Virtual cycling as an exercise intervention in forensic psychiatry: A qualitative study

Area of Science:

• Forensic Psychiatry
• Exercise Science
• Health Psychology

Background:

• Forensic psychiatric patients (FSP) have reduced life expectancy due to comorbidities and lifestyle factors.
• Exercise is beneficial but challenging in forensic settings due to motivation and environmental constraints.
• Virtual cycling (VC) offers potential for motivating exercise in FSP but requires further study.

Purpose of the Study:

• To explore patient and staff experiences with a VC intervention in a forensic psychiatric setting.
• To understand how interactions during VC can inform the development of motivating exercise programs.
• To identify interaction types that foster motivation and support recovery in FSP.

Main Methods:

• Study conducted in a medium-secure forensic psychiatric ward gym.
• Included five male forensic inpatients and four physiotherapists.
• Data collected via participant observation, informal conversations, and staff focus groups.
• Analyzed using constructivist grounded theory.

Main Results:

• VC stimulated four staff-patient interaction types: outcome-focused, distributive, relationship-focused, and accommodating.
• Each interaction type involved distinct motivations, foci, goals, and communication styles.
• These interactions were conceptualized into an overarching theory of motivation in forensic exercise.

Conclusions:

• VC interactions can accommodate challenging conditions crucial for patient recovery.
• Virtual cycling interventions may enhance motivation by addressing FSP's unique needs.
• Staff training in interaction strategies for virtual exercise is recommended to maximize therapeutic potential.