# Scaling up an Evidence-Based Exercise Intervention for Wide-Scale Implementation: A Conceptual Roadmap Using the PRACTIS Framework

## TL;DR

This paper outlines a roadmap for scaling up an evidence-based home exercise program for people with multiple sclerosis using the PRACTIS framework to improve accessibility and real-world implementation.

## Contribution

The paper introduces a conceptual roadmap for scaling an evidence-based exercise intervention for MS using the PRACTIS framework and stakeholder collaboration.

## Key findings

- A conceptual roadmap is proposed for implementing the GEMS exercise program in community settings using the PRACTIS framework.
- Strategic adaptations and stakeholder input are emphasized to ensure long-term sustainability and reach.
- The model could serve as a scalable solution for promoting exercise in other neurological conditions.

## Abstract

Background: Exercise is safe and beneficial for managing symptoms, preventing progression, and enhancing the physical and mental well-being of people with multiple sclerosis (MS). Such evidence has supported prescriptive guidelines delivered alongside behavioral interventions to promote and sustain exercise behavior. Evidence-based exercise training interventions now exist for people with MS, such as Project GEMS, a home-based program grounded in MS-specific exercise training guidelines and supported by principles of behavior change based on social–cognitive theory. The field is now ready for the process of translating evidence-based programs from research settings into clinical or community contexts for greater reach and accessibility, but dissemination and implementation remain significant challenges. Objectives: The current paper presents a conceptual roadmap for implementing a validated home-based exercise training intervention for people with MS, originally tested in controlled research environments, within the broader community context. This is guided by the PRACTIS framework for scaling up physical activity/exercise interventions. Roadmap: Our paper presents a conceptual example along with details regarding strategic adaptations for tailoring the remote GEMS program for a diverse and wide MS population, integrating input from community stakeholders and ensuring long-term sustainability through collaborative researcher–stakeholder partnerships. Such an initiative may bridge the gap between research and practice in the domains of exercise training and behavioral interventions for people with MS and further serve as a scalable model for promoting exercise behavior in other neurological conditions by expanding accessibility for effective digital resources. Conclusion: The design of the exercise intervention discussed in this paper offers one example and conceptual pathway for expanding access for evidence-based exercise programs at the wider level.