Change in exercise behaviour after medical rehabilitation in patients with spondyloarthritis, arthritis and fibromyalgia

Background: In rheumatic diseases physiotherapy and sports therapy are - in addition to medicinal therapy - very important parts of the treatment. Objective: The purpose of this study was to analyse the change in exercise behaviour after medical rehabilitation and the effects of frequency of exercise on pain intensity and other parameters. Methods: 319 patients with rheumatic diseases (spondyloarthritis [SPA], arthritis [CP] and fibromyalgia [FM]) were, among others, asked about their exercise behaviour at the beginning of their medical rehabilitation (t1) as well as 3-5 months (0) and 12 months later (t4). Also assessed was the prescription of functional training through the ward doctor at the end of the rehabilitation. Results: Most of the patients (82 - 91%) received a prescription for functional training. At t3 between 58 and 65% carried out the functional training offered as group physiotherapy or muscle structure training. One year after the rehabilitation, the participation rate in the functional training had decreased; however, it remained obviously higher than the participation rate before rehabilitation. Concerning the home exercise behaviour before rehabilitation, between 27 and 41% carried it out a few times per week or (almost) daily. The exercise behaviour has obviously increased after rehabilitation. 12 months after rehabilitation 59% of SPA, 54% of CP and 66% of the FM patients practiced home exercises several times per week or (almost) daily. Data were further divided into two subgroups according to the frequency of home exercises 12 month after rehabilitation (< 1 per week; >= 1 per week). Patients doing home exercise >= 1 per week showed at all measuring times a lower status of physical health (e.g., pain, disability through pain), as well as higher rates of service utilisation (medical visits, spa therapy, physiotherapy) at G and t4. This subgroup showed also a significantly higher pain reduction in the annual course after rehabilitation, more distress and a different profile in work status than the subgroup doing exercises more rarely. In other characteristics like age, diagnosis duration, school education, no differences between the two subgroups occurred. Conclusion: The study shows that, after a medical rehabilitation, the patients do increase their exercise behaviour and that this is influenced by the degree of suffering and amount of leisure time.