Supervised Intensive Exercise for Strengthening Exercise Health Beliefs in Patients With Axial Spondyloarthritis: A Multicenter Randomized Controlled Trial
Annelie Bilberg, Hanne Dagfinrud, Silje Halvorsen Sveaas
Abstract
OBJECTIVE: To evaluate the effect of a 3-month supervised high-intensity exercise program on exercise health beliefs in patients with axial spondyloarthritis. METHODS: This was secondary analysis of a randomized controlled trial. Participants (ages 23-69 years) were randomized to an exercise group (n = 50) or a control group (n = 50). The intervention was an individually guided cardiorespiratory and strength exercise program performed 2 times per week, plus an additional individual exercise session of personal choice. The control group received standard care and instructions to maintain their physical activity level. Exercise health beliefs using the Exercise Health Beliefs questionnaire (range 20-100, 100 = best), i.e., barriers, benefits, self-efficacy and exercise impact on arthritis, and physical activity, were assessed with self-reported questionnaires at baseline, 3 months, and 12 months after inclusion. RESULTS: The majority of the participants in the exercise group (76%) followed ≥80% of the prescribed exercise protocol. There was a significant effect of the intervention on exercise health beliefs at 3 months (estimated mean group differences 4.0 [95% confidence interval (95% CI) 1.4, 6.6]; P = 0.003) and the effect persisted at 12 months follow-up (estimated mean group differences 3.8 [95% CI 1.0, 6.6]; P = 0.008). Participants with higher exercise health beliefs had a higher odds ratio (1.1 [95% CI 1.0, 1.20]; P = 0.003) for being physically active at 12 months follow-up. CONCLUSION: A supervised high-intensity exercise program had beneficial short- and long-term effects on participants' exercise health beliefs. Stronger exercise health beliefs were positively associated with a higher chance to be physically active on a health-enhancing level at 12 months follow-up.