Keeping physically active with rheumatoid arthritis: semi-structured interviews to explore patient perspectives, experiences and strategies (original) (raw)
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Sports Medicine, 2015
Rheumatoid arthritis (RA) is an autoimmune disease, which not only affects the joints but can also impact on general well-being and risk for cardiovascular disease. Regular physical activity and exercise in patients with RA have numerous health benefits. Nevertheless, the majority of patients with RA are physically inactive. This indicates that people with RA might experience additional or more severe barriers to physical activity or exercise than the general population. This narrative review provides an overview of perceived barriers, benefits and facilitators of physical activity and exercise in RA. Databases were searched for articles published until September 2014 using the terms 'rheumatoid arthritis', 'physical activity', 'exercise', 'barriers', 'facilitators', 'benefits', 'motivation', 'motivators' and 'enablers'. Similarities were found between disease-specific barriers and benefits of physical activity and exercise, e.g. pain and fatigue are frequently mentioned as barriers, but reductions in pain and fatigue are perceived benefits of physical activity and exercise. Even though exercise does not influence the existence of barriers, physically active patients appear to be more capable of overcoming them. Therefore, exercise programmes should enhance self-efficacy for exercise in order to achieve long-term physical activity and exercise behaviour. Encouragement from health professionals and friends/family are facilitators for physical activity and exercise. There is a need for interventions that support RA patients in overcoming barriers to physical activity and exercise and help sustain this important health behaviour. Key Points Patients with rheumatoid arthritis (RA) who exercise regularly and those who do not, report similar barriers to physical activity and exercise but different coping strategies. Support from healthcare providers and family/friends is an important facilitator for physical activity in RA. Knowledge about appropriate exercise programmes is lacking in RA patients and healthcare providers.
Clinical Rheumatology, 2019
Relatively little is known about what motivates or prevents patients with rheumatoid arthritis (RA) from adopting physically active lifestyles. This study aimed to evaluate the levels of physical activity and to identify the factors affecting a physically active lifestyle among Korean patients with RA. In this cross-sectional study, data were collected from a rheumatology outpatient clinic of a universityaffiliated hospital in South Korea. The levels of physical activity were self-reported using the International Physical Activity Questionnaire. Participants who engaged in more than 600 metabolic equivalent task-minutes/week of physical activity and moderate activity or walking at least three times per week were considered physically active in this study. Structured questionnaires were used to assess perceived barriers and self-efficacy for exercise. Of 345 patients with RA included in this study, about 22% of patients were classified as physically active. Factors associated with a physically active lifestyle were good physical function (odds ratio [OR] = 0.56; 95% confidence interval [CI]: 0.36-0.87) and high levels of exercise self-efficacy (OR = 1.36; 95% CI: 1.20-1.54). Common barriers identified were fatigue, interference with other responsibilities, and a lack of time. Participants showed the lowest self-efficacy for exercise when they had pain and were busy with other activities. The level of physical function and exercise self-efficacy were predictors of physical activity. Individualized physical activity programs tailored to personal abilities and barriers and increasing exercise self-efficacy are needed to facilitate engagement of physical activity in Korean patients with RA. Key Points • Factors associated with a physically active lifestyle were good physical function and high levels of exercise self-efficacy. • The levels of exercise self-efficacy in Korean patients with RA are low compared to those in other populations. • Frequently encountered barriers in the subjects were being too tired, interference with other responsibilities, and lack of time. • Individualized physical activity programs tailored to personal abilities and barriers and increasing exercise self-efficacy are needed to facilitate engagement of physical activity in Korean patients with RA.
Musculoskeletal Care, 2013
Objectives. This questionnaire study investigated the perceptions of rheumatoid arthritis (RA) patients across the UK in relation to exercise and joint health. The validity of the measure was also assessed. Methods. Members of the National Rheumatoid Arthritis Society (NRAS) with self-reported RA completed the questionnaire online. Items related to five factors that emerged from previous qualitative research. Participants responded using a five-point Likert-style scale (strongly disagree to strongly agree). The International Physical Activity Questionnaire (IPAQ) assessed physical activity. The model was tested using confirmatory factor analysis (LISREL 8.8); statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS). Results. A total of 247 responses were collected over 47 days (88% females; age: 18-77 years; disease duration: <1-51 years). Acceptable factorial validity was revealed (Satorra-Bentler w 2 = 774.47, df = 454, p < 0.001, root mean squared error of approximation (RMSEA) = 0.05, 90% confidence interval RMSEA = 0.05-0.06, comparative fit index = 0.94, standardized root mean square residual = 0.09), with the following factor endorsements: 'Health professionals show exercise knowledge ' (19%); 'Knowing what exercise should be done' (43%); 'Having to exercise because it is helpful' (72%); 'Worry about causing harm to joints' (44%); and 'Not wanting to exercise as joints hurt' (52%). Patient concerns about joint pain, joint harm and how to exercise were significantly associated with lower physical activity (p < 0.05). Conclusions. These results confirm that patients perceive exercise as beneficial. However, concerns about how to exercise, joint pain, causing harm to joints and a perceived lack of exercise knowledge among health professionals remain. Addressing these concerns may have implications for increasing physical activity within the RA population.
The Exercise Experience in Adults With Arthritis: A Qualitative Approach
American Journal of Health Behavior, 2006
To examine perceptions of exercise prior to arthritis, the ways in which arthritis affects exercise behavior, and current exercise behaviors in people with arthritis. Methods: Qualitative analyses were used to identify themes in 12 focus groups segmented by exercise status, education, and race. Results: Nonexercisers identified arthritis as a factor in exercise cessation. E2xercisers described making changes in type, duration, intensity, and approach to exercise after diagnosis. Ebeercisers also described participating in a wide range of activities, whereas nonexercisers primarily cited walking. Conclusions: Intervention and marketing strategies should focus on different capabilities of exercisers and nonexercisers to modify exercise routines to accommodate arthritis.
Motivation as a determinant of physical activity in patients with rheumatoid arthritis
Arthritis Care & Research, 2010
A sufficient level of physical activity is important in reducing the impact of disease in rheumatoid arthritis (RA) patients. According to self-determination theory, the achievement and maintenance of physical activity is related to goal setting and ownership, which can be supported by health professionals. Our objective was to examine the association between physical activity and the extent to which RA patients 1) believe that physical activity is a goal set by themselves (autonomous regulation) or by others (coerced regulation) and 2) feel supported by rheumatologists (autonomy supportiveness). Method. A random selection of 643 RA patients from the outpatient clinics of 3 hospitals were sent a postal survey to assess current physical activity level (Short Questionnaire to Assess Health-Enhancing Physical Activity), regulation style (Treatment Self-Regulation Questionnaire), and the autonomy supportiveness of their rheumatologists (modified Health Care Climate Questionnaire). Results. Of the 271 patients (42%) who returned the questionnaire, 178 (66%) were female, their mean ؎ SD age was 62 ؎ 14 years, and their mean ؎ SD disease duration was 10 ؎ 8 years. Younger age, female sex, higher education level, shorter disease duration, lower disease activity, and a more autonomous regulation were univariately associated with more physical activity. Hierarchical multiple regression analyses demonstrated that younger age and a more autonomous regulation were significantly associated with a higher physical activity level (P ؍ 0.000 and 0.050, respectively). Conclusion. Regulation style was a significant determinant of physical activity in RA patients. This finding may contribute to further development of interventions to enhance physical activity in RA patients.
Rheumatoid Arthritis: Changing Patients' Perception toward Exercise and Level of Physical Activity
2020
Back ground: Rheumatoid Arthritis (RA) is an autoimmune disease leading to progressivedestruction and deformity of joint causingdifferent degrees of daily activitieslimitations. Exercise is a key component of nonpharmacological management, helps patients to maintain mobility and function. The current studyaimed to evaluate the change of rheumatoid arthritis patients' perception toward exercise and physical activity level. A quasi-experimental research design was used. Subjects: the sample consists of 100 rheumatoid arthritis patientsalong 6 months.Tools:Two tools were used for data collection;patient health relevant information sheet,it includes two main parts (1) Patient s' demographic data, and medical history. (2) Interview based questionnaire (to assess patients' knowledge about RA) and the arthritis impact measurement scales (aims2-sf). Results:There were a statistically significant higher knowledge score in follow up test (after 2-months) (87%±9.1%) compared to pos...
Long-term health-enhancing physical activity in rheumatoid arthritis - the PARA 2010 study
BMC Public Health, 2012
Background: People with rheumatoid arthritis (RA) suffer increased risk of disability andpremature mortality. Healthenhancing physical activity (HEPA) could be one importantfactor to reduce this risk. Rising health care costs call for the development and evaluation ofnew modes of rehabilitation, including physical activity in settings outside the health caresystem.
Peer Reviewed: Factors That Influence Exercise Among Adults With Arthritis in Three Activity Levels
Preventing Chronic Disease, 2006
IntroductionRecent public health objectives emphasize the importance of exercise for reducing disability among people with arthritis. Despite the documented benefits of exercise, people with arthritis are less active than those without arthritis. The purpose of this study was to examine the factors that influence exercise participation among insufficiently active individuals with arthritis and to compare these factors with those identified by nonexercisers and regular exercisers with arthritis.MethodsForty-six individuals with arthritis were recruited from various community-based organizations to participate in seven focus groups segmented by exercise status and education. Trained moderators led each discussion using a standard guide. All focus group discussions were transcribed verbatim and coded.ResultsPain was the most commonly mentioned barrier to exercise and limited exercise participation for nonexercisers and insufficiently active individuals. Paradoxically, insufficiently active individuals also identified exercise-related reductions in pain as a potential motivation for increasing exercise. Likewise, exercise-related reductions in pain were a motivation to continue exercising for the exerciser groups. Nonexercisers expressed that a reduction in pain was a possible outcome of exercise but were skeptical of its occurrence. Receiving tailored advice from a health care provider was consistently identified as an exercise enabler across the groups.ConclusionFindings from this study indicate that potential strategies for increasing exercise participation include incorporating pain management strategies and coping skills into exercise interventions and ensuring that health care providers provide specific exercise advice to their patients with arthritis.