title: Perceptions of issues relating to exercise and joint health in rheumatoid arthritis: a UK-based questionnaire study.
abstract: OBJECTIVE
  This questionnaire study investigated the perceptions of rheumatoid arthritis (RA) patients across the UK in relation to exercise and joint health. The validity of the measure was also assessed.
  
  
  METHODS
  Members of the National Rheumatoid Arthritis Society (NRAS) with self-reported RA completed the questionnaire online. Items related to five factors that emerged from previous qualitative research. Participants responded using a five-point Likert-style scale (strongly disagree to strongly agree). The International Physical Activity Questionnaire (IPAQ) assessed physical activity. The model was tested using confirmatory factor analysis (LISREL 8.8); statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS).
  
  
  RESULTS
  A total of 247 responses were collected over 47 days (88% females; age: 18-77 years; disease duration: <1-51 years). Acceptable factorial validity was revealed (Satorra-Bentler χ(2)  = 774.47, df = 454, p < 0.001, root mean squared error of approximation (RMSEA) = 0.05, 90% confidence interval RMSEA = 0.05-0.06, comparative fit index = 0.94, standardized root mean square residual = 0.09), with the following factor endorsements: 'Health professionals show exercise knowledge' (19%); 'Knowing what exercise should be done' (43%); 'Having to exercise because it is helpful' (72%); 'Worry about causing harm to joints' (44%); and 'Not wanting to exercise as joints hurt' (52%). Patient concerns about joint pain, joint harm and how to exercise were significantly associated with lower physical activity (p < 0.05).
  
  
  CONCLUSIONS
  These results confirm that patients perceive exercise as beneficial. However, concerns about how to exercise, joint pain, causing harm to joints and a perceived lack of exercise knowledge among health professionals remain. Addressing these concerns may have implications for increasing physical activity within the RA population.
authors.affiliation: Bangor University, Bangor, UK. rlaw@uclan.ac.uk
authors.forename: Rebecca-Jane
authors.initials: RJ
authors.lastname: Law
authors.forename: David A
authors.initials: DA
authors.lastname: Markland
authors.forename: Jeremy G
authors.initials: JG
authors.lastname: Jones
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Maddison
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Thom
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000503:physiopathology / Q000523:psychology*; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010465:Perception; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards; D006113:United Kingdom; D055815:Young Adult
keywords: Rheumatoid arthritis; exercise; joint health; questionnaire