Background Physical inactivity is a recognised major public health challenge. Antiphospholipid syndrome (APS) is associated with increased risk of cardiovascular morbidity and mortality.1 Physical activity levels of people with chronic illnesses are lower than those in the general adult population but there is currently no data on exercise participation in people with APS.
Objectives To evaluate self-reported exercise participation in a cohort of adults with APS and associations with exercise self-efficacy and illness perception.
Methods Two hundred and sixty-eight individuals with APS participated in the cross-sectional online survey (85% female, mean age 47±11 years, 59% primary APS). Frequency of exercise of at least 30 minutes with shortness of breath and sweating was self-reported. A regular exerciser was defined as exercise participation 1-2 times per week or more.2,3 Patient reported outcomes included the Brief Illness Perception Questionnaire (B-IPQ), Chronic Disease Self-Efficacy Exercise Scale, SF-36, American College of Rheumatology Patient Activity Level Assessment and questions relating to motivation and confidence in exercise participation. Bivariate correlation analysis was used to determine relationships between variables. Multiple regression analysis was conducted to identify factors associated with exercise participation.
Results Regular exercise (≥1-2 times weekly) was reported by 143 (53.4%) patients while 47 (17.5%) of patients were inactive due to reduced function and APS. There was no significant difference in female:male ratio or age between regular exercisers and irregular/non-exercisers. Irregular/non-exercisers (37.2%) had significantly lower levels of exercise self-efficacy (p≤0.001); lower scores for SF36 physical function, role physical, bodily pain and social function (p≤0.001); and higher scores for B-IPQ consequences and identity (p≤0.01) compared to regular exercisers. Individuals who had a greater perceived influence of APS upon their life and who had a greater experience of severe symptoms as a result of APS were more likely to be irregular or non-exercisers. The linear regression analyses showed that exercise self-efficacy was the factor most associated with being a regular exerciser. Further, the SF36 physical function subscale and “confidence in maintaining an active lifestyle” were the two factors most associated with a higher level of exercise self-efficacy.
Conclusions Physical activity is important in the management of cardiovascular morbidity and mortality in people with APS. Over a third of APS patients in this study were not regular exercisers. Perception of illness and exercise self-efficacy were shown to be key factors associated with participation in regular exercise. There is potential to develop interventions to enhance exercise self-efficacy and change illness perceptions that may increase exercise participation for people with APS.
Garcia C, Perandini L, Seguro L, et al. Impaired aerobic exercise capacity and cardiac autonomic control in primary antiphospholipid syndrome. Lupus. 2013; 22: 928-31.
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Uhlig T and Austad C. Many patients with rheumatoid arthritis remain physically inactive. Ann Rheum Dis. 2012; 71: 121.
Acknowledgements The Hughes Syndrome Foundation and the individuals who participated in the study.
Disclosure of Interest None declared