reduced in people with
MS (pwMS), even when disability is low. Understanding the perspectives of pwMS
on interventions aiming to improve PA is important to inform the development
of such services. The aim of this study was to explore the experiences
of pwMS participating in an outdoor, high-intensity and balance exercise
group intervention.
Methods: This qualitative study was nested within an RCT exploring a novel
intervention integrating sensorimotor exercises with high-intensity intervals of
running/walking. Individual, in-depth interviews with the intervention group
(n = 15; 12 women, 3 men; age 38– 66; EDSS score 0– 3.5) were conducted
postintervention (mean days = 14), analyzed using a phenomenological-
inspired approach with systematic text condensation, and interpreted based on
enactive theory.
Results:Four categories were generated: (1)Exploration of one’s own physical
abilities: Challenging one’s own limits was perceived by all participants to
improve movement performance and/or intensity level. Such bodily changes
engendered strong positive feelings. Some negative consequences of high-
intensity training were described, increasing a feeling of loss. (2)New insights
and beliefs: Participants experienced enhanced beliefs in their own
capabilities, which they integrated in activities outside the intervention. (3)An
engaging environment: The group setting was perceived as supportive, and
the outdoor environment was perceived as stimulating activity. (4)Professional
leadership, tailoring and co-creation of enjoyment: Physiotherapist-led,
individualized interactions were regarded as necessary to safely revisit prior
activities, such as running. Co-creating enjoyment facilitated high-intensity
training and intervention adherence.
TYPE Original Research
PUBLISHED 18 March 2024
| DOI 10.3389/fresc.2024.1303094
Frontiers in Rehabilitation Sciences 01 frontiersin.org