Reframing physical activity barriers in individuals with multiple sclerosis: a proof-of-concept study

PURPOSE: To explore how a brief reframing intervention influences physical activity (PA) behaviors and cognitive biases in individuals with Multiple Sclerosis (MS). MATERIALS AND METHODS: In this mixed-method, single-arm study, 22 individuals with MS received a one-on-one, ∼15-min reframing session targeting negative exercise-related thinking patterns. Participants completed surveys at four time points (pre-, post-, 1-week, and 4-weeks post-intervention) assessing cognitive errors and PA. A follow-up interview at 1 week explored individual experiences and perceived changes. Interview data were analyzed using inductive content analysis; Repeated Measures ANOVA assessed changes in outcomes. FINDINGS: Cognitive errors decreased from pre-reframing (M = 5.32) to 1-week post reframing (M = 4.52, p = 0.013, partial eta = 0.258). Light PA significantly increased from pre-reframing (M = 2.26) to 1-week post reframing (M = 3.14, p = 0.029, partial eta = 0.218). While moderate-vigorous PA significantly increased from pre reframing (M = 2.76) to 4-weeks post reframing (M = 5.76, p = < 0.01, partial eta = 0.460). Changes to PA at all levels were sustained at the 4-week follow-up. Interviews contextualized these changes, revealing shifts in motivation and self-talk. CONCLUSION: Reframing may be an effective strategy to increase physical activity and decrease cognitive biases for individuals with MS. Findings provide preliminary support for a future randomized pilot trial to evaluate efficacy.