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Barriers and facilitators of vigorous cardiorespiratory training in axial Spondyloarthritis: Surveys among patients, physiotherapists, rheumatologists


Niedermann, Karin; Nast, Irina; Ciurea, Adrian; Vliet Vlieland, Thea; van Bodegom-Vos, Leti (2019). Barriers and facilitators of vigorous cardiorespiratory training in axial Spondyloarthritis: Surveys among patients, physiotherapists, rheumatologists. Arthritis Care & Research, 71(6):839-851.

Abstract

OBJECTIVE
Vigorous cardio-respiratory training (vCRT) in patients with axial Spondyloarthritis (axSpA) is effective, safe and feasible, however not yet adopted in axSpA exercise programmes. We therefore aimed to explore the barriers and facilitators for vCRT among patients, physiotherapists (PTs) and rheumatologists.
METHODS
"Stakeholder-specific surveys examined perceptions of barriers and facilitators to vCRT organized under categories identified by Grol & 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; ratings between active and inactive patients were compared."
RESULTS
Patients (n= 575, response rate 34%): the top-3 barrier categories included '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 organisational conditions' (n=217/41%), 'facilitating disease symptoms' (n=209/40%). More inactive than active patients chose 'low motivation' as barrier (p=0.01). PTs (n= 40, response rate 48%): The top-3 barrier categories included 'heterogeneous group composition' (n=26/70%), 'difficult organisational conditions' (n=19/51%) and 'low motivation' (n=19/51%). The PTs' top-3 facilitator categories were 'knowledge' (n=20/54%), 'homogeneous group composition' and 'high perceived motivation' (both n=17/46%). Rheumatologists (n=73, response rate 17%; with 54 (74%) answering barrier items and 68 (93%) answering facilitator items): Strongest barriers included 'not enough information' (n=25/47%) and 'anticipated /perceived disinterest of patient (n=27/50%). Strongest facilitators included 'exercise important topic even in limited consultation time' (n=65/96%) and 'clear evidence for effectiveness of flexibility exercises' (n=62/91%).
CONCLUSION
The identified facilitators and barriers will guide the development of stakeholder-specific implementation strategies. This article is protected by copyright. All rights reserved.

Abstract

OBJECTIVE
Vigorous cardio-respiratory training (vCRT) in patients with axial Spondyloarthritis (axSpA) is effective, safe and feasible, however not yet adopted in axSpA exercise programmes. We therefore aimed to explore the barriers and facilitators for vCRT among patients, physiotherapists (PTs) and rheumatologists.
METHODS
"Stakeholder-specific surveys examined perceptions of barriers and facilitators to vCRT organized under categories identified by Grol & 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; ratings between active and inactive patients were compared."
RESULTS
Patients (n= 575, response rate 34%): the top-3 barrier categories included '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 organisational conditions' (n=217/41%), 'facilitating disease symptoms' (n=209/40%). More inactive than active patients chose 'low motivation' as barrier (p=0.01). PTs (n= 40, response rate 48%): The top-3 barrier categories included 'heterogeneous group composition' (n=26/70%), 'difficult organisational conditions' (n=19/51%) and 'low motivation' (n=19/51%). The PTs' top-3 facilitator categories were 'knowledge' (n=20/54%), 'homogeneous group composition' and 'high perceived motivation' (both n=17/46%). Rheumatologists (n=73, response rate 17%; with 54 (74%) answering barrier items and 68 (93%) answering facilitator items): Strongest barriers included 'not enough information' (n=25/47%) and 'anticipated /perceived disinterest of patient (n=27/50%). Strongest facilitators included 'exercise important topic even in limited consultation time' (n=65/96%) and 'clear evidence for effectiveness of flexibility exercises' (n=62/91%).
CONCLUSION
The identified facilitators and barriers will guide the development of stakeholder-specific implementation strategies. This article is protected by copyright. All rights reserved.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Rheumatology Clinic and Institute of Physical Medicine
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Rheumatology
Language:English
Date:1 June 2019
Deposited On:12 Sep 2018 13:47
Last Modified:29 Jul 2020 07:40
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:2151-464X
Additional Information:This is the peer reviewed version of the following article: Niedermann, K et al: Barriers and facilitators of vigorous cardiorespiratory training in axial Spondyloarthritis: Surveys among patients, physiotherapists, rheumatologists , which has been published in final form at https://doi.org/10.1002/acr.23705. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms).
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1002/acr.23705
PubMed ID:30004189

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