Perceptions of physical activity engagement among adults with rheumatoid arthritis and rheumatologists

Abstract

Aim Physical activity (PA) among adults with rheumatoid arthritis (RA) is suboptimal. This study assessed PA motivations and perceptions in adults with RA and rheumatologists. Methods Patients and rheumatologists participated in structured interviews led by a behavioral scientist. Sessions were audiotaped, transcribed and coded. Results Twenty-three patients (mean age = 63 [standard deviation = 10], 96% female) and seven rheumatologists (57% male, 29% fellows) participated. Nine themes emerged: communication with the rheumatologist, environment/access, symptom management, social support, mental health, breaking inactivity cycles, integrating PA into routines, staying in control and challenge/intimidation. Highly active patients viewed PA differently than low active patients. The need to compete with RA-free individuals may impede PA. Conclusion Understanding how patients conceptualize PA will enable clinicians to formulate PA strategies to motivate patients.

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

“…However, significantly more inactive patients than active patients chose the category "low motivation" as a barrier, while significantly more active patients chose the category "facilitating disease symptoms" as a facilitator. In fact, it was a general pattern that barrier items were chosen as barriers by significantly more inac- (18), a review based on 26 articles concluded that the main barriers were not different between those who exercised regularly and those who did not (19). The barrier categories on the individual patient level (i.e., no motivation and difficult organization in daily routine) are barriers that patients share with healthy individuals (19).…”

“…Many categories identified in the focus group with patients with axial SpA related to vigorous CRT were similar to the themes identified by interviews with rheumatoid arthritis patients and rheu- matologists with regard to physical activity. Mutually identical barriers were vigorous CRT/physical activity as daily routine, disease symptoms, social support, and organizational condition/intimidation (18). Thus, for implementing vigorous CRT and physical activity promotion in general, it is important to understand a patient's perceptions and conceptualization of vigorous CRT/physical activity, i.e., to identify the motivational and organizational barriers and facilitators on the individual patient level.…”

“…Mutually identical barriers were vigorous CRT/physical activity as daily routine, disease symptoms, social support, and organizational condition/intimidation (18). Mutually identical barriers were vigorous CRT/physical activity as daily routine, disease symptoms, social support, and organizational condition/intimidation (18).…”

2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis

“…There is strong evidence for the benefits of PA on improvements on disease activity,7 activities and participation; however, people with rheumatic and musculoskeletal diseases (RMDs) are in general less active compared with healthy controls 8–10. Possible underlying reasons could be that healthcare providers (HCP, including rheumatology health professionals (eg, physiotherapist (PT), occupational therapist (OT), nurse, podiatrist, psychologist), physical education professions and medical doctors (rheumatologists and other specialists)) and people with iA and OA may be reluctant towards engaging in PA, fearing flare-up or joint damage by exercising 11. Furthermore, current clinical management recommendations such as the European League Against Rheumatism (EULAR) recommendations on the management of RA,12 SpA13 or HOA/KOA14 and the ACSM guidelines for exercise testing and prescription15 recommend exercise and/or PA, but none of these is specific regarding the required type and dosage.…”

Patients’ conceptions of their own influence on good treatment response to biological therapy in chronic inflammatory arthritis

“…Research shows that there is a relationship between physical activity and disease activity, and patients with a low level of disease activity tend to be more physically active 38–40. Furthermore, it is also important to be aware of patients’ beliefs about the positive effect of physical activity in reducing their symptoms,41 and it has been found in several qualitative studies that patients emphasize the importance of physical activity in the management of their CIA and as a way of maintaining control over their symptoms and their lives and of being independent 42,43. Feelings of pain relief, improvements in joint function, and increased energy from physical activities are reported to have a positive impact on patients’ daily lives43 and to lead to feelings of greater freedom and strength in the body 44…”