Abstract
BARRIERS AND FACILITATORS FOR PHYSICAL ACTIVITY ARE MAINLY RELATED TO PSYCHOLOGICAL ISSUES IN INFLAMMATORY ARTHRITIS – A MIXED-METHODS STUDY OF 66 PATIENTS IN FRANCE.
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Background: Patients with inflammatory arthritis (IA) like (ankylosing spondylitis (AS), rheumatoid arthritis (RA), and psoriatic arthritis (PsA) are more prone to physical inactivity but derive specific benefits from regular physical activity (PA) (1). Barriers and facilitators to PA are key elements that have not yet been well described.
Objectives: To assess if barriers and facilitators for PA in patients with IA are mostly related to disease, psychological, social or environmental factors.
Methods: A list of the most important barriers and facilitators was derived from a systematic review of barriers and facilitators to PA in rheumatoid arthritis (2). This list was assessed for face validity by 11 experts from Rheumatology or physiotherapy then tested by 10 patients through structured interview.
The list of barriers and facilitators was completed in a binary way: “barriers or facilitators are relevant to me” yes or no, for 66 patients in a monocentric, cross-sectional study. Then, patients assessed the level of each barrier or facilitator on a 0-10 scale. Statistics were descriptive. There was no imputation of missing data.
Results: The study included 66 patients (27 axial spondyloarthritis, 26 rheumatoid arthritis, 13 psoriatic arthritis), mean age 52.0 (standard deviation (SD) 16.6) years, mean disease duration 14.3 (SD 11.7) years, 53% women. Disease activity was moderate (mean DAS28 2.1 (SD 1.1), mean BASDAI 2.8 (SD 1.4)), and 75.4% received a biologic. The main factors described by patients were related to the knowledge of the benefits of PA and symptoms (
table 1
). Psychological factors were more reported and social factors less reported as influential for PA.
Table 1.
Barriers and facilitators for physical activity reported by patients with inflammatory arthritis.
Barriers or facilitators
Categories
Modifiable
N (%) reporting this barrier or facilitator
Level of patients reporting this item (0-10) (mean (SD))
Knowledge of benefits of physical activity for health
Psych
Yes
49 (78)
6.6
Knowledge of benefits of physical activity for mood
Psych
Yes
47 (75)
6.8 (3.4)
Level of symptoms (pain, fatigue, lack of mobility)
Phy
Yes
44 (69)
5.7 (2.8)
External reminders (eg: from health professionals, calendars…)
Soc
Yes
36 (57)
6.2 (3.1)
Presence or absence of activity facilities (ex: green area for walking, gym …)
Evmt
No
34 (56)
6.3 (3.7)
Lack of motivation
Psych
Yes
34 (55)
5.7 (3.2)
Weather conditions
Evmt
No
33 (52)
5.7 (3.2)
Confidence on how to exercise safely
Psych
Yes
31 (49)
6.0 (2.6)
Contact and proximity with others during physical activity
Soc
No
29 (47)
6.1 (3.7)
Presence or absence of support from others (friends, family)
Soc
No
26(42)
6.5 (3.9)
Lack of time
Evmt
No
35 (40)
5.4 (3.4)
Presence or absence of support and/or advice from healthcare professionals
Soc
Yes
25 (40)
6.0 (3.7)
A belief that physical activity will make symptoms worse
Psych
Yes
17 (27)
4.8 (3.3)
Lack of knowledge on which exercises to do and how much
Psych
Yes
17 (27)
4.7 (3.0)
Psych = psychological, Evmt = environmental, Phy = physical, Soc = social
Conclusion: The main factors that influence PA in patients with IA were mostly related to psychological aspects, and could be modifiable. The role of health professionals supporting patient PA is key. Interventions should be further explored to meet these important barriers and facilitators.
REFERENCES:
[1] O’Dwyer T, Physical activity guidelines: is the message getting through to adults with rheumatic conditions? Rheumatol U K. 2014
[2] Davergne T, Thu0716-Hpr Major Barriers and Facilitators to Physical Activity in Rheumatoid Arthritis Are Related to Physical and Psychological Health, Setting and Social Environmental Factors: A Systematic Literature Review. Ann Rheum Dis. 2019
Disclosure of Interests: Thomas Davergne: None declared, Rikke Helene Moe: None declared, Bruno Fautrel Grant/research support from: AbbVie, Lilly, MSD, Pfizer, Consultant of: AbbVie, Biogen, BMS, Boehringer Ingelheim, Celgene, Lilly, Janssen, Medac MSD France, Nordic Pharma, Novartis, Pfizer, Roche, Sanofi Aventis, SOBI and UCB, Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB
Citation: Ann Rheum Dis, volume 79, supplement 1, year 2020, page 921Session: HPR Interdisciplinary research
(Poster Presentations)
2 organizations