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Views on Exercise Maintenance: Variations Among Patients With Rheumatoid Arthritis

E Swärdh, PT, MSc, is a PhD student, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23100, SE-141 83 Huddinge, Sweden, and Physical Therapist, Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
G Biguet, PT, MSc, is a PhD student and University Lecturer, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
CH Opava, PT, PhD, is Professor, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and Department of Rheumatology, Karolinska University Hospital

emma.swardh{at}ki.se

Background and Purpose: Individuals with rheumatoid arthritis (RA) often have to make changes in exercise behavior in order to gain and sustain health benefits. The purpose of this study was to explore and describe ways of understanding exercise maintenance among individuals with RA who had already started to exercise.

Participants: Fourteen women and 4 men with RA of at least 2 years' duration, selected from 4 hospitals or primary health care physical therapy clinics, participated. They had exercised regularly at least twice weekly during the previous 2 months with various levels of support from a physical therapist, and they had attempted to exercise without support outside of the health care environment during the previous year.

Method: A phenomenographic approach was used to analyze semistructured interviews. A pattern of categories of descriptions was constructed based on the participants' conceptions and ways of understanding the phenomenon of exercise maintenance.

Results: Five categories were identified: "external control," "sticks and carrots," "a joint venture," "the easy way," and "on one's own terms." The categories became clear by elucidating 2 aspects related to exercise maintenance: (1) the way the participants talked about and experienced the type of support needed and (2) personal factors.

Discussion and Conclusion.: The results highlight the importance of finding the proper context and support for each patient's needs. Furthermore, preparing for exercise maintenance by strengthening the patient's beliefs in his or her ability to exercise in different settings, by discussing pros and cons of exercise, and by exploiting the patient's ability to adapt and continue exercise outside of the health care environment might be valuable.

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