Niedermann, Karin;
Nast, Irina;
Ciurea, Adrian;
Vliet Vlieland, Thea;
van Bodegom‐Vos, Leti
Barriers and Facilitators of Vigorous Cardiorespiratory Training in Axial Spondyloarthritis: Surveys Among Patients, Physiotherapists, and Rheumatologists
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Media type:
E-Article
Title:
Barriers and Facilitators of Vigorous Cardiorespiratory Training in Axial Spondyloarthritis: Surveys Among Patients, Physiotherapists, and Rheumatologists
Contributor:
Niedermann, Karin;
Nast, Irina;
Ciurea, Adrian;
Vliet Vlieland, Thea;
van Bodegom‐Vos, Leti
Description:
<jats:sec><jats:title>Objective</jats:title><jats:p>Vigorous cardiorespiratory training (<jats:styled-content style="fixed-case">CRT</jats:styled-content>) in patients with axial spondyloarthritis (SpA) is effective, safe. and feasible; however, it has not yet been adopted in axial SpA exercise programs. Therefore, the aim of this study was to explore the barriers and facilitators for vigorous <jats:styled-content style="fixed-case">CRT</jats:styled-content> among patients, physiotherapists, and rheumatologists.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Stakeholder‐specific surveys were used to examine perceptions of barriers and facilitators to vigorous <jats:styled-content style="fixed-case">CRT</jats:styled-content>, with categories organized according to the recommendations proposed by Grol and Wensing. Respondents chose the 3 most important barrier and facilitator categories and rated individual items on a 4‐point scale. Frequencies and proportions were calculated, and ratings between active and inactive patients were compared.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among all patients (n = 575 [response rate 34%]), the top 3 barrier categories were “low motivation” (n = 317 [59%]), “unsuccessful timing in daily routine” (n = 292 [55%]), and “hindering disease symptoms” (n = 272 [51%]). The top 3 facilitator categories were “high motivation” (n = 248 [47%]), “good organizational conditions” (n = 217 [41%]), and “facilitating disease symptoms” (n = 209 [40%]). More inactive patients than active patients chose “low motivation” as a barrier (<jats:italic>P</jats:italic> = 0.01). Among physiotherapists (n = 40 [response rate 48%]), the top 3 barrier categories were “heterogeneous groups” (n = 26 [70%]), “difficult organizational conditions” (n = 19 [51%]), and “low perceived motivation” (n = 19 [51%]). Among physiotherapists, the top 3 facilitator categories were “knowledge” (n = 20 [54%]), “homogeneous group composition,” and “high perceived motivation” (both n = 17 [46%]). For rheumatologists (n = 73 [response rate 17%], with 54 [74%] answering barrier items and 68 [93%] answering facilitator items), the strongest barriers included “not enough information” (n = 25 [47%]) and “anticipated or perceived disinterest of patient” (n = 27 [50%]). The strongest facilitators reported by rheumatologists included “exercise important topic even in limited consultation time” (n = 65 [96%]) and “clear evidence for effectiveness of flexibility exercises” (n = 62 [91%]).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The identified facilitators and barriers will guide the development of stakeholder‐specific implementation strategies.</jats:p></jats:sec>