Physical activity engagement in early rheumatoid arthritis: a qualitative study to inform intervention development

Background: Physical activity (PA) in patients with rheumatoid arthritis (RA) is lower than in the general population. PA can improve physical function in RA, decrease chronic inflammation and reduce pain, without adversely affecting disease activity.

Objectives: To explore patient's views on approaches to delivering PA programmes and inform a programme to maximise functional ability through long-term engagement with PA.

Methods: Qualitative data were collected via three focus groups which explored the views of people with RA of their PA support needs following diagnosis; experiences relating to PA; motivators and facilitators to support PA engagement and the suitability for people with RA of evidence based PA programmes designed for other long-term conditions.

Results: Study participants (15 female, 4 male; 59.9 (standard deviation (SD) 10.3) years) had a mean time (SD) since diagnosis of 44 (34) months. Data analysis yielded 4 key themes relating to PA programmes: (1) why people join and why they drop out; (2) venue and timing; (3) what people want to do and hear; and (4) who should deliver programmes and how.

Conclusion: Patients with RA are interested in PA programmes 6 to 12 months after diagnosis, which support safe exercise and provide expert physiotherapist input. Recommendation by trusted health professionals and promotion of the benefits for 'people like me' would positively impact recruitment and retention. Key elements of the programme include proficient, safety-oriented exercise guidance, RA education, peer support, relaxation, coping strategies and self-set goals. Findings indicate that a group-based programme with a social aspect would support adherence.