"My arthritis is flared and I can't exercise...or maybe I can...": Is self-regulatory efficacy to overcome flare barriers predictive of exercise?

Résumé

Adults with arthritis struggle to adhere to evidence-based exercise recommendations for disease self-management (150+ minutes/week of moderate-vigorous intensity). Calls to understand theory-based psychosocial factors important for adherence have been under-investigated. According to social cognitive theory, self-regulatory efficacy (SRE) to overcome challenging barriers may be associated with adherence. Adults often report that being in an arthritis flare, which involves increases in usual arthritis symptoms (e.g., pain, tiredness), is a challenge to regular exercise. However, no research has examined associations between SRE to overcome flare barriers (SRE-flare) and exercise. Study purposes were to: (1) Examine whether SRE-flare predicted moderate-vigorous exercise, after controlling for arthritis flares and (2) Determine if participants who met exercise recommendations (150+ minutes/week) differed from those who did not (<150 minutes/week) in flares and SRE-flare. Ninety adults (M_age = 49.36 ±16.38 years) with self-reported medically diagnosed arthritis responded to an online survey that assessed SRE-flare, prior two-week exercise and flare experiences (yes/no). A hierarchical multiple regression analysis to predict exercise from flares (step 1) and SRE-flare (step 2) was significant (R² adjusted=.14, p<.01). SRE-flare was the lone significant predictor (R² change=0.11, standardized β=.35, p<0.01). Chi-square analysis comparing those who met exercise recommendations (n=37) to those who did not (n=53) in flares was not significant. However, a t-test comparing the two exercise groups in SRE-flare was significant. Those who met recommendations reported significantly higher SRE-flare than those not meeting recommendations (6.64±1.71 versus 5.35±2.00, p<.01). Findings demonstrate the potential importance of having higher SRE-flare beliefs to help adults overcome the challenge of being in an arthritis flare and continue to exercise. Future research should determine if a causal relationship exists between SRE-flare and exercise. If affirmed, social cognitive theory-based interventions to enhance SRE-flare may promote better arthritis self-management through exercise adherence.

Acknowledgments: Funded by a grant provided by the Canadian Institutes of Health Research (CIHR) Regional Partnership Program with the Saskatchewan Health Research Foundation (SHRF)