Title: Barriers and facilitators of vigorous cardiorespiratory training in axial Spondyloarthritis : surveys among patients, physiotherapists, rheumatologists
Authors : Niedermann Schneider, Karin
Nast, Irina
Ciurea, Adrian
Vliet Vlieland, Thea
van Bodegom-Vos, Leti
Published in : Arthritis Care & Research
Publisher / Ed. Institution : Wiley
Issue Date: 13-Jul-2018
License (according to publishing contract) : Licence according to publishing contract
Type of review: Peer review (publication)
Language : English
Subject (DDC) : 615.82: Physical therapy
616.7: Diseases of musculoskeletal system and orthopaedics
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 were used to examine perceptions of barriers and facilitators to vigorous CRT, 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. Results: 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 (P = 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%]). Conclusion: The identified facilitators and barriers will guide the development of stakeholder‐specific implementation strategies.
Departement: Health Professions
Organisational Unit: Institute of Physiotherapy (IPT)
Publication type: Article in scientific journal
DOI : 10.1002/acr.23705
ISSN: 2151-464X
URI: https://digitalcollection.zhaw.ch/handle/11475/14190
Appears in Collections:Publikationen Gesundheit

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