Clinical Scorecard: Investigation of National-Specific Challenges and Supportive Factors for Adopting Physical Activity Based on EULAR Guidelines in Individuals with Rheumatic Musculoskeletal Disorders Across Four European Nations: The COPA Initiative

At a Glance

Key Highlights

• Physical activity is a safe and effective component of disease management for RMDs but adherence remains insufficient.
• Barriers and facilitators to physical activity include personal factors (pain, fatigue, psychological distress) and extra-personal factors (social, environmental, system-level).
• The COPA-BFQ questionnaire was developed to systematically assess country-specific social, environmental, and system-level determinants influencing physical activity in RMD populations.

Guideline-Based Recommendations

Diagnosis

• Assess physical activity levels and barriers/facilitators in individuals with RMDs using validated or newly developed tools such as COPA-BFQ.

Management

• Promote physical activity as an essential part of RMD management according to EULAR recommendations.
• Address both personal and extra-personal barriers to improve physical activity adherence.
• Tailor interventions to country-specific social, environmental, and systemic contexts.

Monitoring & Follow-up

• Regularly evaluate physical activity participation and perceived barriers/facilitators to adapt support strategies.

Risks

• Consider disease-specific symptoms such as pain and fatigue that may limit physical activity participation.
• Monitor for psychological distress or fear of symptom exacerbation that may act as barriers.

Patient & Prescribing Data

Individuals with rheumatoid arthritis, axial spondyloarthritis, and osteoarthritis from four European countries

Physical activity is underutilized despite benefits; country-specific social and systemic factors influence adherence and should be considered in prescribing physical activity.

Clinical Best Practices

• Use comprehensive assessment tools that include social, environmental, and system-level factors to identify barriers and facilitators to physical activity.
• Engage multidisciplinary teams including rheumatologists, physical therapists, and patient input to tailor physical activity promotion.
• Implement culturally and linguistically adapted interventions based on country-specific determinants.
• Incorporate patient education addressing fears and misconceptions about physical activity safety in RMDs.

References

• EULAR Recommendations for Physical Activity in RMDs
• Theoretical Domains Framework (TDF)
• COPA-BFQ Questionnaire Development and Validation