Abstract

Background For individuals with rheumatic diseases, it is important to be sufficiently physically active. Several standardized exercise programs have been developed for patients with rheumatic diseases, that have proven to be effective in increasing physical activity level for a short period of time or only in a selection of the patients. A more personalized approach based on shared-decision making to tailor the intervention on personal physical activity goals could increase compliance to improve and sustain the physical activity level in patients with rheumatic diseases. Objectives Primary, this study will examine whether a personalized physical activity program is effective to increase and sustain the level of physical activity in patients with a rheumatic disease. Secondary, this study will examine whether this program also results in a reduction in pain and fatigue. Methods A before after study will be performed among patients of the rheumatology outpatient clinic of Bernhoven in the Netherlands who do not meet the international physical activity recommendations1 and who are motivated to improve their physical activity level. Physical activity will be measured with an activity tracker (steps/week) and as secondary outcomes the VAS pain and VAS fatigue will be measured over time. Measurements will take place before and 1, 3, 6 and 12 months after inclusion. Each participant starts the programme with an intake by a physiotherapist to identify motives and barriers for being physically active. Additionally, motivational interviewing and shared decision-making are used to tailor the intervention on personal physical activity goals. Participants will perform an individualized program, but they will also be a member of a group of 5-15 participants who will start at the same time. This group will meet three times a year to get feedback about their goals and physical activity level. Besides that, they can share experiences, questions, remarks and ideas with each other and with the physiotherapists involved in this study. Results Since February 2018, 49 patients are included in the physical activity program with a mean (±sd) age of 53 ± 12 years and a median (IQR) disease duration of 2 (1-6) years. The majority of the participants is female (71%) and most frequently diagnoses are rheumatoid arthritis, spondyloarthropathy and fibromyalgia. At baseline mean±sd daily steps is 8469±4170, mean VAS pain is 43±23 and mean VAS fatigue is 53±25. Results after 1, 3 and 6 months after baseline will be presented at EULAR. The inclusion of newly participants is still ongoing. Conclusion Despite it is too early to make a statement about the effectiveness of a personalized physical activity program, there are signs that participants became more physically active. During group meetings patients told they spent more time being physically active; they took more frequently their bike or went outside for a walk. This study will be continued giving the patients of the rheumatology outpatient clinic a personalized opportunity to become more physically active.

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