NHS Tayside, Physiotherapy Department Crieff Community Hospital, King Street, Crieff, PH7 3HR, UK.
Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BMC Musculoskelet Disord. 2022 Oct 5;23(1):897. doi: 10.1186/s12891-022-05847-z.
Physical activity has been shown to be of great benefit to people with an inflammatory joint disease (IJD), however people with an IJD have been shown to be very inactive compared to the general population. The aims of this study were to explore 1) whether the transition from a National Health Service (NHS)-run exercise programme into exercising in the community could be achieved successfully; and 2) the barriers and facilitators during the transition period.
This study adopted a complementary mixed-methods study design including a qualitative approach using focus groups and a prospective cohort study. Descriptive statistics were used to summarise the cohort study data. All variables were assessed for normality of distribution using the Sharpiro-Wilk test. Paired t-tests or Wilcoxon tests were undertaken for two consecutive assessment timepoints; one-way repeated measures ANOVAs or Friedman's tests for three consecutive assessment timepoints. Micro-interlocutor analysis was used to analyse the focus group data. Areas of congruence and incongruence were explored by confirming the statistical results against the qualitative results. The adapted ecological model of the determinants of physical activity was then used as a framework to describe the findings.
A successful transition was defined as still exercising in the community 6-months post discharge from the NHS-run Inflammatory Arthritis Exercise Programme. This was self-reported to be 90% of the cohort. An individual barrier to physical activity in people with an IJD was found to be the unpredictable nature of their condition. Other barriers and facilitators found were similar to those found in the general population such as recreation facilities, locations, transportation and cost. Other facilitators were similar to those found in people living with other chronic long-term conditions such as the importance of peer support.
90% of the cohort data were defined as a successful transition. People with an IJD have similar barriers and facilitators to exercise as the general population and those living with other chronic long-term conditions. A barrier which appears to be unique to this population group is that of the unpredictable nature of their condition which needs to be considered whenever tailoring any intervention.
体育活动对患有炎症性关节疾病（IJD）的人非常有益，然而，与一般人群相比，患有 IJD 的人活动量非常低。本研究旨在探讨：1）是否可以成功实现从国民保健服务（NHS）运行的运动项目过渡到社区锻炼；2）过渡期间的障碍和促进因素。
本研究采用了互补的混合方法设计，包括使用焦点小组的定性方法和前瞻性队列研究。使用描述性统计来总结队列研究数据。使用 Shapiro-Wilk 检验评估所有变量的正态分布情况。对于连续两次评估时间点，使用配对 t 检验或 Wilcoxon 检验；对于连续三次评估时间点，使用单向重复测量方差分析或 Friedman 检验。使用微观对话者分析对焦点小组数据进行分析。通过将统计结果与定性结果进行对比，探索一致性和不一致性的领域。然后，将物理活动决定因素的适应性生态模型用作描述研究结果的框架。
成功过渡被定义为从 NHS 运行的炎症性关节炎运动项目出院后仍在社区中进行锻炼。这一比例自我报告为 90%的队列。发现 IJD 患者进行体育活动的个体障碍是其病情的不可预测性。其他发现的障碍和促进因素与一般人群相似，如娱乐设施、地点、交通和费用。其他促进因素与患有其他慢性长期疾病的人群相似，如同伴支持的重要性。
90%的队列数据被定义为成功过渡。IJD 患者进行锻炼的障碍和促进因素与一般人群和患有其他慢性长期疾病的人群相似。似乎是该人群独有的障碍是病情的不可预测性，在定制任何干预措施时都需要考虑这一点。
