Abstract
Supervised group exercise (SGE) is recommended for people with axial spondyloarthritis (axSpA). Recent literature suggests that its contents and dosage must probably be revised. As a first step towards renewal, this study examined the current SGE organisation and content for people with axSpA in The Netherlands. A pen-and-paper survey was sent to the boards of the 82 local patient associations affiliated with the Dutch Arthritis Society in 2016. One member of each board was asked to complete questions on the nature and organisation of SGE and one of the supervising therapists to complete questions on the SGE supervision and contents. The questionnaire was returned by representatives of 67/82 (82%) local patient associations, of which 17 (25%) provided axSpA-specific SGE (16/17 SGE programmes with both land-based exercise and hydrotherapy and 1/17 with only hydrotherapy). These involved in total 56 groups with 684 participants and 59 supervisors, of whom 54 were physical therapists and 21 had had postgraduate education on rheumatic and musculoskeletal diseases (RMDs). Besides mobility and strengthening exercises and sports (17/17), most programmes included aerobic exercise (10/17), but rarely with heart rate monitoring (1/17), patient education (8/17), periodic assessments (2/17), or exercise personalisation (1/17). In the Netherlands, a quarter of local patient associations organised axSpA-specific SGE, mostly containing land-based exercises combined with sports and hydrotherapy. Most supervisors lacked postgraduate education on RMDs and most programmes lacked intensity monitoring, patient education, periodic assessments, and personalisation, which are needed for optimising exercise programmes according to current scientific insights.
Highlights
Axial spondyloarthritis is an inflammatory rheumatic disease that primarily affects the spine and sacroiliac joints, and is characterised by chronic back pain andThe implementation of these new insights in current practice of Supervised group exercise (SGE) in axial spondyloarthritis (axSpA), appears to be insufficient.1 3 Vol.:(0123456789)Rheumatology International (2021) 41:391–401In the Netherlands, the nature and contents of many of the SGE programmes for axSpA patients are still based on an intervention used in a randomised, controlled trial from a few decades ago [17]
Forty-three (64%) of these 67 associations were involved in organising SGE for people with axSpA: 17/67 (25%) provided SGE for axSpA and 26/67 (39%) for people with any rheumatic and musculoskeletal diseases (RMDs)
From all these 43 associations involved in organising SGE, a supervisor had completed survey Part Two on SGE contents and supervisor characteristics (n = 43)
Summary
Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease that primarily affects the spine and sacroiliac joints, and is characterised by chronic back pain andThe implementation of these new insights in current practice of SGE in axSpA, appears to be insufficient.1 3 Vol.:(0123456789)Rheumatology International (2021) 41:391–401In the Netherlands, the nature and contents of many of the SGE programmes for axSpA patients are still based on an intervention used in a randomised, controlled trial from a few decades ago [17]. Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease that primarily affects the spine and sacroiliac joints, and is characterised by chronic back pain and. The implementation of these new insights in current practice of SGE in axSpA, appears to be insufficient. Additional knowledge regarding current SGE engagement, organisation, and content among people with axSpA from other studies appears to be scarce. Two Swiss studies report that 68 axSpA-specific SGE groups are organised by the Ankylosing Spondylitis Association of Switzerland, in which SGE is provided mostly on land, often complemented with hydrotherapy, on a weekly basis, supervised by a physical therapist and focusing on muscular strength and joint mobility [20, 21]. Regarding overall SGE use, a recently published crosssectional study on the engagement of people with axSpA in SGE found that, in the Netherlands and Switzerland, 9% and 30% of the respondents are attending SGE, respectively, and that these numbers are declining over time, while the average age of SGE participants is increasing [23]
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