Supervised Intensive Exercise for Strengthening Exercise Health Beliefs in Patients With Axial Spondyloarthritis: A Multicenter Randomized Controlled Trial

Abstract

Objective. To evaluate the effect of a 3-month supervised high-intensity exercise program on exercise health beliefs in patients with axial spondyloarthritis.Methods. This was secondary analysis of a randomized controlled trial. Participants (ages 23-69 years) were randomized to an exercise group (n = 50) or a control group (n = 50). The intervention was an individually guided cardiorespiratory and strength exercise program performed 2 times per week, plus an additional individual exercise session of personal choice. The control group received standard care and instructions to maintain their physical activity level. Exercise health beliefs using the Exercise Health Beliefs questionnaire (range 20-100, 100 = best), i.e., barriers, benefits, self-efficacy and exercise impact on arthritis, and physical activity, were assessed with self-reported questionnaires at baseline, 3 months, and 12 months after inclusion.Results. The majority of the participants in the exercise group (76%) followed ≥80% of the prescribed exercise protocol. There was a significant effect of the intervention on exercise health beliefs at 3 months (estimated mean group differences 4.0 [95% confidence interval (95% CI) 1.4, 6.6]; P = 0.003) and the effect persisted at 12 months followup (estimated mean group differences 3.8 [95% CI 1.0, 6.6]; P = 0.008). Participants with higher exercise health beliefs had a higher odds ratio (1.1 [95% CI 1.0, 1.20]; P = 0.003) for being physically active at 12 months follow-up.Conclusion. A supervised high-intensity exercise program had beneficial short-and long-term effects on participants' exercise health beliefs. Stronger exercise health beliefs were positively associated with a higher chance to be physically active on a health-enhancing level at 12 months follow-up.ClinicalTrials.gov identifier: NCT02356874.

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

“…Prior to starting an exercise intervention, a PT should explore a patient’s beliefs regarding PA and exercise, detect individual barriers and define a goal, according to individual preferences and through shared decisions. Sufficient coaching, exercise guidance and correctly dosed exercise could enhance the adherence to long-term PA [ 51 ]. Our data show how diverse the understanding and personal approaches to PA and CRT can be, e.g.…”

Efficacy and safety of non-pharmacological and non-biological interventions: a systematic literature review informing the 2022 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis

“…Twenty publications focused on exercise, corresponding to 17 main studies (RCTs or CCTs), [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] and four post-hoc analysis (Table 1 and Supplementary Tables S6-8). [40][41][42][43] The type, intensity and duration of exercise were very heterogeneous, ranging from Tai-Chi to high intensity exercise. In addition, some of the programs were supervised by physiotherapist, while others were not.…”

Current aspects for the treatment of axial spondyloarthritis

“…However, the importance of physical therapy and education should also be highlighted. There are quite a few studies 1 about physical therapy, which provide evidence that this intervention is of great importance 2–6 . In addition, studies have pointed out that smoking has adverse influence on axSpA 7 .…”

“…There are quite a few studies 1 about physical therapy, which provide evidence that this intervention is of great importance. [2][3][4][5][6] In addition, studies have pointed out that smoking has adverse influence on axSpA. 7 Clinicians should take the initiative to Yung-Heng Lee 2,3,4,5…”

“…[2][3][4][5][6] In addition, studies have pointed out that smoking has adverse influence on axSpA. 7 Clinicians should take the initiative to Yung-Heng Lee 2,3,4,5…”