The implementability of healthcare professional-led physical activity promotion interventions for people living with multiple sclerosis: A scoping review

Abstract

Objective To identify healthcare professional-led physical activity promotion interventions for multiple sclerosis care and evaluate their implementability. Data Sources A systematic search was conducted across CINAHL, Scopus, MEDLINE, PEDro, SPORTDiscus, PsycINFO, CENTRAL, OpenGrey, Google Scholar. Methods Eligible studies included adults (≥18 years) with confirmed multiple sclerosis participating in healthcare professional-led physical activity promotion interventions measuring participation outcomes. Stage of intervention development was assessed using the National Institute of Health Stage Model, and implementability assessed using the Implementability Framework, evaluating acceptability, fidelity, and feasibility (recruitment, retention, adherence, compliance, and safety). Quantitative and qualitative data were synthesised using parallel-results convergent design. Results Twenty-eight interventions from ten countries were included. Across 11 randomised controlled trials, two pretest-posttest studies, and 12 mixed-methods studies, 1662 participants were enrolled. Participants were predominantly female, with relapsing-remitting multiple sclerosis, and mild impairment. Acceptability was favourable, with participants valuing professional expertise and support. Healthcare professionals recognised their role in promoting physical activity but identified implementation challenges at service levels. Recruitment (76%), retention (88%), and adherence (81%) were high, although reporting of fidelity ( n = 4 interventions), compliance ( n = 5), and safety ( n = 17) was inconsistent. No interventions met National Institute of Health Stage 4 or 5 criteria, indicating lack of real-world implementation and dissemination research. Conclusions Available data suggest favourable feasibility and acceptability of healthcare professional-led physical activity promotion interventions for people with multiple sclerosis at the efficacy evaluation stage. However, absence of later-stage translational research means it remains unclear whether these interventions can be effectively implemented, sustained, and disseminated within routine clinical services.