P036 Missing vital steps: why does my rheumatology team never speak to me about exercise?
Authors: Bosworth Ailsa M , Gregory William J 
Published: April 2024

Abstract

Background/Aims
UK Rheumatology services are stretched. Rollout of Patient Initiated Follow Up and pressure on job plans/clinic templates mean people with inflammatory arthritis (IA) may spend less time with their rheumatology team. An important but insufficient aspect of care in people with IA is empowering them to acquire good understanding of their disease and building their ability to deal effectively with the practical, physical and psychological impacts of it. Ability to self-manage in IA represents an essential component of care beyond drug therapy, but barriers to implementation of education in self-management exist. Surveys show that rheumatology Healthcare Practitioners (HCPs) don’t know how best to support patients becoming more physically active. Research demonstrates that people with IA have multiple barriers to undertaking regular physical activity (PA) or exercise, including physical limitations, reduced mobility, fatigue, also lack of confidence and not knowing what to do, fear of embarrassment, injury or making symptoms worse, a lack of professional input, advice and resources, inaccessible facilities and financial costs.

Methods
To address these issues in those living with IA, the National Rheumatoid Arthritis Society (NRAS) collaborated with experts in PA and exercise to create a module on this topic to include in their e-Learning programme, SMILE-RA. The module included: • science behind the research in lay terms • role of physiotherapists (both specialist rheumatology physios and community-based physios) • barriers and facilitators to exercising • goal setting • types of exercise • stories from people with RA inspired by exercise NRAS wanted to provide free resources for people to use who may struggle with exercise due to loss of mobility/function who may lack confidence to exercise. In addition to the online learning, NRAS approached experts in different exercise and PA fields, some of whom had RA themselves, to provide supplemental 15-minute video sessions to run alongside the module.

Results
The Module launched end of June 2023 with five 15 minute ‘taster’ videos on different forms of exercise appropriately adapted for a broad spectrum of people with IA. These taster sessions can be done safely, seated or standing, and used as ad hoc routines or as regular daily workout, increasing the repetitions as strength and ability increases. Over 3,500 people are registered to SMILE-RA, and, amongst other beneficial results, a survey has shown that 84% of users would recommend SMILE to another person. An HCP, in recommending this resource to colleagues, stated that this exercise module “will revolutionise your consults on exercise in RA.”

Conclusion
The “PA and Exercise” module can be used to support busy rheumatology professionals by recommending this free resource to their patients and in educating themselves to gain confidence in how to advise patients in this crucial and often overlooked area.

Disclosure
A.M. Bosworth: None. W.J. Gregory: Honoraria; W.G. has received honoraria for speakers and advisory board roles from Abbive, Novartis, Pfizer and UCB.