Background Physical activity (PA) and exercise are important for people with rheumatoid arthritis (RA) (Van den Ende et al 2000; Kennedy et al 2007). Establishing current practice among Irish Physiotherapists regarding PA and exercise promotion and management of people with RA is important in ascertaining if there are educational needs in this important area of practice.
Objectives To investigate Irish physiotherapists current practice in managing people with RA and promoting PA and exercise in this population.
Methods Physiotherapists from three Irish Society of Chartered Physiotherapists (ISCP) clinical interest groups (N=792) were invited to participate in a cross-sectional survey hosted on SurveyMonkey(R)TM. Ethical approval was received. Descriptive statistics, Chi-square tests/Fisher's exact tests were used to analyse the data using SPSS v21.
Results One hundred and sixty-eight (21%) physiotherapists responded. Physical activity is a key component of treatment with the majority of respondents (52%) always/regularly using it as an intervention. The majority also agreed that PA is attainable (69%), safe (68%) and an important goal (67%) for people with RA. Self-management techniques combined with exercise prescription were always/regularly (84%) provided. Electrotherapeutic modalities were not a key feature of practice (Ultrasound (57%) & TENS (36%) never used). However, the majority (62%) never recommend the ACSM guidelines when advising on PA, while only 14% defined PA according to frequently used definitions (Caspersen et al 1985). The majority of respondents (96%) indicated a need for further education on promotion of PA among people with RA. Low-intensity exercises were prescribed by almost all respondents (99%) with just 33% providing high-intensity exercises. A moderate level of confidence was reported (mean 6.45/10±1.70) regarding confidence in promoting PA to people with RA. There was a statistically significant association between longer years qualified (p=0.018) and more years working with people with RA (p=0.013) and using the ACSM guidelines to guide PA and exercise prescription.
Conclusions Promotion of PA to people with RA is strong among Irish Physiotherapists. However, two-thirds never recommend the ACSM guidelines, and only 10% defined PA correctly. The majority prescribe light-intensity exercise only and indicate that their confidence is moderate in the promotion of PA to people with RA with an overwhelming majority interested in further education. Therefore, there is a need to develop education and training for physiotherapists in the promotion of PA in people with RA.
Caspersen C, Powell E, Christenson G. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. Vol 100: pp 126–131.
Kennedy N, Keogan F, Fitzpatrick M, Cussen G, Wallace L. (2007). Characteristics of patients with rheumatoid arthritis presenting for physiotherapy management: a multicentre study. Musculoskelet Care. Vol 5(1): pp 20–35.
van den Ende CHM, Breedveld FC, le Cessie S, Dijkmans BAC, de Mug AW, Hazes JMW. (2000). Effect of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial. Ann Rheum Dis Vol 59: pp 615–21.
Disclosure of Interest None declared