Different types of physical activity are positively associated with indicators of mental health and psychological wellbeing in rheumatoid arthritis during COVID-19

Sophia M Brady,Jet J C S Veldhuijzen Van Zanten,George D Kitas,George S Metsios,Ailsa Bosworth,Joan L Duda,Sally A M Fenton

doi:10.1007/s00296-020-04751-w

Abstract

Nationwide lockdowns during SARS-CoV-2 (COVID-19) can compromise mental health and psychological wellbeing and limit opportunities for physical activity (PA), particularly in clinical populations, such as people with rheumatoid arthritis (RA), who are considered at risk for COVID-19 complications. This study aimed to investigate associations between PA and sedentary time (ST) with indicators of mental health and wellbeing in RA during COVID-19 lockdown, and examine the moderation effects of self-isolating. 345 RA patients completed an online questionnaire measuring PA (NIH-AARP Diet and Health Study Questionnaire), ST (International Physical Activity Questionnaire-Short Form), pain (McGill Pain Questionnaire and Visual Analogue Scale), fatigue (Multidimensional Fatigue Inventory), depressive and anxious symptoms (Hospital Anxiety and Depression Scale), and vitality (Subjective Vitality Scale) during the United Kingdom COVID-19 lockdown. Associations between PA and ST with mental health and wellbeing were examined using hierarchical multiple linear regressions. Light PA (LPA) was significantly negatively associated with mental fatigue (β = − .11), depressive symptoms (β = − .14), and positively with vitality (β = .13). Walking was negatively related to physical fatigue (β = − .11) and depressive symptoms (β = − .12) and positively with vitality (β = .15). Exercise was negatively associated with physical (β = − .19) and general (β = − .12) fatigue and depressive symptoms (β = − .09). ST was positively associated with physical fatigue (β = .19). Moderation analyses showed that LPA was related to lower mental fatigue and better vitality in people not self-isolating, and walking with lower physical fatigue in people self-isolating. These findings show the importance of encouraging PA for people with RA during a lockdown period for mental health and wellbeing.

Highlights

SARS-CoV-2 (COVID-19) has been declared a pandemic by the World Health Organisation (WHO) [1]
Examination of the β values of the covariates showed that functional disability was most strongly and consistently associated with all indicators of mental health and psychological wellbeing, with higher functional disability related to more pain, fatigue and depressive and anxious symptoms and lower vitality
Exercise was related to lower physical and general fatigue and fewer depressive symptoms and sedentary time (ST) was related to higher physical fatigue

Summary

Introduction

SARS-CoV-2 (COVID-19) has been declared a pandemic by the World Health Organisation (WHO) [1]. People considered at increased risk of serious complications following infection were advised to “self-isolate” (i.e. limit outside contact and not leave their homes). One such at risk population is Rheumatoid Arthritis (RA), which is an autoimmune disease characterised by inflammation, pain, fatigue and poor mental health, and commonly managed by immunosuppressive therapies [2, 3]. Whilst restrictions were deemed necessary to contain the spread of the virus, they can negatively impact mental health and psychological wellbeing [4], as well as behaviours which can support mental health and wellbeing such as physical activity (PA) and sedentary behaviour [5]

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