Exploration of the perceptions of the benefits and barriers to exercise in patients with spondyloarthritis

Objective: The primary aims of this thesis are to determine physical activity level and perceived benefits and barriers to exercise of spondyloarthritis (SpA) patients, and to compare these to population controls. Secondary aim is to investigate the relationships between perceived benefits and barriers to exercise and demographic characteristics, medications, disease activity, function, mobility, psychological status, quality of life and concomittant diseases among SpA patients. Patients and methods: This cross-sectional study included patients meeting Assessment of Spondyloarthritis International Society (ASAS) criteria for SpA, and population controls. Perceptions of exercise were assessed using the Exercise Benefits and Barriers Scale (EBBS). Physical activity was reported with the İnternational Physical Activity Qustionnaire-Short form (IPAQ-S). Most commonly reported types of exercises and durations of exercise last week were asked. Participants completed questionnaires assesing fatique, psychological status, quality of life. Patients were also asked about disease activity, function and mobility. Correlations were analyzed between disease parameters and perceived benefits of and barriers to exercise. Results: Two hundred patients (118 males, 82 females) and 100 controls (50 males, 50 females) completed the questionnaires. Patients reported some of barrier items more than controls such as "Exercise tires me" and "Exercise takes too much time". When disease activity, functional and mobility index, fatique, psychological status and quality of life of the patients deteriorated, perceived barriers to exercise increased. Physical activity levels and walking durations of patients and controls were similar. Patients spent more time doing stretching exercises while controls spent more time doing aerobic exercises. No correlations were observed between disease activity with physical activity levels of the patients. Deterioration of psychological status and quality of life and increase of body mass index were associated with decreased physical activity level of the patients. Conclusions: While disease parameters of patients deteriorate, perceived barriers to exercise increase. Health professionals should focus on personal barriers to exercise to improve exercise behaviour in SpA patients.