What are the perceived barriers, facilitators and attitudes to exercise for women with rheumatoid arthritis? A qualitative study

Purpose: This study qualitatively examined the attitudes and perceived barriers to exercise of women with rheumatoid arthritis (RA). We also explored the level of exercise that might be considered helpful or harmful, and whether walking would be an acceptable type of exercise. Method: Eight women with RA were interviewed via telephone using a semi-structured approach. Transcripts were coded for themes using the General Inductive Approach. These themes were used to develop a theoretical model of the effect of barriers and facilitators to exercise for women with RA. Results: Two themes emerged (social connections and fear). Social connections could facilitate participation in exercise or prove to be a barrier. Fear had three distinct sub-themes: fear of the unknown (including a safe level of exercise), fear of the known and fear for safety. For most participants, walking 3-4 times a week was thought to be an acceptable programme for themselves or others with RA. Conclusion: Among those interviewed, walking was considered an acceptable form of exercise for people with RA. Many of the barriers to exercise identified by participants could be alleviated by detailed instructions on the type and duration of exercise recommended. These findings inform the development of walking interventions.Implications for RehabilitationPeople with RA and various other chronic illnesses have previously been found to request more specific guidance for incorporating physical activity into their treatment.There was a willingness to participate in physical activity among our participants with RA.Activities such as walking appear to be feasible for people with RA but fears and social support can be barriers.Rehabilitation professionals are ideally placed to help people with RA overcome fears and social support barriers: providing encouragement to participate with others is recommended.