Identifying barriers to exercise

Remaining physically active is important for everyone, but sometimes this is very challenging for the SRUK community. A study set up by the Scleroderma Patient Intervention Network sought to understand what the major barriers and facilitators to exercise are.

The role of physical activity in protecting and improving mental health cannot be understated. A monumental amount of work has gone into understanding how the two are associated and can result in improving overall wellbeing. It is now being widely agreed that exercise can increase our mental alertness, reduce anxiety and increase our self-esteem. This is because exercise leads to the release of endorphins, chemicals which trigger a sense of positivity in the brain, and the release of cortisol, a chemical which helps us manage stress, as well as helping us sleep better.

SRUK is aware that several members of our community face a number of barriers in remaining physically active and in adapting exercises in accordance to how their scleroderma may be limiting movement. It is therefore critical that these barriers are recognized on an individual basis, so as to empower our community to be active in a way that is safe and adjusted to their body's capability.

A multi-centre study was set-up as part of the Scleroderma Patient-centred Intervention Network (SPIN) to identify physical activity barriers and facilitators which may support their attempts. Sessions were held with individuals diagnosed with scleroderma, where they rated the importance of barriers from 0 to 10, as well as the likelihood of using facilitators. At the end of 9 sessions, 20 barriers were defined which fit under 4 key categories: health and medical; social and personal; time, work and lifestyle; environmental. Interestingly, some of the barriers in the health and medical category were the same as those identified in patient groups with other auto-immune conditions, such as fatigue, pain, muscle weakness and reduced mobility. Barriers within the remaining three categories included fear of injury, cost of exercise, and lack of both motivation and time, also identified by the general population and those with other rheumatic conditions. These hurdles are also critical to acknowledge as they illustrate that some are put off by exercise before they have even begun, lack the confidence or do not feel able to access it in the first place.

Facilitators to exercise were all items that are feasible to implement, such as exercise partners, group exercise sessions and support from fitness instructors and healthcare professionals and were similar to those previously identified by both the general population and people with other rheumatic conditions. Promisingly, previous interventions that have employed strategies to overcome recognised barriers and appropriate facilitators have shown to be effective in helping their participants commence an exercise routine. This present study was the first phase of the SPIN – Physical Activity Enhancement Project, set up with the goal of disseminating an online scleroderma-specific intervention to promote and support physical activity. Whilst still in early stages, the findings demonstrate a route for both the patient community and healthcare professionals to address barriers and utilise different approaches to overcome them.

SRUK look forward to providing further updates on how this study is progressing. Research like this is crucial as it provides an opportunity to equip our community with the skills and independence to maintain and improve their quality of life. It also demonstrates the potential in helping people with scleroderma to tailor physical activities according to individual ability and needs. Most people with scleroderma are able to take part in aerobic and resistance exercises safely, but SRUK recommend that if you are changing your exercise regime that you ask your medical team for advice on how to do this safely, as well as potentially a personal trainer. This is because what works for one person may not work for the next, especially as scleroderma can have diverse and severe manifestations. If you have any tips to share about how you overcame any hurdles to exercising, then please do let us know!

If you are interested in helping SRUK fund more work like this, then please visit our donations page here: We rely on the generosity of our community to continue to support groundbreaking research in both scleroderma and Raynaud's.

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