Unique Barriers for Adults with Arthritis
So why is this recommended intervention—physical activity—so underutilized by adults with arthritis? A large part of the answer lies in the array of arthritis-specific barriers adults with arthritis face, compounded by barriers present in their physical and social environments. These barriers are both perceived and objective. Understanding these barriers can help shape new environmental and policy strategies specific to adults with arthritis or identify existing strategies that might be adapted.
Below is a list of common barriers to physical activity for adults with arthritis (some of the barriers listed are arthritis specific, while others are barriers that anyone would experience) (Brittain et al, 2011; Gyurcsik et al, 2009;Der Ananian et al, 2006; Wilcox et al., 2006; Rimmer et al, 2004; Rimmer et al, 2005):
Physical barriers such as pain and fatigue, lack of mobility, or comorbid conditions.
- Pain – including occurrence of pain preventing exercise, pain experienced during exercise, and pain experienced after exercise
- Fatigue – including fatigue related to medication, insomnia, and depression
- Mobility – impaired mobility is a major challenge to exercise
- Comorbid conditions – including conditions ranging from musculoskeletal to cardiovascular ailments
Psychological barriers related to attitudes, beliefs, and fears.
- Attitudes and beliefs – including lack of time, motivation, and enjoyment of exercise
- Fear – including fear of experiencing or worsening pain and fear of water preventing participation in water aerobics
- Perceived negative outcomes – including negative outcomes that might result from pushing beyond one’s limits
Social barriers such as lack of family support, no exercise partner, or competing responsibilities of job and family.
- Lack of support – including not having support from family, friends, and health care providers (failure to mention exercise, not referring patients to helpful exercise programs, or not instructing patients how to exercise properly)
- No one to exercise with – without exercise partners, frequency of exercise decreased
- Competing role responsibilities – including feelings of responsibility to one’s family that relate to lack of time
Environmental barriers due to costly fees, no transportation, or lack of safe and accessible exercise sites.
- Lack of programs or facilities – including few programs or facilities that meet specific needs and lack of qualified instructors
- Environmental conditions – including hot and cold weather, rain, congested parking, concrete surfaces, and presence of dogs
- Cost – such as membership fees to local exercise facilities
- Transportation – including lack of transportation to facilities or programs
- Exercise facility barriers – including inaccessible access routes, lack of elevators, slippery floors, absence of hand rails on stairs, lack of adaptive and/or accessible equipment, paying the same membership even though the facility is not fully accessible, and poor equipment maintenance
- Lack of accessibility to parks and recreational centers – due to the challenge of complying with ADA guidelines while preserving the natural surroundings of parks and trails
- Public space barriers – including damaged sidewalks, no sidewalks, terrain too steep a grade or slope, unsafe neighborhoods, poor weather causing slippery or impassible sidewalks, insufficient number of benches along a trail for people who need frequent rest periods, and poorly designated signage.
To learn more
For more detail on barriers, visit Additional Resources or read the following articles—
General and arthritis-specific barriers to moderate physical activity in women with arthritis. Womens Health Issues. 2011 Jan-Feb
Factors that influence exercise among adults with arthritis in three activity levels. Prev Chronic Dis. 2006 Jul