Barriers and motivations to exercise participation among women with severe systemic lupus erythematosus who have recently undergone glucocorticoid pulse therapy: A qualitative analysis

BackgroundPhysical activity is important in the management of systemic lupus erythematosus, yet available evidence indicates that inactivity and poor physical fitness are commonplace. Individuals with SLE, and particularly those whose condition severity warrants aggressive pharmacological treatment such as glucocorticoid pulse therapy, may face substantial barriers to exercise participation. A better understanding of these may be useful to develop targeted and effective exercise recommendations and strategies.PurposeTo explore motivations and barriers for exercise participation in a group of women with SLE who have recently undergone glucocorticoid pulse therapy.MethodsThis is a cross-sectional, exploratory study, whereby participants underwent individually administered semi-structured interviews related to personal motivations and barriers to exercise training. Self-reported well-being and quality of life were assessed using the Systemic Lupus Erythematosus Quality of Life (SLEQOL) and SF-36 questionnaires.ResultsTwenty-three women, with a high median level of disease activity (SLEDAI 8; IQR: 4-12) participated in the study. All participants reported wide-ranging health benefits as a motivation to exercise, but the majority did not exercise. They cited numerous health-related, personal and social barriers to exercise participation. SF-36 results indicated that the group experienced difficulties in participating in work and other regular daily activities.ConclusionAlthough the group recognized the health-related benefits of exercise, this knowledge was insufficient to encourage exercise participation. Exercise professionals must remain cognizant of the wide-ranging health-related, personal and social barriers that may exist for this group, and to consider these when formulating exercise recommendations.