{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T17:56:54Z","timestamp":1781459814079,"version":"3.54.1"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"German Federal Joint Committee\u2019s Innovation Fund","award":["01VSF19046"],"award-info":[{"award-number":["01VSF19046"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Participation plays a pivotal role in rehabilitation for people with multiple sclerosis. In clinical practice, the International Classification of Functioning, Disability and Health serves as a basis for characterizing participation. However, this framework lacks the subjective perception of participation. This study examines the perceived participation of people with multiple sclerosis and gait impairment through a sense of connection, efficacy, and meaning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative research design with focus group and individual interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants were interviewed using an online conference tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Transcripts from four online focus group interviews with people with multiple sclerosis and gait impairment (4\u20136 participants each, totaling N\u2009=\u200919, aged 33 to 76, with 12 females) and from 12 individual interviews with participants from these focus groups were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main measures<\/jats:title>\n                    <jats:p>Two researchers coded transcripts using qualitative content analysis by Kuckartz.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A sense of connection was about common activities, a sense of inclusion, sameness, familiarity, and contributing to a social system. Experiences of exclusion, otherness, and foreignness were reported. A sense of efficacy ranged from a sense of competence, influence, and independence to a sense of dependence, a lack of spontaneity, and helplessness, leading to refraining from activities. Meaningful activities, sensual experience, a sense of purpose, identity, and equality were related to a sense of meaning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perceived participation goes beyond the ability of being involved in life situations. Clinicians following a patient-centered approach can incorporate the presented perspective of people with multiple sclerosis and gait impairment on participation into their clinical action.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155261458318","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:54:16Z","timestamp":1781258056000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["How do people with multiple sclerosis who have walking difficulties perceive participation? A qualitative analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4197-6048","authenticated-orcid":false,"given":"Anna Levke","family":"Br\u00fctt","sequence":"first","affiliation":[{"name":"Carl von Ossietzky Universit\u00e4t Oldenburg"},{"name":"University Medical Center Hamburg-Eppendorf"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2740-1157","authenticated-orcid":false,"given":"Elise-Marie","family":"Dilger","sequence":"additional","affiliation":[{"name":"Carl von Ossietzky Universit\u00e4t Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1856-7801","authenticated-orcid":false,"given":"Nadja","family":"Reeck","sequence":"additional","affiliation":[{"name":"Carl von Ossietzky Universit\u00e4t Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dyon","family":"Hoekstra","sequence":"additional","affiliation":[{"name":"Carl von Ossietzky Universit\u00e4t Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annett","family":"Thiele","sequence":"additional","affiliation":[{"name":"Carl von Ossietzky Universit\u00e4t Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-662-49204-8","volume-title":"Wei\u00dfbuch multiple sklerose: versorgungssituation in deutschland [white paper multiple sclerosis: care situation in Germany]","author":"Kip M","year":"2016","unstructured":"Kip M, Zimmermann A. Krankheitsbild multiple sklerose [disease pattern of multiple sclerosis]. In: Kip M, Sch\u00f6nfelder T, Ble\u00df HH (eds) Wei\u00dfbuch multiple sklerose: versorgungssituation in deutschland [white paper multiple sclerosis: care situation in Germany]. Berlin, Heidelberg: Springer Berlin Heidelberg, 2016, pp.1\u201312."},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/978-3-662-49204-8_2","volume-title":"Wei\u00dfbuch multiple sklerose: versorgungssituation in deutschland [white paper multiple sclerosis: care situation in Germany]","author":"Kip M","year":"2016","unstructured":"Kip M, Zimmermann A, Ble\u00df H-H. Epidemiologie der multiplen sklerose [epidemiology of multiple sclerosis]. In: Kip M, Sch\u00f6nfelder T, Ble\u00df HH (eds) Wei\u00dfbuch multiple sklerose: versorgungssituation in deutschland [white paper multiple sclerosis: care situation in Germany]. Berlin, Heidelberg: Springer Berlin Heidelberg, 2016, pp.13\u201321."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-3-437-22084-5.00007-X"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.08.031"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903433528"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-94"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/15459683221093587"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2014.008672"},{"key":"e_1_3_3_10_2","article-title":"Effective rehabilitation interventions and participation among people with multiple sclerosis: an overview of reviews","author":"Momsen AMH","unstructured":"Momsen AMH, \u00d8rtenblad L, Maribo T. Effective rehabilitation interventions and participation among people with multiple sclerosis: an overview of reviews. 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