Fri0700-Hpr lessons Learned From Pilot Implementation of Physical Activity Recommendations in Axspa Exercise Group Therapy – Less May Be More

Abstract

BackgroundThe Ankylosing Spondylitis Association of Switzerland (SVMB) offers 68 exercise groups (EG) for people with axial Spondyloarthritis (axSpA). Participants exercise weekly with focus on strength and flexibility supervised by a physiotherapist (PT). Given the EULAR physical activity (PA) recommendations [1] and recent research [2, 3], the SVMB aims to further develop the concept of their EG by introducing: a) exercises in all dimensions, cardiorespiratory fitness, muscle strength, flexibility and neuromotor performance, according to the general PA recommendations [4]; b) individual exercise-coaching (three sessions in first six months) by the group PT, specifically trained in communication and action planning skills to support individual exercising, and c) bi-annual fitness-assessments for all exercise dimensions.ObjectivesTo evaluate the new EG concept among the participating people with axSpA and PTs across four pilot groups.MethodsAfter six months, a survey on the perception and satisfaction towards the new EG concept was sent to 30 people with axSpA, who rated the questions on a 0-10 numeric rating scale (0=not satisfied, 10=very satisfied). Semi-structured telephone-interviews were conducted with the PTs to explore their experiences with the new GE concept.ResultsPeople with axSpA:The survey’s response rate was 83% (25/30); of these, 15 (62%) participants were satisfied with the concept (mean 6.7±2.23) and 20 (80%) with the exercise-coaching (mean 7.7±2.92). 22 (88%) individuals defined a training goal and 15 (60%) achieved it. The exercise diary was used by 16 (64%) participants, five reported app-based. Reasons for not using the diary were the daily effort and problems with correctly allocating activities to exercise dimensions. A minority (n=7, 28%) reported to use a technical device for cardiovascular exercising. 17 (68%) were satisfied with the fitness-assessment (mean 7.5±1.78). PTs perceived the exercise-coaching as very useful for supporting individualised exercising. However, they emphasised that the frequency of the sessions should be flexibly based on the participant’s individual training goal and motivation. The PTs perceived controversial reactions to the fitness-assessments: increased but also decreased motivation towards exercising.ConclusionExercise-coaching and fitness-assessments were generally appreciated; however, the frequency was perceived as too high. The GE concept will be adapted accordingly to improve feasibility for national implementation: the exercise-coachings will be reduced to two in the first six months, the first one compulsory for all participants, then bi-annually, according to individual needs and training goals. The fitness-assessments will take place annually instead of bi-annually. There is a need for easy-to-use exercise diaries, covering all exercise dimensions.References[1] Rausch AK, et al. Ann Rheum Dis2018; 9(77):1251-1260.[2] Sveaas SH, et al. Br J Sports Med2017;51:1065-1072[3] Rausch AK, et al. RMD open, accepted[4] Garber CE, et al. Med Sci Sports Exerc...

Organisation and content of supervised group exercise for people with axial spondyloarthritis in The Netherlands

“…When compared with a similar Dutch cross-sectional study from 1994 [18], it appears that little has changed over the last two and a half decades. Current practice in The Netherlands also appears to be in line with relatively recent studies on the delivery of SGE for patients with axSpA from Switzerland and the United Kingdom [20][21][22]. In all, the focus is still mainly on joint mobility and muscle strengthening exercises, combined with sports and hydrotherapy, provided during once weekly sessions of relatively long duration.…”

“…Additional knowledge regarding current SGE engagement, organisation, and content among people with axSpA from other studies appears to be scarce. Two Swiss studies report that 68 axSpA-specific SGE groups are organised by the Ankylosing Spondylitis Association of Switzerland, in which SGE is provided mostly on land, often complemented with hydrotherapy, on a weekly basis, supervised by a physical therapist and focusing on muscular strength and joint mobility [20,21]. In the United Kingdom, it is reported that land-based SGE and hydrotherapy are organised by 74 and 65 branches from the National Axial Spondyloarthritis Society (NASS), respectively [22].…”