Systemic sclerosis (SSc) is a connective tissue autoimmune disease that results in significant reduction in physical function and quality of life. Exercise may offer health benefits in people with autoimmune disease, yet approximately 50% of people with SSc are physically inactive and experience a wide array of barriers that may impede their exercise engagement. Currently, there are no exercise recommendations or guidelines for this population. In this qualitative study, we explore and describe barriers and facilitators to exercise in adults with SSc, aiming to provide person-centerd exercise recommendations for people with SSc.


Adults with SSc were purposefully recruited to represent diversity in disease type, duration, and manifestations. Three online focus groups were conducted to explore barriers and facilitators to exercise in people with SSc, transcribed, and thematically analyzed.


Twenty-three adults with SSc (mean age 59 ± 11 years, 91% female) participated. Four themes emerged: (a) disease-related and general barriers to exercise, (b) perceived change in personal exercise capacity postdiagnosis, (c) beneficial effects of exercise, and (d) preference for modified supervised exercise.


SSc imposes disease-related barriers that, combined with general barriers, impede exercise engagement. People with SSc understand that exercise is potentially beneficial. Key recommendations and advice to counter these barriers include (a) ensuring a comfortable temperature to exercise, (b) using modified equipment (e.g., adjustable weighted straps), (c) individually supervising and modifying exercise as required, and (d) keeping people with SSc accountable and motivated to exercise.

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