Fitness Maintenance

Maintenance-phase activity produces progressive fitness gains rather than simply holding current fitness levels steady. Fifteen of 20 interviewed patients continued exercising independently after the supervised programme ended; five did not. Patients who maintained exercise framed it as equivalent to DMARD medication—requiring consistent performance to prevent disease progression. After an intensive training phase, the focus shifts to maintaining achieved fitness levels through a less demanding but consistent routine. Once the supervised external structure ended, the barrier to restarting exercise became too high for those who stopped. Structural barriers including work stress, long working hours, financial concerns about gym membership, and discomfort with gym culture contributed to dropout. Negative associations with exercise from childhood physical education resurfaced in patients who had to exercise alone, without the safety of the supervised group. Patients who struggled to complete the once-weekly non-supervised session during the intervention were more likely to stop exercising after it ended. Patients who maintained exercise requested periodic physiotherapy follow-up visit…