Background/Purpose: Osteoarthritis (OA) is highly prevalent, disabling and incurs considerable healthcare costs. Symptoms of pain and functional impairment can be ameliorated through participation in regular exercise, and this is encouraged as a long-term self-management strategy. Community based, instructor-led ‘exercise on referral’ schemes are common but infrequently assessed to determine their effectiveness; furthermore, participant and instructor views on these services are rarely reported. The aims of this study were to audit a 12-week local authority subsidised exercise programme and to report on participant and instructor views of this scheme.
Methods: Pre-existing databases were analysed to determine participation and health outcomes, an on-line survey and semi-structured interviews recorded instructor beliefs, whilst focus groups were used to collect data regarding participant views of community-based exercise. (Ethical approval references IRAS 11/SW/0084 and UREC HSC/11/02/27).
Results: In a two-year period 2101 people, age 45 and over with chronic joint pain/OA were referred for exercise. 36% of individuals completed the 12-week scheme; 22% of individuals did not start the programme; the remainder started but did not finish. Improvements were seen in BMI, blood pressure and self-reported activity levels for those that did complete all 12 sessions. Qualitative interviews (n=14) suggested people with OA were sceptical regarding the ability of gym instructors to manage their condition appropriately when exercising, and they feared their condition may worsen in this environment. Feedback from instructors (n=88) demonstrated a reduced specialist knowledge regarding the management of rheumatological conditions, and a recogntion that they required further specialist training to manage OA effectively. Instructors did however consider themselves appropriately trained to manage psychosocial issues, and to motivate individuals to exercise.
Conclusion: Community based exercise schemes are common, but there is an apparent reluctance amongst people with OA to engage with these schemes. Reasons for non-engagement include a perception that instructors are not appropriately qualified to manage their condition safely, and that symptoms may worsen. These beliefs may be vindicated as instructors reported a lack of specialised knowledge to support exercise programmes in people with rheumatological conditions. Although only 36% of individuals referred onto a 12-week exercise scheme completed the programme, these individuals demonstrated physiological improvements and an increase in self-reported activity levels. Future success of these programmes is likely to be dependant on exercise instructors gaining further qualifications in managing rheumatological conditions.
Disclosure:
D. N. E. Walsh,
None;
P. M. Hurley,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/exercise-on-prescription-barriers-to-participation-in-community-based-exercise-programmes/