FRI0700-HPR LESSONS LEARNED FROM PILOT IMPLEMENTATION OF PHYSICAL ACTIVITY RECOMMENDATIONS IN AXSPA EXERCISE GROUP THERAPY – LESS MAY BE MORE

Abstract

Background: The Ankylosing Spondylitis Association of Switzerland (SVMB) offers 68 exercise groups (EG) for people with axial Spondyloarthritis (axSpA). Participants exercise weekly with focus on strength and flexibility supervised by a physiotherapist (PT). Given the EULAR physical activity (PA) recommendations [1] and recent research [2, 3], the SVMB aims to further develop the concept of their EG by introducing: a) exercises in all dimensions, cardiorespiratory fitness, muscle strength, flexibility and neuromotor performance, according to the general PA recommendations [4]; b) individual exercise-coaching (three sessions in first six months) by the group PT, specifically trained in communication and action planning skills to support individual exercising, and c) bi-annual fitness- assessments for all exercise dimensions. Objectives: To evaluate the new EG concept among the participating people with axSpA and PTs across four pilot groups. Methods: After six months, a survey on the perception and satisfaction towards the new EG concept was sent to 30 people with axSpA, who rated the questions on a 0-10 numeric rating scale (0=not satisfied, 10=very satisfied). Semi-structured telephone-interviews were conducted with the PTs to explore their experiences with the new GE concept. Results: People with axSpA: The survey's response rate was 83% (25/30); of these, 15 (62%) participants were satisfied with the concept (mean 6.7 ±2.23) and 20 (80%) with the exercise-coaching (mean 7.7±2.92). 22 (88%) individuals defined a training goal and 15 (60%) achieved it. The exercise diary was used by 16 (64%) participants, five reported appbased. Reasons for not using the diary were the daily effort and problems with correctly allocating activities to exercise dimensions. A minority (n=7, 28%) reported to use a technical device for cardiovascular exercising. 17 (68%) were satisfied with the fitness-assessment (mean 7.5±1.78). PTs perceived the exercise-coaching as very useful for supporting individualised exercising. However, they emphasised that the frequency of the sessions should be flexibly based on the participant's individual training goal and motivation. The PTs perceived controversial reactions to the fitness- assessments: increased but also decreased motivation towards exercising. Conclusion: Exercise-coaching and fitness-assessments were generally appreciated; however, the frequency was perceived as too high. The GE concept will be adapted accordingly to improve feasibility for national implementation: the exercise-coachings will be reduced to two in the first six months, the first one compulsory for all participants, then bi-annually, according to individual needs and training goals. The fitness-assessments will take place annually instead of bi-annually. There is a need for easyto- use exercise diaries, covering all exercise dimensions.