Physical activity during and after a residential rehabilitation programme for people living with axial spondyloarthritis: a qualitative exploration of patient and health care professional perspectives

Objective: To explore the experiences of people living with axial spondyloarthritis (axSpA), and views of health care professionals (HCPs), on physical activity engagement and maintenance during and after a structured physiotherapy led residential rehabilitation programme. Methods and measures: Nineteen individuals with axSpA who attended a two-week residential rehabilitation programme, and nine HCPs were recruited. Patient focus groups and HCP interviews were audio recorded, transcribed verbatim, and thematic analysis was conducted. Where appropriate, self-determination theory was used in the interpretation and discussion of inductively constructed themes. Results: Four key themes were identified: Interactions within the social environment (Immersion, Group dynamic, Interactions with health care professionals, Interactions with family and others); Adjusting to PA (Enjoyment & interest, Balance & body awareness, Routine & habit, Feedback); Transformative experience (Education as a foundation, Perception of PA, Ownership, Visible difference); and Psychological challenges (Frustration, Guilt, Fear, Normalisation). Conclusion: Rehabilitation programmes for people with axSpA should be holistic. Framing PA in terms of enjoyment, instead of purely for health, may support PA maintenance. For HCPs, creating a more socially supportive environment, involving important others, and focusing on techniques to support autonomous motivation can help those with axSpA maintain PA after a rehabilitation programme.