The European Alliance of Associations for Rheumatology (EULAR) emphasized the benefits of physical activity for individuals with rheumatic and musculoskeletal diseases during the organization's 2024 Congress. Benefits associated with physical activity in this patient population included enhanced overall fitness, symptom alleviation, improved quality of life, and positive impacts on cardio-metabolic biomarkers. Despite these advantages, a gap remained between research findings and the real-world implementation of these recommendations.
During the Health Professionals in Rheumatology abstract sessions at the 2024 EULAR congress, Mohamed Saadi, M.D., presented results from a systematic review that highlighted barriers and facilitators affecting adherence to EULAR's physical activity recommendations. The review examined 68 articles and identified 29 different themes: 9 social, 16 environmental, and 4 systemic. The most frequently found themes were supportive family and friends, a supportive health professional, costs, and access to adapted and supervised programs. Notably, there were potential country-level differences in these factors. Social considerations included support availability; social pressure; body shaming; and incorporating physical activity into daily life, such as walking a dog or playing with children. Systemic differences encompassed costs and financial support; environmental factors involved weather, safety, and transportation to activity locations. Further research is needed to understand these differences and tailor strategies for patients in each country. The next phase of this project aimed to develop a questionnaire for use in four European countries to identify barriers and facilitators for adhering to EULAR's recommendations.
In Denmark, similar qualitative research was underway in four rheumatology outpatient clinics, and findings from that effort were also presented at the Congress. This study involved 10 days of clinical practice observations and 12 semistructured interviews with physicians, nurses, and clinical leaders. Tanja Thomsen, Ph.D., the lead author, conducted all observations and interviews. The research used the Theoretical Domains Framework and template analysis for data interpretation. Barriers identified by nurses and physicians were related to skills, competencies, and professional roles. Clinical management highlighted environmental context and resource constraints as primary barriers. Optimism emerged as a mutual facilitator, with shared beliefs about the potential of physical activity guidance in routine care.
These studies identified factors affecting the implementation of physical activity guidance for individuals with rheumatic and musculoskeletal diseases. The findings highlighted the importance of targeted training and resources to support healthcare professionals in implementing physical activity recommendations in clinical practice.