gave them advice for follow-up. Some participants said that when the
physiotherapist conducted the exercises or ran/walked together with
them, it made them increase their exercise intensity. One participant
described this as follows:
The physiotherapists pushed me to perform beyond what I
thought I was able to— and that was great! There is no doubt
that if someone is running beside you and shouting“come on-
well done”, you manage to push yourself further.(ID8, EDSS: 2)
However, one participant described an incident where the
interaction with the physiotherapists was not perceived as helpful:
When I get tired, it gets difﬁcult. I can only do one thing at a
time, and then these physiotherapists came running, talking
and trying to motivate at the same time. I got very tired, and
my leg would not follow my commands to run.(ID7, EDSS: 3.5)
Participants reported that they appreciated that the
physiotherapists made them engage in playful activities with a
ball, run for beanbags, and sing and in general created an
informal and nice atmosphere. The enjoyment created was
described as important for adherence to the intervention and as
encouraging participants’ physical effort during the session, as
exercise felt easier when it was enjoyable. It was appreciated that
the physiotherapists were perceived as both cheerful and serious
about the intervention.
4 Discussion
The main ﬁndings of this study are that (1) being supported
to explore and push one ’s own physical capabilities by
combining high-intensity running/walking with detailed
exercises was meaningful and evoked strong emotions.
Improving one ’s balance, walking, and running lead to
increased beliefs in one ’s own possibilities. Some negative
experiences were also described, particularly from the high-
intensity training. (2) An engaging outdoor group with tailored
physiotherapist-participant interactions and the co-creation of
enjoyment was perceived to be important for the success of the
individual. These ﬁndings illustrate how the dynamic
intertwining of the body and movement, context and
intersubjective interactions create meaning and beliefs in one’s
own physical capabilities (19).
4.1 Bodily experiences are inherent to
beliefs in the mastery of physical activity
The meaningfulness of exploring the limits of training
intensity that we identi ﬁed in our study corresponds with
other studies of pwMS ’s experiences of interventions
addressing intensity of activity ( 31, 32). The exercises
emphasizing trunk control were reported to reduce movement
impairments and are in line with a study of pwMS with higher
disabilities participating in an indoor group intervention ( 16).
However, the perceived interlinking of improved sensorimotor
functions and the ease of and ef ﬁciency in high-intensity
walking/running have not been reported previously. It is likely
that the detailed exercises prompted activations of the CNS
and musculoskeletal systems, which are prerequisites for high-
intensity walking and running ( 33). Impairments in such
systems commonly occur due to CNS lesions or secondary
inactivity, and function can improve with increased use ( 18).
Our results support the value of integrating such speciﬁcity to
optimize the capability to train at high intensity, even in
individuals with low EDSS scores.
The described emotional associations of these bodily changes
are interesting. Achieving higher exercise intensities, easier
movements, reduced pain and improved sensation lead to
positive feelings and enhanced prospects for both PA and life,
while for some individuals, a failure to achieve high-intensity or
no immediate changes in impairments are associated with
feelings of loss and negative prospects. This calls attention to
acknowledging that sensorimotor capacities facilitate or constrain
how an individual perceives the world, which is closely
interlinked with feelings, and that in ﬂuence why participants
perceive what they do (34). These experiences necessitate that