How Do Patients With Axial Spondyloarthritis Experience High‐Intensity Exercise?

Abstract

Objective. In a few studies, high-intensity exercise has displayed beneficial effects on cardiovascular health among patients with rheumatic diseases, yet the high-intensity exercise mode is still not fully accepted among health care professionals. The aim of this study was to investigate experiences of high-intensity exercise among patients with axial spondyloarthritis.Methods. Fourteen respondents who had participated in a high-intensity exercise program for 12 weeks were included in this qualitative study with individual semistructured, in-depth interviews. The respondents' median age was 53, ranging from 23 to 63 years old, and both men and women of different ethnicities were represented. Interviews were analyzed by qualitative content analysis, including both manifest content and interpretations of underlying latent meaning.Results. The analysis resulted in five categories describing the respondents' experiences with high-intensity exercise: 1) high-intensity exercise as a challenge for both body and mind, 2) increased faith in one's own body, 3) changed attitude toward exercise, 4) taking charge of one's own health by challenging the disease, and 5) exercise in a social context.Conclusion. Supervised high-intensity interval exercise was perceived as challenging for both body and mind but was also described as a positive experience, with rapid bodily effects that strengthened respondents' faith in their own bodies. The new experience seemed to have changed the respondents' attitude and motivation for exercise and made them start taking charge of their health by challenging the disease. Exercise in a social context, under professional leadership, enhanced exercise self-efficacy and helped the respondents to adhere to the exercise program.

Post-COVID-19 Syndrome and the Potential Benefits of Exercise

“…Thus, motivating patients to start with an exercise programme is a key challenge. However, whereas entering an exercise program is physically and mentally challenging in people with chronic pain, once the practice starts, making exercise a pleasant, fun and well-tolerated experience contributes in setting the routine and eventually achieving health improvements [98][99][100]. Accordingly, maintaining the motivation and monitoring intensity is of the utmost importance among people with post-COVID-19 syndrome to avoid overtraining by working out within individuals limits and allowing enough recovery time between efforts.…”

The Influence of Exercise Intensity on Psychosocial Outcomes in Musculoskeletal Disorders: A Systematic Review

“…The following data were extracted from the included studies according to a template that was agreed on in advance: (1) author names, (2) year of publication, (3) participant characteristics (pathology, n, mean age, sex); (4) exercise intensity (as a percentage of HR max , HRR, or 1RM), (5) intervention type (cardiorespiratory, resistance, or combined training), (6) intervention duration (in weeks), (7) exercise frequency (in days/week), (8) psychosocial outcome measures (categorized into affective factors, perceptual-cognitive factors, behavioral factors, or general mental health 80 ), and (9) withingroup baseline to postintervention therapy results on psychosocial outcome measures. Data extraction is summarized in Table 1.…”

“…The latter also changed the respondents’ attitude and motivation for exercise and made them start taking charge of their health by challenging the disease. 7 With regard to neurophysiological mechanisms, exercise intensity can influence the inflammatory response 19 and the response of stress-related biomarkers such as brain-derived neurotrophic factor, opioids, and cortisol, 65,66 which in turn affect pain experience and affective response. 55,66 Therefore, this systematic review investigated the effects of different modes of exercise intensity on psychosocial outcomes in adult persons with CMSDs.…”

“…6,44,62 For example, Jung et al 37 already showcased that in healthy persons high-intensity interval training increases self-efficacy beliefs as it breaks down exercise sessions into short, surmountable bursts, potentially allowing for multiple successful experiences. Likewise, Bilberg et al 7 found that in axial spondyloarthritis, a combined high-intensity cardiorespiratory and resistance training program was perceived as challenging for both body and mind and described as a positive experience, with rapid bodily effects that strengthened respondents' faith in their own bodies. The latter also changed the respondents' attitude and motivation for exercise and made them start taking charge of their health by challenging the disease.…”

Understanding beliefs related to physical activity in people living with axial Spondyloarthritis: a theory-informed qualitative study

“…Group supervisors need to be aware that a “one-size fits all” approach is not useful and that the dose of exercises needs to be tailored to the fitness state of the individual [ 9 ]. Independent of setting, patients report that continual guidance and acknowledgement, and receiving advice and feedback from a supervisor is important—especially during high-intensity exercising [ 55 ]. Further research should consider how the promising area of technology-based counselling [ 64 ] could be integrated into axSpA exercise groups to promote individually-tailored CRT.…”