Abstract
BackgroundPhysical 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.MethodA 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.ResultsThe 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.ConclusionThese 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.
Highlights
Physical activity and exercise are acknowledged as important parts in the management of rheumatoid arthritis (RA)
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
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
Summary
Physical activity and exercise are acknowledged as important parts in the management of rheumatoid arthritis (RA). Physical activity needs to be performed regularly and maintained over time to maintain health benefits and the World Health Organization (WHO) recommendations for health-enhancing physical activity comprise 150 min of moderate intensity aerobic exercise each week together with muscle-strengthening activities two times a week [1]. These recommendations align with the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis, where it is advocated that physical activity should be part of standard care (ref). Exercise with person-centred guidance seemed to prepare the participants for independent exercise [6] and 7 months after completion of intervention the participants were still active to a large extent when compared to previous studies among adults with RA reporting maintenance of exercise after an intervention [8, 9]
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