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Research profile

Regular participation in physical activity (PA) is particularly important for health, well-being and longevity of people living with chronic disability.

Encouragement to participate in PA in New Zealand is delivered via public health media. People living with disability find it difficult to regularly participate and maintain long-term participation in PA. Our previous qualitative research identified that disabled people's long-term engagement in PA is enabled by having: (1) choice of activity, (2) control over level of engagement, and (3) support, expert advice and encouragement from a physiotherapist. These components build intrinsic motivation. From these findings, we developed a new approach to help disabled people to engage in regular PA called “Blue Prescription”. Our exploratory phase II study found Blue Prescription is feasible to deliver and the programme is acceptable to people with multiple sclerosis.

Research in a more diverse population of adults living with disability, with longer follow-up, will show if this approach is generalisable to this wider population.


Hale, L. A., Smith, C. M., Mulligan, H. F., Adhia, D., Siew, B., & Treharne, G. J. (2018). Exploring the Blue Prescription intervention to promote physical activity in people with long-term conditions. International Journal of Therapy & Rehabilitation, 25(7), 365-376. doi: 10.12968/ijtr.2018.25.7.365

Sangelaji, B., Smith, C.S, Paul, L., Sampath, K., Treharne, G.J., and Hale, L.A (2015) The effectivenss of behaviour change interventions to increase physical activity participation in people with multiple sclerosis: A systematic review and meta-analaysi. Clinical Rehabiliation

Walter, T., Hale, L., and Smith, C. (2015) Blue Prescription: a single-subject design intervention to enable physical activity for people with stroke. International Journal of Therapy and Rehabilitation, 22 (2)

Hale LA, Smith C, Mulligan M, Treharne GJ. (2012) Tell me what you want, what you really really want: asking people with multiple sclerosis about enhancing their participation in physical activity. Disabil Rehabil. doi:10.3109/09638288.2012.670037.

Hale LA, Mulligan HF, Treharne GJ, Smith CM. (2012) The feasibility and short-term benefits of Blue Prescription: a novel intervention to enable physical activity for people with multiple sclerosis. Disabil Rehabil

Mulligan HF, Treharne GJ, Hale LA, Smith CM. (2013) Combining Self-help and Professional Help to Minimize Barriers to Physical Activity in Persons With Multiple Sclerosis: A Trial of the "Blue Prescription" Journal of Neurologic Physical Therapy, 37(2):51-57. doi: 10.1097/NPT.0b013e318292799e.

Mulligan HF, Hale LA, Whitehead L and Baxter GD. (2012). Barriers to physical activity participation for individuals with long-term neurological conditions: A review study. Adapted Physical Activity Quarterly, 29, 243-265.

Mulligan H. (2010) Promotion of physical activity for individuals with neurological disability. Doctoral thesis, University of Otago

Mulligan H, Hale L, Whitehead L, Thomas D, Baxter GD. (2011) Promoting physical activity for individuals with neurological disability: Indications for practice. Disability and Rehabilitation DOI:10.3109/09638288.2011.631683

Mulligan H, Hale L, Fjellman-Wiklund C, Thomas D, Häger-Ross C. (2011) Promoting physical activity for people with neurological disability: Perspectives and experiences of physiotherapists. Physiotherapy Theory and Practice , 27 (6): 399-410.

Mulligan H, Hale L, Fitzgerald L and Baxter GD (2008): Influences on participation in active recreation for people with disability. New Zealand Journal of Physiotherapy 36: 89.

Smith C, Hale L. (2007) The unique nature of fatigue in multiple sclerosis: prevalence, pathophysiology, contributing factors and subjective experience. Phys Ther Reviews; 12: 43-51.

Smith C, Hale L, Schneiders A, Olson K. (2009) How does exercise influence fatigue in people with multiple sclerosis? Disabil Rehabil; 31(9):685-692.

Smith C, Hale L, Olson K, Schneiders AG, Baxter GD.(2011) How does fatigue influence community-based exercise participation in people with multiple sclerosis? Disabil Rehabil; Early online, 1-10. DOI: 10.3109/09638288.2011.573054

Smith C, Hale LA, Mulligan H, Treharne GJ.(2012) Participant perceptions of a novel physiotherapy approach ('Blue Prescription') for increasing levels of physical activity in people with multiple sclerosis: A qualitative study following intervention. Disabil Rehabil; Early Online: 1–8. DOI: 10.3109/09638288.2012.723792

Research funding

C. Smith, L. Hale, B. Sangelaji (2016) Developing an intervention to promote physical activity engagement for people with multiple sclerosis living in rural settings: a feasibility study, MPPT

L Hale, C Smith, H Mulligan, G Treharne (2013) Blue Prescription: Enhancing physical activity for people living with disability. PNZ Scholarship Trust Fund $11,438

L Hale, G Treharne, H Mulligan, C Smith (2010) Blue Prescription: physiotherapy activity support package for chronic disability $ 45,000 University of Otago Research Grant

L Hale, S Dean (2007) Can exercise reduce the impact multiple sclerosis has on daily life? $2,000. Rehabilitation and Disability Research Theme seed funding.

Community engagement

MS Society Otago
MS Society Southland
Canterbury MS and Parkinson's Disease Society

Research collaborators

International collaborators

Stefan Peters

Institute of Sport Science and Sport, Erlangen

Prof Lorna Paul

University of Glasgow

Research students

Bahram Sangelaji (PhD candidate)

Developing and testing an intervention to promote life-long exercise in people with MS

Tayler Walter

Blue Prescription: Enabling Physical Activity for People with Stroke, a Case Series
Honours project

Further information

Please email the Project leader, Professor Leigh Hale at

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