Abstract
BackgroundPatients with rheumatoid arthritis spend most of their daily hours in sedentary behavior (sitting), a predisposing factor to poor health-related outcomes and all-cause mortality. Interventions focused on reducing sedentary time could be of novel therapeutic relevance. However, studies addressing this topic remain scarce. We aim to investigate the feasibility and efficacy of a newly developed intervention focused on reducing sedentary time, and potential clinical, physiological, metabolic and molecular effects in rheumatoid arthritis.MethodsThe Take a STAND for Health study is a 4-month, parallel-group, randomized controlled trial, in which postmenopausal patients with rheumatoid arthritis will set individually tailored, progressive goals to replace their sedentary time with standing and light-intensity activities. Patients will be recruited from the Clinical Hospital (School of Medicine, University of Sao Paulo) and will be assessed at baseline and after a 4-month follow up. Outcomes will include objectively measured sedentary behavior (primary outcome) and physical activity levels, clinical parameters, anthropometric parameters and body composition; aerobic fitness, muscle function, blood pressure, cardiovascular autonomic function, vascular function and structure, health-related quality of life, and food intake. Blood and muscle samples will be collected for assessing potential mechanisms, through targeted and non-targeted approaches.DiscussionFindings will be of scientific and clinical relevance with the potential to inform new prescriptions focused on reducing sedentary behavior, a modifiable risk factor that thus far has been overlooked in patients with rheumatoid arthritis.Trial registrationClinicalTrials.gov, NCT03186924. Registered on 14 June 2017.
Highlights
Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation, joint damage, pain, fatigue, and physical disability [1]
Excessive time spent in sedentary behavior has been associated with poor health outcomes and all-cause mortality [11, 12]
Patients with rheumatoid arthritis spend most of their daily hours in sedentary behavior [10, 18,19,20,21]
Summary
Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation, joint damage, pain, fatigue, and physical disability [1]. Patients with rheumatoid arthritis have a greater risk of cardiovascular disease and premature mortality, which are partially explained by the complex interplay between chronic inflammation, adverse effects of drugs, associated comorbidities (e.g., dyslipidemias, insulin resistance, hypertension), and lifestyle [2,3,4]. In the 1970’s, bed rest and immobilization were recommended [6] It is well-known that exercise training improves disease symptoms, cardiometabolic risk factors, and physical fitness, which together may confer protection against premature mortality [7,8,9]. Patients with rheumatoid arthritis spend most of their daily hours in sedentary behavior (sitting), a predisposing factor to poor health-related outcomes and all-cause mortality. We aim to investigate the feasibility and efficacy of a newly developed intervention focused on reducing sedentary time, and potential clinical, physiological, metabolic and molecular effects in rheumatoid arthritis
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