Barriers and facilitators for physical activity in rheumatic and musculoskeletal disease: a European-based survey

George S Metsios^{1

2}, S A M Fenton³, K Tzika⁴, R H Moe⁵, G E Fragoulis⁶, T P M Vliet Vlieland⁷, E Nikiphorou⁸, C H M Van den Ende⁹, I Fatouros¹⁰, M van der Esch¹¹, K Niedermann¹², A Stavropoulos-Kalinoglou¹³, J J C S Veldhuijzen van Zanten³, N Brodin¹⁴, C M O'Brien¹⁵, Y Koutedakis^{4

10}, N Kennedy¹⁶, T W Swinnen¹⁷, C Bostrom¹⁴, G D Kitas^{18

3}; IMPACT-RMD Consortium

Affiliations

¹ School of Physical Education, Sport Science and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132, Trikala, Greece. g.metsios@uth.gr.
² Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK. g.metsios@uth.gr.
³ School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
⁴ Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.
⁵ National Resource Centre for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
⁶ Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
⁷ Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.
⁸ Rheumatology Department, King's College Hospital, London, UK.
⁹ Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
¹⁰ Department of Physical Education and Sport Science, University of Thessaly, Karies, Trikala, Greece.
¹¹ ACHIEVE-Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Reade, Center for Rehabilitation and Rheumatology/Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands.
¹² School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
¹³ Centre for Active Lifestyles, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
¹⁴ Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
¹⁵ School of Psychology, University of Surrey, Guildford, UK.
¹⁶ School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute, University of Limerick, Limerick, Ireland.
¹⁷ Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.
¹⁸ Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK.

PMID: 36877304
DOI: 10.1007/s10067-023-06518-7

Barriers and facilitators for physical activity in rheumatic and musculoskeletal disease: a European-based survey

George S Metsios et al. Clin Rheumatol. 2023 Jul.

. 2023 Jul;42(7):1897-1902.

doi: 10.1007/s10067-023-06518-7. Epub 2023 Mar 6.

Authors

Affiliations

¹ School of Physical Education, Sport Science and Dietetics, Department of Nutrition and Dietetics, University of Thessaly, 42132, Trikala, Greece. g.metsios@uth.gr.
² Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK. g.metsios@uth.gr.
³ School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
⁴ Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.
⁵ National Resource Centre for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
⁶ Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
⁷ Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.
⁸ Rheumatology Department, King's College Hospital, London, UK.
⁹ Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
¹⁰ Department of Physical Education and Sport Science, University of Thessaly, Karies, Trikala, Greece.
¹¹ ACHIEVE-Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Reade, Center for Rehabilitation and Rheumatology/Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands.
¹² School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
¹³ Centre for Active Lifestyles, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
¹⁴ Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
¹⁵ School of Psychology, University of Surrey, Guildford, UK.
¹⁶ School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute, University of Limerick, Limerick, Ireland.
¹⁷ Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.
¹⁸ Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK.

PMID: 36877304
DOI: 10.1007/s10067-023-06518-7

Abstract

Physical activity (PA) is a key strategy for improving symptoms in people with rheumatic and musculoskeletal diseases (RMDs). The aim of this study was to investigate and rank the importance of known barriers and facilitators for engaging in PA, from the perspective of people living with RMD. Five hundred thirty-three people with RMD responded to a survey (nine questions) disseminated by the People with Arthritis and Rheumatism (PARE) network of the European Alliance of Associations for Rheumatology (EULAR). The survey required participants to rank - based on their perceived importance - known PA barriers and facilitators from the literature, and specifically RMD symptoms as well as healthcare and community factors that may affect PA participation. Of the participants, 58% reported rheumatoid arthritis as their primary diagnosis, 89% were female, and 59% were between 51 and 70 years of age. Overall, participants reported fatigue (61.4%), pain (53.6%) and painful/swollen joints (50.6%) as the highest ranked barriers for engaging in PA. Conversely, less fatigue (66.8%) and pain (63.6%), and being able to do daily activities more easy (56.3%) were identified as the most important facilitators to PA. Three literature identified PA barriers, i.e., general health (78.8%), fitness (75.3%) and mental health (68.1%), were also ranked as being the most important for PA engagement. Symptoms of RMDs, such as pain and fatigue, seem to be considered the predominant barriers to PA by people with RMD; the same barriers are also the ones that they want to improve through increasing PA, suggesting a bi-directional relationship between these factors. Key Points • Symptoms of rheumatic and musculoskeletal disease (RMD) are the predominant barriers for lack of physical activity engagement. • RMD symptoms are the factors that people with RMDs want to improve when engaging in PA. • The barriers that stop people living with RMDs to do more PA are the ones that can be significantly improved through PA engagement.

Keywords: Exercise; Fatigue; Pain; Physical activity; Rheumatic and musculoskeletal disease; Rheumatoid arthritis.

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References

1. Metsios GS, Moe RH, Kitas GD (2020) Exercise and inflammation. Best Pract Res Clin Rheumatol 34(2):101504 - DOI - PubMed
1. Metsios GS, Moe RH, van der Esch M, van Zanten J, Fenton SAM, Koutedakis Y et al (2019) The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis. Rheumatol Int 40(3):347–357. https://doi.org/10.1007/s00296-019-04483-6
1. Rausch Osthoff AK, Niedermann K, Braun J, Adams J, Brodin N, Dagfinrud H et al (2018) 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 77:1251–1260
1. Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJ et al (2017) EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis 76(1):17–28 - DOI - PubMed
1. Veldhuijzen van Zanten JJ, Rouse PC, Hale ED, Ntoumanis N, Metsios GS, Duda JL et al (2015) Perceived barriers, facilitators and benefits for regular physical activity and exercise in patients with rheumatoid arthritis: a review of the literature. Sports Med 45(10):1401–12 - DOI - PubMed - PMC

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Barriers and facilitators for physical activity in rheumatic and musculoskeletal disease: a European-based survey

Affiliations

Barriers and facilitators for physical activity in rheumatic and musculoskeletal disease: a European-based survey

Authors

Affiliations

Abstract

References

MeSH terms

Supplementary concepts

Grants and funding

LinkOut - more resources

Full Text Sources

Medical