Rheumatology Practitioners' View of Exercise in Adults With Systemic Sclerosis or Systemic Lupus Erythematosus

Background Exercise is part of the general recommendations for care of people with most arthropathies or connective tissue diseases, but it does not feature specifically in the clinical guidelines for management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) by rheumatology practitioners. In this study, we sought to explore rheumatologists' (RHs') and rheumatology nurses' (RNs') perspectives and use of exercise interventions for adults with SLE or SSc. Methods Semistructured interviews were conducted with Australian RHs and RNs online using Zoom (video conferencing software). Interviews were transcribed verbatim, then coded and analyzed using NVivo for content analysis of themes. Results Seventeen participants completed the interviews (RHs n = 12, RNs n = 5). Five themes were identified: rheumatology practitioners perceive that (1) exercise is beneficial for adults with SLE or SSc, especially in managing fatigue, pain, and wellbeing; (2) exercise presents some general, structural, and disease-related barriers for adults with SLE or SSc; (3) rheumatology practitioners are confident in providing general exercise advice but lack time and confidence in prescribing exercise; (4) rheumatology practitioners' concerns about exercise are limited to those with heart and lung disease, inflamed joints, ulcerated fingertips, and severe contractures; and (5) to facilitate safe and attainable exercise, rheumatology practitioners recommend long-term, supervised, gradual, and affordable exercise options. There were no clear differences identified between the views of RNs and RHs. Conclusion Rheumatology practitioners require information and options for long-term and affordable exercise for adults with SLE or SSc that are supervised, individualized, and focus on a gradual progressive approach.