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Health Professionals' Perceptions of the Effects of Exercise on Joint Health in Rheumatoid Arthritis Patients

Jones, Jeremy G.; Markland, David A.; Maddison, Peter J.; Thom, Jeanette M.; Jones, Jeremy; Markland, David; Halls, Serena; Maddison, Peter; Law, Rebecca Jane; Thom, Jeanette


Jeremy G. Jones

David A. Markland

Peter J. Maddison

Jeanette M. Thom

Jeremy Jones

David Markland

Peter Maddison

Rebecca Jane Law

Jeanette Thom


Copyright © 2016 John Wiley & Sons, Ltd. Objectives: Although exercise is an important factor in the management of rheumatoid arthritis (RA), research indicates that patients perceive that health professionals (HPs) are uncertain about the place of exercise in treatment and its relationship with joint damage. The present study investigated the perceptions of HPs regarding the effects of exercise on joint health in RA patients. Methods: A questionnaire investigating perceptions of exercise and joint health was distributed via professional networks and websites. Confirmatory factor analysis (CFA) was used to analyse questionnaire data and develop a focus group interview guide. Focus groups were conducted with multidisciplinary teams (MDTs) of rheumatology HPs and analysed using framework analysis. Results: A total of 137 rheumatology HPs (95 female; 27–65 years of age) completed questionnaires. CFA showed that a four-factor model provided a marginally acceptable fit. Analysis of four focus groups (n = 24; 19 female; 30–60 years of age) identified five themes relating to HPs' perceptions of exercise and joint health in RA patients: ‘Exercise is beneficial’, ‘Concerns about damage to joints’, ‘Patients have barriers to exercise’, ‘HP knowledge differs’ and ‘Patients may think service delivery is vague’. Conclusions: HPs were highly aware of the benefits and importance of exercise for RA patients. However, to remove the patient perception that HPs lack certainty and clarity regarding exercise it is important to ensure: (i) consistent promotion of exercise across the whole MDT; (ii) clear provision of information regarding rest, joint protection and exercise; (iii) HP education to ensure consistent, accurate knowledge, and understanding of the potential for conflicting advice when promoting exercise as part of an MDT. Copy © 2016 John Wiley & Sons, Ltd.


Thom, J. M., Maddison, P. J., Markland, D. A., Jones, J. G., Halls, S., Law, R. J., …Thom, J. (2017). Health Professionals' Perceptions of the Effects of Exercise on Joint Health in Rheumatoid Arthritis Patients. Musculoskeletal Care, 15(3), 196-209.

Journal Article Type Article
Acceptance Date Jun 4, 2016
Online Publication Date Oct 6, 2016
Publication Date Sep 1, 2017
Journal Musculoskeletal Care
Print ISSN 1478-2189
Electronic ISSN 1557-0681
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 15
Issue 3
Pages 196-209
Keywords exercise, rheumatoid arthritis
Public URL
Publisher URL
Additional Information This is the peer reviewed version of the following article: Halls, S., Law, R.-J., Jones, J., Markland, D., Maddison, P. and Thom, J. (2016) Health professionals’ perceptions of the effects of exercise on joint health in rheumatoid arthritis patients. Musculoskeletal Care. ISSN 1478-2189, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.


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