Barriers and Facilitators of Vigorous Cardiorespiratory Training in Axial Spondyloarthritis: Surveys Among Patients, Physiotherapists, and Rheumatologists

Abstract

The identified facilitators and barriers will guide the development of stakeholder-specific implementation strategies. This article is protected by copyright. All rights reserved.

Supervised Group Exercise in Axial Spondyloarthritis: Patients' Satisfaction and Perspective on Evidence‐Based Enhancements

“…A larger proportion of participants from SGE classes with a shorter duration were willing to exercise more frequently than participants from classes with a longer duration. This is in line with other studies that have shown that time is an important factor for exercise behavior. Since the present study and a previous study have shown that most patients preferred a personally tailored exercise program in addition to SGE, it might be desirable (from a patient's perspective) to combine relatively shorter SGE with a personal (home) exercise program.…”

“…The findings of the present study are highly important for a successful implementation of proposed SGE enhancements and are in line with the findings of studies by Niedermann et al , Curbelo Rodríguez et al , and O'Dwyer et al , which endorse the importance of education, periodic reassessments, and monitoring of exercise, as these components are needed to personalize exercise. Including such components in an SGE would require the guiding therapists to specialize in exercise for patients with axial SpA, and patients in the present study viewed this expertise by the SGE guidance as very important.…”

“…This view suggests a knowledge gap regarding the health benefits of these exercise types. Therefore, a planned implementation strategy, which includes education on the importance of adequate and frequent exercise and addresses potential barriers to and facilitators for the uptake of certain SGE enhancements, is warranted . Such a strategy is especially important because appropriately dosed cardiorespiratory and strengthening exercises are rarely included in SGE for patients with axial SpA even though these exercises have been recommended by current scientific insights .…”

“…All of the aforementioned insights would imply that several enhancements in current practice might be needed in order to improve the contents and quality of SGE for patients with axial SpA. As a prerequisite for successful implementation, it is important to explore the current perspective of various stakeholders on this matter, including patients' perspectives . The literature on patient perspective, specifically regarding SGE for patients with axial SpA, is scarce.…”

“…The literature on patient perspective, specifically regarding SGE for patients with axial SpA, is scarce. A cross‐sectional study by Niedermann et al , which used a survey of 575 patients with axial SpA, explored barriers to and facilitators for vigorous cardiorespiratory exercise and identified motivation and disease symptoms as the most important factors for implementing vigorous cardiorespiratory training in exercise programs; these results underpinned the need to address motivation and tailor exercise programs to a patient's individual level. Such needs were also demonstrated in a qualitative study by O'Dwyer et al , in which the attitudes of 17 patients with axial SpA toward their current exercise program were explored using individual, semistructured interviews and thematic analysis.…”