Barriers and Facilitators for Being Physically Active in Patients with Ankylosing Spondylitis: A Cross-sectional Comparative Study

Objectives: The aims of the present study were to explore the barriers and facilitators for being physically active and the perceived health benefits of physical activity in a group of patients with ankylosing spondylitis (AS), and to compare the findings with those in population controls.

Methods: A total of 148 patients and 133 controls were included in a cross-sectional study. Barriers, facilitators and perceived health benefits were registered in a structured interview.

Results: Patients were significantly more likely to report barriers to being physically active compared with controls (78% versus 58%; p ≤ 0.001). The barriers most frequently reported by patients were pain (48%), stiffness (36%), fatigue (30%) and disability (21%). A similar proportion of patients (62%) and controls (61%) reported that they had the potential to become more physically active (p = 0.12). Time and motivation were the most frequently reported facilitators in both groups. Patients also reported stable disease (15%) and individually adapted physical activity (8%) as facilitators. An equal proportion of patients (96%) and controls (96%) reported that physical activity had a positive effect on their health (p = 0.94). Improved fitness and increased vitality were the most frequently reported health benefits in both groups. Patients also reported greater disease stability (37%) and reduced pain (33%) as benefits.

Conclusions: A larger proportion of patients than controls reported barriers to being physically active. In addition to regular barriers, facilitators and health benefits, patients reported that disease-related factors influenced their participation in physical activity.