How to optimize exercise behavior in axial spondyloarthritis? Results of an intervention mapping study

Bas Hilberdink; Florus van der Giesen; Thea Vliet Vlieland; Marjan Nijkamp; Salima van Weely

doi:10.1016/j.pec.2019.12.017

How to optimize exercise behavior in axial spondyloarthritis? Results of an intervention mapping study

Patient Educ Couns. 2020 May;103(5):952-959. doi: 10.1016/j.pec.2019.12.017. Epub 2019 Dec 31.

Authors

Bas Hilberdink¹, Florus van der Giesen², Thea Vliet Vlieland³, Marjan Nijkamp⁴, Salima van Weely³

Affiliations

¹ Leiden University Medical Center, Dept. of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, the Netherlands. Electronic address: B.Hilberdink@lumc.nl.
² Leiden University Medical Center, Dept. of Rheumatology, Leiden, the Netherlands.
³ Leiden University Medical Center, Dept. of Orthopaedics, Rehabilitation and Physical Therapy, Leiden, the Netherlands.
⁴ Open University, Psychology and Educational Sciences, Heerlen, the Netherlands.

PMID: 31926668
DOI: 10.1016/j.pec.2019.12.017

Abstract

Objective: Many individuals with axial spondyloarthritis (axSpA) do not engage in adequate exercise, despite its proven health benefits. This study aimed to identify the intervention components needed to optimize exercise behavior in people with axSpA.

Methods: The first three steps of the Intervention Mapping protocol were used: 1) needs assessment; 2) identification of axSpA-specific exercise barriers and facilitators (´determinants'); 3) selection of effective intervention components addressing potentially modifiable determinants. All three steps included scoping reviews and semi-structured interviews with patients (n = 2) and physical therapists (n = 2).

Results: The scoping reviews included 28, 23 and 15 papers, respectively. Step 1 showed that only one third of axSpA patients exercise regularly, demonstrating especially a lack of strengthening and cardiorespiratory exercises. Based on eight determinants identified in Step 2, 10 intervention components were selected in Step 3: education, motivational interviewing, goal setting, action planning, monitoring, feedback, tailoring, guided practice, therapists' training and group exercise encouragement.

Conclusion: Using the Intervention Mapping method, 10 intervention components for optimizing exercise behavior in people with axSpA were identified and an intervention with behavior change guidance and a training for health professionals is proposed.

Practice implications: This study provides a foundation for the development of an axSpA-specific exercise intervention.

Keywords: Axial spondyloarthritis; Exercise behavior; Intervention mapping.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adult
Exercise Therapy / methods*
Exercise*
Female
Health Behavior*
Humans
Male
Middle Aged
Motivational Interviewing
Patient Compliance*
Spondylarthritis / therapy*