Facilitators influencing participation in digitally-based high-intensity interval training among individuals with axial spondyloarthritis - a qualitative study

Background: Physical exercise is part of the recommended treatment for individuals with axial spondyloarthritis (axSpA). High-intensity interval training (HIIT) is an effective way to improve cardiovascular health without risk of increased disease activity. Nevertheless, there is a lack of knowledge regarding facilitating factors for digitally-based HIIT among individuals with axSpA. Objective: This study aimed to explore facilitators influencing participation in a twelve-week digitally-based HIIT intervention among individuals with axSpA. Methods: Individuals with axSpA (9 females/7 males) were recruited from the intervention group of a randomized controlled trial. The intervention included three high-intensity training sessions, two of which would be interval training, weekly for twelve weeks with digitally-based coaching by a physiotherapist. Individual semi-structured interviews were conducted with the participants after completing the intervention. At baseline, the median (min-max) age was 47 (28–65), disease activity (BASDAI) was 2.6 (0.2–5.5) and aerobic capacity was 31 ml O2/kg/min (24–54). A qualitative content analysis was used to bring out manifest content from the interviews. The analysis revealed three categories and eight sub-categories. Results: The participants described that HIIT was facilitated by intervention design, encouragement, and feelings of well-being. The intervention design facilitated HIIT to be feasible to perform, adaptable to everyday life, and by use of digital tools. The importance of inner drive, need for individual coaching, and support of social networks were highlighted as keys for encouragement. Feelings of well-being facilitated HIIT through perceived health effects and improved self-efficacy. Conclusion: A self-managed digitally-based HIIT intervention coached by a physiotherapist but performed outside the healthcare settings could be used as an additional non-pharmacological treatment for individuals with axSpA. Trial registration: Not applicable.