Physiotherapist Supervision

Individual guidance from a physiotherapist with rheumatology expertise was essential to patients' willingness to exercise at high intensity. Patients felt safe exercising at high intensity because physiotherapists could tailor the programme to current symptoms and flare-ups in real time. The study recommends follow-up physiotherapy appointments after the supervised period be routinely offered and framed as clinically purposeful—equivalent to physician medication reviews. Patients who were unaccustomed to exercise sometimes found elevated heart rate and sweating uncomfortable and needed physiotherapist reassurance that they were exercising correctly.