Assessment prior to both individual and group interventions is fundamental to neurological physiotherapy practice. However, knowledge is limited regarding how assessments are carried out, particularly assessments conducted prior to group interventions, which have recently gained increasing attention in clinical research. In this qualitative study, we investigated how physiotherapy assessments of patients with multiple sclerosis prior to a group exercise intervention were carried out and what physiotherapists considered vital elements in the assessment process. Data were gathered through 12 qualitative non-participatory video observations followed by in-depth interviews of physiotherapists. Systematic text condensation analysis was conducted within an enactive theoretical framework of participatory sense making. In the assessments, patients' bodily perceptions of movement changes appeared to be vital in establishing patient expectations for the forthcoming intervention. The extent of patient participation and an embodied approach to communication influenced both the physiotherapists' and patients' insights into the patients' movement problems, which were further utilized in the initial intervention planning. Significant differences in context from the assessment to the intervention require a systematic completion of the assessments in the course of the first clinical meeting, which should be considered in the further development of research and clinical practices.

Background and purpose: Reablement is aimed to enable people to remain independent in their lives and is based on users' own goals. Interventions are described to involve both physical exercises and guidance in everyday activities. However, descriptions of the content of reablement practices are sparse. This study aims to investigate and discuss how physiotherapists (PTs) on reablement teams plan and adapt training interventions to enhance users' functional abilities. Methods: We conducted fieldwork with seven Norwegian reablement teams, including video observations of interventions and interviews with PTs and home trainers. The results were analysed through thematic content analyses in which we used motor learning theory to interpret the results. Results: The analyses revealed that reablement practices typically involved either (i) exercise-based training, (ii) activity-based training, or (iii) a combination of both exercise-and activity-based training. Discussion: Reablement interventions are described as individually tailored and goal oriented. However, in practice, it is challenging to implement training that emphasises both physical functionand goal-oriented activities. Motor learning and relearning depend on several principles and require both exercise-based and activity-based training. Standardised approaches emphasising physical exercises may neglect a particular activity that is important to the user. On the other hand, exclusively activity-based approaches may omit individual, specific aspects of bodily movement and physical constraints. The use of only one aspect of training may limit the potential for functional improvement, while a combination of the two is more likely to meet the principles of motor learning theories.

Our study indicates that despite challenges, the PTs' integration of embodied interaction and mutual participation enables the patients to concurrently benefit from individualization and being in a group. These findings contribute to the question regarding the significance of individual adaptations in group interventions and point toward a need for future effect studies that compare standardized and individualized exercise protocols.

ObjectiveGroup‐based physiotherapy is a common and beneficial intervention for people with multiple sclerosis (MS). Most group interventions are not individually adapted to each participant's needs. Evidence on how individualization and group elements can be combined in a clinical setting is lacking. The objective of this study is to expand the knowledge base in neurological physiotherapy by investigating the nature of group dynamics in a group‐based, individualized intervention for people with MS.MethodsThis qualitative study included 13 nonparticipatory video observations (14 hr 38 min) of GroupCoreDIST exercise sessions complemented by 13 interviews (12 hr 37 min) with physiotherapists (PTs). The purposively sampled participants included 40 patients with MS (expanded disability scale of 1.0–6.5) and six PTs with expertise in neurological physiotherapy. Data were analysed using systematic text condensation in an enactive theoretical framework.ResultsTwo main categories emerged from the material. (a) Individual systems affect group dynamics: Individual perceptions of success through adapted and embodied approaches positively affected the dynamics of the group. (b) Disease and exercise peer support: Social support was a substantial product of dynamic group processes and was enhanced through the PTs' strategic focus on experience sharing.ConclusionThe results revealed that group dynamics benefit from individualization and the PTs' focus on experience sharing. These findings are contrary to the prevailing view that individualization and group‐based interventions are mutually exclusive and thus should be considered in group‐based interventions for people with MS.