Background/Purpose: Current literature indicates that exercise is safe and effective in improving fatigue, depression, aerobic capacity, and health-related quality of life in systemic lupus erythematosus (SLE). Only 28% of SLE patients self-report that they meet the US government public health goal of at least 150 minutes/week of moderate to vigorous intensity physical activity (PA). Some barriers to PA for patients with SLE include fatigue, exposure to sunlight, pain, depression, sleep disturbance and hematologic and bony abnormalities predisposing to bleeding and fracture. We assessed barriers to PA as well as goals to improving PA before and after a behavioral intervention in a group of patients with SLE.

Methods: In a mixed-methods pilot study of 8 SLE adults, we identified barriers to increasing their PA using the Arthritis Comprehensive Treatment Assessment. In addition, we identified goals they would like to achieve over the next 6 weeks to increase their PA. All participants completed the Motives for Physical Activity Measure-Revised (MPAM-R), a questionnaire to assess the strength of five motives for participating in PA, at baseline and completion of the study. Individual coaching sessions were held at baseline and 6 weeks with a healthy lifestyle coach (exercise physiologist or occupational therapist) to review their barriers to PA and the achievement of their goals at the end of the study.  Participants were also offered 3 group educational sessions highlighting PA, healthy nutrition and motivation to behavior change.

Results: The sample consisted of 6 women and 2 men, mean age 47 years (SD=7.75) and included 50% African-American, Asian and Caucasian (25% each). Sixty-two percent were married. At baseline, 8 participants participated in an individual coaching session; 7 completed the 3 group educational sessions and the individual session at the end of the study. At the baseline visit, 6 participants identified feeling tired or washed out, 5 identified motivation and 4 identified pain as barriers to doing PA. PA goals included: going to the gym (treadmill, elliptical, swimming and strength training), doing yoga or Zumba classes. Post-intervention, 4 participants stated an increase in their level of satisfaction with their PA. Fatigue, pain and motivation continued to be barriers to increasing PA. Mean MPAM-R subscale change scores for enjoyment (4.01), social (2.18), and appearance (1.56), all increased post-intervention, while change scores for competence (-0.48) and fitness (-0.57) remained relatively the same.

Conclusion: Fatigue, pain and motivation appear to be the most common barriers to increasing PA in this pilot study. Enjoyment, appearance and social motives for PA appeared to increase post intervention. A larger clinical trial is needed to confirm these findings.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/barriers-to-improving-physical-activity-in-patients-with-systemic-lupus-erythematosus-the-activity-and-nutrition-trial-in-lupus-to-energize-and-renew-antler-pilot-study/