Table 2 Content of the different treatment modalities

Exercise therapy including a personal physical activity plan

A personalized exercise therapy plan will be formulated, based on current physiotherapy guidelines for RA [33] and recommendations for axSpA [34] and consists of guided PT and formulating a personal physical activity plan. The guided exercise therapy will specifically target the work-related problems identified in step 1 and 2 and aims at modifiable factors for physical fitness (strength, aerobic capacity, mobility), of which improvements have been linked to improved work ability [44, 45]. If indicated by the PT and agreed upon by the participant a behavioral graded activity approach is included [46]. The personalized physical activity plan will be jointly developed by the PT and participant and aims to integrate physical activity into the participants’ daily life in a sustainable way

Education and self-management support

Personalized information (written and oral) on self-management strategies will be provided, focusing on work-related problems for people with RA/axSpA (i.e., balance between load and capacity at work, coping with fatigue/pain/energy level, discussing work disability with colleagues) and personal barriers and facilitators

‘Work-roadmap’

The work-roadmap guides the participant in when and how to get the necessary support from different (occupational) healthcare professionals. A step-by-step roadmap is used and tailored for the individual participant, based on the individuals’ work context and their work-related limitations in physical functioning as determined in the screening process. The PT will act as a coach to support the participant in taking actions as described in the roadmap

Optionally (if considered beneficial by PT and agreed by the participant)

An online self-management course

To further optimize self-management and empowerment skills specifically focusing on work. This course is paid from the study budget and consists of two 1,5 h online sessions. The course is organized in groups of four to six participants of the intervention arm and is supervised by an experienced coach in rheumatic diseases and work-related problems (www.annemiekdecrom.nl)

A workplace examination

PT visiting the workplace or by pictures/video of the participant working at the workplace. Targeting necessary adaptations at the workplace and/or (help with preparing) a dialogue between employee and supervisor or colleagues to facilitate possible work adaptations and acceptance from the supervisor and colleagues [46]