Correlation Between Physical Activity In Patients With Inflammatory Arthritis And Beliefs About Aerobic Exercise-pilot Study

Abstract

PURPOSE: Patients with inflammatory arthritis are at increased risk of cardiovascular disease. Regular aerobic exercise (AE) significantly reduces the risk of CV events in the general population. Current ACR guidelines recommend that regular AE should be introduced as part of routine care for rheumatoid arthritis. Aims: To survey the ideas and perceptions about AE in adults, children and adolescents with inflammatory arthritis. To quantify the level of activity undertaken by these patients. To identify any correlation between the outcome expectations and perceptions about AE with self reported physical activity levels. METHODS: 108 patients sequentially attending rheumatology clinics. A questionnaire of 5 questions concerning exercise perceptions, fears and beliefs was given to adults(n=84), adolescents(n=9) and parents of children (n=19) with inflammatory arthritis. This was answered on a 4 point Likert scale -2(least positive) to +2(most positive). The same adults, adolescents and parents completed internationally validated physical activity questionnaires.(IPAQ, PAC-A and PAQ-C respectively). Physical activity levels and positivity of outcome expectation were calculated for each group. Outcome expectation was then correlated with physical activity levels using the Spearman correlation. RESULTS: On a scale of -10(least positive) to +10(most positive), the mean outcome expectation among adults was 1.65, among adolescents was 5.1 and among children was 7. Adults felt most negative about the impact AE would have on their joints and general health but felt most positive about the effect it would have on their heart. Exercise levels were generally low with only 25% of adults scoring high on IPAQ. Exercise levels correlated significantly with outcome expectations in adults(p=0.01). The correlation in adolescents and children was not significant (p=0.089). CONCLUSIONS: Children and adolescents have higher outcome expectations of AE than adults. Outcome expectation of AE in adults correlates significantly with self reported physical activity level. Adults with inflammatory arthritis are poorly informed about the benefits of AE, have inaccurate beliefs about the safety of AE and exercise below recommended levels. These findings suggest that improved education may improve AE levels in patients with inflammatory arthritis.