Experiences of integrating and sustaining physical activity in life with multiple sclerosis, Alzheimer’s disease, and ischaemic heart disease: a scoping review

The effects of physical activity on health are well-established for chronic diseases such as multiple sclerosis (MS), Alzheimer’s disease (AD), and ischaemic heart disease (IHD). However, sustaining physical activity in everyday life is difficult. Lifeworld knowledge can help qualify interventions aimed at resolving this public health issue, but there is a gap in regard to synthesized research on peoples’ experiences with integrating and sustaining physical activity. Hence, the purpose of this review is to explore and present the available evidence on experiences with integrating and sustaining physical activity in a lived life with MS, AD, and IHD. We conducted a scoping review with qualitative analysis and narrative syntheses in accordance with PRISMA-ScR. Based on SPIDER we ran a systematic search in Cinahl, Embase, Medline, and PsychInfo for primary qualitative research papers published until December 2022. 43 papers were included. A thematic content analysis found that individuals who have MS, AD or IHD find integrating and sustaining physical activity in everyday life meaningful on several levels: Physical activity can facilitate meaningful movement with outcomes of physical, psychosocial, and existential importance. The research literature presents a meaning to physical activity that extends the idea of physical fitness to one of existential movement and personal growth. In addition, our review finds that people are more likely to integrate and sustain physical activity if they feel acknowledged, supported and believe that physical activity has a meaningful purpose reflecting their sense of self. Taking a more person-centred approach in rehabilitative care might help qualify the content of physical activity in terms of integration into everyday life, but more research is needed on how to implement a person-centred approach in practice. The research literature presents an experiential meaning to physical activity that extends the idea of physical fitness to one of more existential movement and personal growth.To ensure the integration of physical activity in people’s everyday life, future rehabilitation interventions might benefit from adapting a more person-centred approach.People are more likely to sustain physical activity when they feel acknowledged, supported through social relationships, can access activities adapted to their specific needs and preferences, and believe that physical activity has a meaningful purpose reflecting their sense of self. The research literature presents an experiential meaning to physical activity that extends the idea of physical fitness to one of more existential movement and personal growth. To ensure the integration of physical activity in people’s everyday life, future rehabilitation interventions might benefit from adapting a more person-centred approach. People are more likely to sustain physical activity when they feel acknowledged, supported through social relationships, can access activities adapted to their specific needs and preferences, and believe that physical activity has a meaningful purpose reflecting their sense of self.

体力活动对健康的影响已在多发性硬化症（multiple sclerosis, MS）、阿尔茨海默病（Alzheimer’s disease, AD）及缺血性心脏病（ischaemic heart disease, IHD）等慢性病领域得到充分证实。然而，在日常生活中坚持体力活动并非易事。生活世界知识（lifeworld knowledge）有助于优化旨在解决这一公共卫生问题的干预方案，但目前针对人们整合并坚持体力活动的体验开展的综合研究仍存在缺口。因此，本综述旨在探索并呈现现有证据，以了解多发性硬化症、阿尔茨海默病及缺血性心脏病患者在真实生活中整合并坚持体力活动的体验。

本研究遵循PRISMA范围综述扩展声明（PRISMA-ScR），采用质性分析（qualitative analysis）与叙事综合（narrative syntheses）方法开展范围综述（scoping review）。基于SPIDER检索框架，我们在Cinahl、Embase、Medline及PsychInfo数据库中对截至2022年12月发表的原创质性研究论文进行了系统检索，最终纳入43篇文献。

主题内容分析结果显示，罹患MS、AD或IHD的个体认为，在日常生活中整合并坚持体力活动在多个层面具备意义：体力活动可促成富有意义的运动，其带来的收益兼具生理、社会心理与存在主义层面的重要性。现有研究文献将体力活动的意义拓展至超越身体健康的范畴，使其成为一种存在主义层面的运动与个人成长路径。此外，本综述发现，若患者能够感受到被认可、获得支持，且坚信体力活动具备契合自身自我认知的意义，则更有可能将体力活动融入日常并长期坚持。在康复护理中采用更以患者为中心的方法（person-centred approach），或许有助于优化体力活动内容，使其更好地融入日常生活，但目前仍需更多关于如何在实践中落实以患者为中心的方法的研究。

现有研究文献将体力活动的体验意义拓展至超越身体健康的范畴，使其成为一种更具存在主义色彩的运动与个人成长路径。为确保体力活动融入患者的日常生活，未来的康复干预或许可通过采用更以患者为中心的方法获益。当患者感受到被认可、通过社会关系获得支持、能够获取适配自身特定需求与偏好的活动，且坚信体力活动具备契合自身自我认知的意义时，他们更有可能长期坚持体力活动。

现有研究文献将体力活动的体验意义拓展至超越身体健康的范畴，使其成为一种更具存在主义色彩的运动与个人成长路径。为确保体力活动融入患者的日常生活，未来的康复干预或许可通过采用更以患者为中心的方法获益。当患者感受到被认可、通过社会关系获得支持、能够获取适配自身特定需求与偏好的活动，且坚信体力活动具备契合自身自我认知的意义时，他们更有可能长期坚持体力活动。