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Keeping physically active with rheumatoid arthritis: semi-structured interviews to explore patient perspectives, experiences and strategies

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Thomas R1, Hewlett S2, Swales C3, Cramp F2. Physiotherapy. 2018 Sep 6. pii: S0031-9406(18)30225-6. doi: 10.1016/j.physio.2018.09.001. [Epub ahead of print]

Abstract

Author information

1 Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom. Electronic address: rachel4.thomas@uwe.ac.uk.

2 Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom.

3 Patient Research Partner, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.

Abstract

BACKGROUND: Regular physical activity is safe and beneficial for people with rheumatoid arthritis (RA) but the majority of people with RA are less active than the general population and have a higher risk of co-morbidities. Exploring strategies used by physically active people with RA could inform effective methods to support those who are less active.

OBJECTIVE: To explore the perspectives, experiences and strategies employed by people with RA who successfully engage with regular physical activity.

DESIGN: Individual semi-structured interviews and thematic analysis.

PARTICIPANTS: A purposive sample of physically active people with RA.

RESULTS: Twelve females and three males participated (mean age 56, range 29 to 80; mean disease duration 13 years, range 10 months to 46 years). Analysis revealed eight constructs clustered into three themes. Theme 1: 'the individual' incorporated constructs of symptoms, feelings and role; theme 2: 'management' incorporated medical and self-management; theme 3: 'physical activity' incorporated constructs of type of physical activity, including barriers or facilitators. Participants reported a long history of physical activity prior to diagnosis and good support networks. All participants recognised that physical activity was key to their RA management, acknowledged the benefits from engaging in physical activity and were able to overcome barriers. Participants had strong beliefs that physical function would decline without regular physical activity.

CONCLUSIONS: People with RA who successfully maintain physical activity are motivated by a desire to manage symptoms, resist functional decline and maintain health and independence. These findings should be explored with a wider range of people with RA.