What factors influence physical activity participation in people with rheumatoid arthritis?

Abstract

Text 3027What factors influence physical activity participation in people with rheumatoid arthritis? Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by periods of inflammation and remission. Physical activity can reduce disease activity and lower the risks of associated co-morbidities such as cardiovascular disease. Despite the benefits, a high percentage of people with RA do not participate in regular physical activity.Objective: The purpose of this qualitative literature review was to explore and synthesize the experiences of people with RA to develop better insight of the factors that influence physical activity participation.Method: A systematic search was conducted across five online databases; MEDLINE, CINAHL, ScienceDirect, PsycINFO, Web of Science. Studies were assessed for quality, data were extracted and analyzed using thematic synthesis.Results: A total of 186 articles were identified and screened against inclusion/exclusion criteria. Seven studies met the criteria and were included in this review. Five key themes were identified as the most significant factors to physical activity participation: professional knowledge and guidance; part of a community; knowing me, knowing RA; what's in it for me; and where, when, how much? Professional knowledge and guidance was the underpinning factor influencing physical activity participation. Conclusion:The results identify several internal and external factors that affect physical activity participation. To engage, facilitate and motivate patients to participate in physical activity, ongoing education and support from health care professionals is required. This will promote better symptom management and maintain functional independence. Additionally, health care professionals need to consider individual preferences and abilities when recommending physical activity.

“A Necessary Investment in Future Health”: Perceptions of Physical Activity Maintenance Among People With Rheumatoid Arthritis

“… 32 Previous findings suggest that intimidations by others may occur when engaging in public gyms 32 and that access to suitable facilities within health care are important for PA adherence, 31 but also that a community or public gym setting can be more practical and accessible than a health care facility. 13 , 33 The benefits of public gym settings for long-term PA maintenance, as described by our participants, are probably larger than for occasional PA during a couple of weeks or months. Thus, hearing about other’s experiences and feeling connected to others, as well as observing and replicating skills by trusted other people with similar conditions, may encourage affinity and support for PA maintenance, as may a suitable PA facility.…”

“…Similar aspects have been described previously, such as better ability to modify exercise, 15 to differentiate between reactions of the body through PA, 14 and reduction of symptoms, better mental health, and/or increased strength and mobility. 12 , 13 , 15 , 30–31 However, perceived benefits of feedback, that is, positive peer pressure, self-registration, text messages, and assessments of physical capacity, for maintenance of PA have not previously been much described in similar populations. Most importantly, perceptions of the importance of PA of high enough intensity as essential for long-term health benefits has not been described previously.…”

“…Our participants described how affinity was fostered through social support and the PA context. It is well known that social aspects positively influence PA behavior in people with RA , 13–14 , 31–35 but although group activities can be enjoyed, social support is not always necessary for maintenance. 32 Previous findings suggest that intimidations by others may occur when engaging in public gyms 32 and that access to suitable facilities within health care are important for PA adherence, 31 but also that a community or public gym setting can be more practical and accessible than a health care facility.…”

“…Perceived facilitators, barriers, and benefits to PA and exercise in people with RA have been described in studies with qualitative and quantitative designs. 12 , 13 Findings across studies indicate that pain and fatigue often represent barriers, while reductions in pain and fatigue are perceived benefits of PA and exercise. It is suggested that self-efficacy support and social support from health professionals, family, and friends may encourage people with RA to overcome barriers to PA and exercise and help maintain this important health behavior.…”

“… 12 A synthesis of studies with qualitative designs identified 5 themes—professional knowledge and guidance, part of a community, knowing me, knowing RA, what’s in it for me, and where, when, how much—that are important for PA participation with professional knowledge and guidance as its underpinning factor. 13 To our knowledge, only 3 previous studies with a qualitative design have focused specifically on the maintenance of PA behavior in people with RA. 14–16 However, none of them focused on PA according to public health recommendations but rather on maintenance of planned and structured exercise 15–16 or more general PA, including a variety of aspects from housework and walking to running, cycling, and resistance training.…”