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Lange E, Gjertsson I, Mannerkorpi K. Long-time follow up of physical activity level among older adults with rheumatoid arthritis. Eur Rev Aging Phys Act 2020; 17:10. [PMID: 32699561 PMCID: PMC7368988 DOI: 10.1186/s11556-020-00242-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/30/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Physical activity and exercise are acknowledged as important parts in the management of rheumatoid arthritis (RA). However, long-term maintenance of exercise is known to be difficult. The aim of this study was to evaluate change in physical activity and physical fitness after four years in older adults with RA who had previously participated in exercise with person-centred guidance compared to controls. METHOD A follow-up study was performed where older adults (> 65 years) who had participated in a randomized controlled trial where they were allocated to either exercise with person-centred guidance or home-based, light-intensity exercise (controls) were invited to one visit and assessed with performance-based test, blood-sampling and self-reported questionnaires. Forty-seven out of 70 older adults accepted participation, 24 from the exercise group and 23 from the control group. Comparisons of the result with baseline values were performed and explanatory factors for increase of physical activity were examined with logistic regression. RESULTS The result show that there was no significant difference in weekly hours of physical activity when groups where compared. However, participants in the exercise group rated significantly increased weekly hours of physical activity after four years (p = 0.004) when compared to baseline. Higher levels of fatigue, BMI and physical activity, at baseline were negatively associated with increased physical activity after four years. There was no significant difference in change of physical fitness between the groups. Within group analysis showed that the control group reported increased pain (p = 0.035), fatigue (p = 0.023) increased number of tender joints (p = 0.028) higher disease activity (p = 0.007) and worsening of global health (p = 0.004) when compared to baseline while the exercise group remained at the same level as at baseline. CONCLUSION These results indicate that introducing moderate- to high intensity exercise with person-centred guidance might favor increased physical activity after four years in older adults with RA. Previous partaking in moderate- to high intensity exercise might also be protective against increased disease activity, pain and fatigue over time.
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Affiliation(s)
- Elvira Lange
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30 Göteborg, Sweden
- University of Gothenburg Center for Person-centred Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gjertsson
- University of Gothenburg Center for Person-centred Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Rheumatology and Inflammation research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kaisa Mannerkorpi
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30 Göteborg, Sweden
- University of Gothenburg Center for Person-centred Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Sahlgrenska University Hospital, Gothenburg, Sweden
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Rhie K, Feger DM, June RR, Sciamanna CN, Banks SE. Determining Rheumatology Patient Interest in a Group Strength Training Program - Results of an Exercise Survey. ACTA ACUST UNITED AC 2019; 5. [PMID: 31328185 PMCID: PMC6641551 DOI: 10.23937/2469-5718/1510121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Exercise has proven benefits in rheumatologic disease including reducing inflammation and improving symptoms. A Group Strength Training (GST) program design has improved adherence to exercise in primary care patients but the effect is unknown in rheumatology patients. We examined the interest of rheumatology patients with different diagnoses and the effect of comorbidities in pursuing an organized GST program. Methods: We conducted a cross-sectional survey of patients from a rheumatology practice in central Pennsylvania in February and April 2017. This survey assessed self-reported interest of patients in a GST program in addition to demographics, comorbidities, and quality of life measures. Primary care data from a previous survey were used for comparative analysis for the primary outcome: interest in a GST program. Results: Fifty percent of rheumatology patients were interested in a GST program and there was no difference of interest compared to primary care patients (X2 = 2.04, p = 0.15). There was no difference in interest in a GST program for rheumatology patients with poor health compared to patients with good health (OR = 0.9, p = 0.8). Female patients were more interested in a group strength training program than male patients (OR = 3.7, p = 0.001). Patients with a BMI of 25–30 (OR = 2.2, p = 0.04) or > 30 (OR = 1.7, p = 0.12) were more interested compared to those with a normal BMI. There was no difference in interest in group strength training regardless of rheumatology diagnosis or comorbidities. Conclusion: Our data suggest that rheumatology patients are interested in a GST program regardless of disease, medical comorbidities, perceived mental or physical health, or education level. Further study is needed to determine the effects of GST on rheumatologic diseases.
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Affiliation(s)
- Kevin Rhie
- Department of Internal Medicine, Penn State Health, USA
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Flaherty LM, Schoeppe J, Kruse‐Jarres R, Konkle BA. Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study. Res Pract Thromb Haemost 2018; 2:147-154. [PMID: 30046715 PMCID: PMC6055559 DOI: 10.1002/rth2.12060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/12/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Prior research has established that falls are commonplace in adults with hemophilia, and advises that physical therapy and exercise are successful in fall prevention. Recognizing obstacles and catalysts to physical therapy and exercise in people with hemophilia may augment the efficacy of efforts to prevent falls in this population. OBJECTIVES To learn about the experiences and ideas of patients with hemophilia, especially associated with balance, falls, and exercise. METHODS Semi-structured interviews with 14 adult patients with hemophilia were performed. The interviews were coded for themes founded on the study aims. RESULTS Most subjects described difficulty with balance, often ascribed to joint problems. They believed that staying strong and fit could positively influence balance, but expressed concerns and fear related to falling. Those who exercised regularly did not view exercise as hazardous, while those who did not dependably exercise articulated worry that dangers of exercise may offset the benefits. The most common obstacle to exercise was pain and having someone to exercise with was often described as an enabler. Barriers to partaking in physical therapy included weak proof of its success and distrust in the therapist. Positive physical therapy experiences in the past and the connection with the therapist were reported as facilitators. CONCLUSIONS People with hemophilia describe some attitudes and experiences that are unique to hemophilia while others are found in the general population. Attending to fear, pain, and support for interventions, while encouraging a robust therapeutic alliance and a plan for routine exercise may aid fall prevention behaviors.
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Affiliation(s)
| | - Jennie Schoeppe
- Health Research InstituteKaiser Permanente Washington Health Research InstituteSeattleWAUSA
| | - Rebecca Kruse‐Jarres
- Washington Center for Bleeding DisordersBloodworks NorthwestSeattleWAUSA
- Division of HematologyUniversity of WashingtonSeattleWAUSA
| | - Barbara A. Konkle
- Washington Center for Bleeding DisordersBloodworks NorthwestSeattleWAUSA
- Division of HematologyUniversity of WashingtonSeattleWAUSA
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Duarte N, Rodrigues AM, Branco JDC, Canhão H, Hughes SL, Paúl C. Health and Lifestyles Factors Associated With Osteoarthritis among Older Adults in Portugal. Front Med (Lausanne) 2017; 4:192. [PMID: 29167793 PMCID: PMC5682311 DOI: 10.3389/fmed.2017.00192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 10/24/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to identify independent associations of sociodemographic, functionality, physical activity, physical and mental health, and osteoarthritis (OA), among older adults. METHODS A sample of 1,645 older adults (50+ years) observed by rheumatologists, from EpiReumaPt, a population-based study was analyzed. A structured interview included sociodemographic data, chronic non-communicable disease, and physical activity. Functional ability was assessed by the Health Assessment Questionnaire Disability Index; depression and anxiety were assessed by Hospital Anxiety and Depression Scale. OA (knee OA and/or hip OA and/or hand OA) was defined after medical evaluation by rheumatologists according to expert opinion combined with the fulfillment of the American College of Rheumatology classification criteria. RESULTS 1,059 participants (64.9%) met the OA classification criteria. Statistically significant differences were found between persons with and without OA in all sociodemographic variables, non-communicable diseases, functional status, physical activity, depression, and anxiety. In the unadjusted logistic regression models, all variables were associated with OA. The final adjusted model explained 32% of the variance. Those who are female with higher age, have more than five comorbidities, and lower levels of function and physical activity were more likely to meet the criteria for a diagnosis of OA. DISCUSSION We have analyzed data from a population-based study and found that a diagnosis of OA was independently associated with age, female gender, higher number of comorbidities, physical disability, and low levels of physical activity. These results reinforce the usefulness of the development of a multidimensional assessment to design and test effective interventions for this population.
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Affiliation(s)
- Natália Duarte
- Research Unit on Ageing, Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), University of Porto, Porto, Portugal
| | - Ana Maria Rodrigues
- EpiReumaPt Study Group—Sociedade Portuguesa de Reumatologia, Lisboa, Portugal
- EpiDoc Unit—Unidade de Epidemiologia em Doenças Crónicas (CEDOC, NMS/UNL), Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Jaime Da Cunha Branco
- EpiReumaPt Study Group—Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Centro Hospitalar Lisboa Ocidental (CHLO-EPE), Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
| | - Helena Canhão
- EpiReumaPt Study Group—Centro de Estudos de Doenças Crónicas (CEDOC), EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Escola Nacional de Saúde Publica, Universidade Nova de Lisboa, Sociedade Portuguesa de Reumatologia, Serviço de Reumatologia do Hospital de Santa Maria, Centro Hospitalar Lisboa Norte (CHLN-EPE), Lisboa, Portugal
| | - Susan L. Hughes
- Community Health Sciences, School of Public Health, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL, United States
| | - Constança Paúl
- Research Unit on Ageing, Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), University of Porto, Porto, Portugal
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Quicke JG, Foster NE, Ogollah RO, Croft PR, Holden MA. Relationship Between Attitudes and Beliefs and Physical Activity in Older Adults With Knee Pain: Secondary Analysis of a Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2017; 69:1192-1200. [PMID: 27696795 PMCID: PMC5601293 DOI: 10.1002/acr.23104] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/19/2016] [Accepted: 09/27/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA). METHODS We conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross-sectional and longitudinal associations between baseline Self-Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self-report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6-month followup) were investigated using multiple linear and logistic regression. RESULTS Cross-sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found. CONCLUSION Greater exercise self-efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity.
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Affiliation(s)
- Jonathan G Quicke
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Nadine E Foster
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Reuben O Ogollah
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Peter R Croft
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Melanie A Holden
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
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6
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Factors influencing adherence among older people with osteoarthritis. Clin Rheumatol 2015; 35:2283-91. [DOI: 10.1007/s10067-015-3141-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/18/2015] [Accepted: 11/28/2015] [Indexed: 10/22/2022]
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7
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O'Donovan R, Kennedy N. “Four legs instead of two” – perspectives on a Nordic walking-based walking programme among people with arthritis. Disabil Rehabil 2014; 37:1635-42. [DOI: 10.3109/09638288.2014.972591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Peeters GMEEG, Brown WJ, Burton NW. Psychosocial factors associated with increased physical activity in insufficiently active adults with arthritis. J Sci Med Sport 2014; 18:558-64. [PMID: 25174532 DOI: 10.1016/j.jsams.2014.08.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 06/30/2014] [Accepted: 08/08/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Although physical activity can potentially reduce symptoms of arthritis, 50% of people with arthritis are insufficiently active. The aim was to identify psychosocial factors associated with increased physical activity in mid-age adults with arthritis who did not meet recommended physical activity levels. DESIGN Longitudinal cohort study. METHODS Data were from 692 insufficiently active men and women (mean age 55 ± 6.6 years) with arthritis, who answered mailed surveys in 2007 and 2009 in the HABITAT study. Increased physical activity was defined as a change of ≥ 200 MET min/week in walking, moderate and vigorous activities from 2007 to 2009. Scale scores were used to measure psychosocial factors including intention, experiences, attitudes, efficacy, barriers, motivation, social support, and health professional advice. Associations between (1) 2007 psychosocial factors and (2) 2007-2009 improvement (≥ +1 standard deviation) in psychosocial factors and increased physical activity were examined with logistic regression models. Results were adjusted for education, body mass index, and self-rated health. RESULTS Between 2007 and 2009, 296 participants (42.8%) increased their physical activity. Engagement, mastery and physical activity intention in 2007 were associated with this increase in physical activity (engagement OR = 1.11, 99% confidence interval (CI) = 1.05-1.17; mastery OR = 1.12, 99%CI = 1.02-1.22; physical activity intention OR = 1.29, 99%CI = 1.06-1.56). Improved scores for encouragement (OR = 2.07, CI = 1.07-4.01) and self-efficacy (OR =2 .27, CI = 1.30-3.97) were also significantly associated with increased physical activity. CONCLUSIONS Positive physical activity experiences and intentions were predictors of increased physical activity among people with arthritis. Improved physical activity confidence and social support were associated with increased physical activity. It is important to consider these psychosocial factors when planning physical activity interventions for people with arthritis.
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Affiliation(s)
- G M E E Geeske Peeters
- The University of Queensland, School of Human Movement Studies, Australia; The University of Queensland, School of Population Health, Australia.
| | - Wendy J Brown
- The University of Queensland, School of Human Movement Studies, Australia
| | - Nicola W Burton
- The University of Queensland, School of Human Movement Studies, Australia
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Marks R. Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care. Health Psychol Open 2014; 1:2055102914564582. [PMID: 28070346 PMCID: PMC5193269 DOI: 10.1177/2055102914564582] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Self-efficacy, denoting the degree of confidence an individual has in carrying out a specific activity, was initially discussed in the 1970s as a potential correlate of disease outcomes. Drawn from 35 years of related research, this review provides an updated understanding of the concept of self-efficacy and its relevance for arthritis management. There is a consistent link between self-efficacy, arthritis pain and disability, and adherence to recommended therapeutic strategies. A wide variety of intervention strategies improve arthritis self-efficacy, as well as outcomes. Steps to assess and intervene thoughtfully to maximize self-efficacy beliefs are likely to impact arthritis disability outcomes quite favorably and significantly, regardless of disease type, duration, or sociodemographic factors.
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Affiliation(s)
- Ray Marks
- The City University of New York, USA; Columbia University, USA
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10
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Theis KA, Helmick CG, Hootman JM, Barbour KE. Physical activity among adults with arthritis. Prev Chronic Dis 2014; 11:E23. [PMID: 24556249 PMCID: PMC3938955 DOI: 10.5888/pcd11.140025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Kristina A Theis
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
| | - Charles G Helmick
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
| | - Jennifer M Hootman
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
| | - Kamil E Barbour
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
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Loeppenthin K, Esbensen BA, Ostergaard M, Jennum P, Thomsen T, Midtgaard J. Physical activity maintenance in patients with rheumatoid arthritis: a qualitative study. Clin Rehabil 2013; 28:289-99. [DOI: 10.1177/0269215513501526] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: To describe the experience of physical activity maintenance in patients with rheumatoid arthritis. Design: A qualitative salutogenic-oriented interview study. Setting: A rheumatology outpatient clinic. Subjects: A purposive sample of 16 physically active patients (mean age 50, range 37–67) diagnosed with rheumatoid arthritis on average 21 years previously (range 4–46 years). Methods: In-depth interviews were conducted using a semi-structured interview guide to illuminate how the phenomenon ‘physical activity maintenance’ was experienced by patients with rheumatoid arthritis. The interviews were analysed using systematic text condensation, inspired by Giorgi’s descriptive phenomenological methodology. Results: The analysis revealed three categories: (1) knowing and enjoying the body; (2) responsibility and challenges; (3) autonomy and social belonging. On the basis of these categories, the essential meaning of the phenomenon of physical activity maintenance for patients with rheumatoid arthritis was summarized into ‘striving for a transparent body and participation’, pointing to experiences of sensations of wellbeing, liberation from restrictions and social participation on equal terms with non-arthritis populations. Conclusion: This study demonstrates that physical activity in patients with rheumatoid arthritis may be understood as a resource to resist disability and to feel and stay healthy while creating and sustaining meaningfulness in life.
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Affiliation(s)
- K Loeppenthin
- Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Denmark
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
| | - BA Esbensen
- Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Denmark
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
- Department of Public Health, University of Copenhagen, Denmark
| | - M Ostergaard
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - P Jennum
- Department of Clinical Medicine, University of Copenhagen, Denmark
- Danish Centre for Sleep Medicine, Glostrup Hospital, Copenhagen University, Denmark
| | - T Thomsen
- Research Unit of Nursing and Health Science, Glostrup Hospital, Copenhagen University, Denmark
- Centre for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen University, Denmark
| | - J Midtgaard
- Department of Clinical Medicine, University of Copenhagen, Denmark
- University Hospitals Centre for Health Care Research, Rigshospitalet, Denmark
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Law RJ, Markland DA, Jones JG, Maddison PJ, Thom JM. Perceptions of issues relating to exercise and joint health in rheumatoid arthritis: a UK-based questionnaire study. Musculoskeletal Care 2012; 11:147-58. [PMID: 23125122 DOI: 10.1002/msc.1037] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This questionnaire study investigated the perceptions of rheumatoid arthritis (RA) patients across the UK in relation to exercise and joint health. The validity of the measure was also assessed. METHODS Members of the National Rheumatoid Arthritis Society (NRAS) with self-reported RA completed the questionnaire online. Items related to five factors that emerged from previous qualitative research. Participants responded using a five-point Likert-style scale (strongly disagree to strongly agree). The International Physical Activity Questionnaire (IPAQ) assessed physical activity. The model was tested using confirmatory factor analysis (LISREL 8.8); statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS). RESULTS A total of 247 responses were collected over 47 days (88% females; age: 18-77 years; disease duration: <1-51 years). Acceptable factorial validity was revealed (Satorra-Bentler χ(2) = 774.47, df = 454, p < 0.001, root mean squared error of approximation (RMSEA) = 0.05, 90% confidence interval RMSEA = 0.05-0.06, comparative fit index = 0.94, standardized root mean square residual = 0.09), with the following factor endorsements: 'Health professionals show exercise knowledge' (19%); 'Knowing what exercise should be done' (43%); 'Having to exercise because it is helpful' (72%); 'Worry about causing harm to joints' (44%); and 'Not wanting to exercise as joints hurt' (52%). Patient concerns about joint pain, joint harm and how to exercise were significantly associated with lower physical activity (p < 0.05). CONCLUSIONS These results confirm that patients perceive exercise as beneficial. However, concerns about how to exercise, joint pain, causing harm to joints and a perceived lack of exercise knowledge among health professionals remain. Addressing these concerns may have implications for increasing physical activity within the RA population.
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Cooney JK, Law RJ, Matschke V, Lemmey AB, Moore JP, Ahmad Y, Jones JG, Maddison P, Thom JM. Benefits of exercise in rheumatoid arthritis. J Aging Res 2011; 2011:681640. [PMID: 21403833 PMCID: PMC3042669 DOI: 10.4061/2011/681640] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 12/15/2010] [Indexed: 11/20/2022] Open
Abstract
This paper aims to highlight the importance of exercise in patients with rheumatoid arthritis (RA) and to demonstrate the multitude of beneficial effects that properly designed exercise training has in this population. RA is a chronic, systemic, autoimmune disease characterised by decrements to joint health including joint pain and inflammation, fatigue, increased incidence and progression of cardiovascular disease, and accelerated loss of muscle mass, that is, “rheumatoid cachexia”. These factors contribute to functional limitation, disability, comorbidities, and reduced quality of life. Exercise training for RA patients has been shown to be efficacious in reversing cachexia and substantially improving function without exacerbating disease activity and is likely to reduce cardiovascular risk. Thus, all RA patients should be encouraged to include aerobic and resistance exercise training as part of routine care. Understanding the perceptions of RA patients and health professionals to exercise is key to patients initiating and adhering to effective exercise training.
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Affiliation(s)
- Jennifer K Cooney
- School of Sport, Health and Exercise Sciences, Bangor University, George Building, Holyhead Road, Bangor, Gwynedd LL57 2PZ, UK
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