Abstract
BackgroundExercise is associated with major benefits in patients with rheumatic diseases for both cardiovascular and rheumatic status. However, information about exercise generally is not collected systematically in routine rheumatology care. A multidimensional health assessment questionnaire (MDHAQ), which was designed for busy clinical settings, includes a query about exercise status. We analyzed possible associations between change in MDHAQ exercise scores and other MDHAQ measures in patients with various rheumatic diseases over one year.MethodsIn one rheumatology clinical setting, all patients, regardless of diagnosis, complete an MDHAQ before seeing a rheumatologist. The MDHAQ includes scores for physical function, pain, and patient global estimate, compiled into an index, routine assessment of patient index data (RAPID3), as well as a self-report joint count and a query about exercise. Patients were classified into four groups according to their exercise status at baseline and one year later as: EXER-Yes (regular exercise), EXER-Yes; EXER-No (no regular exercise), EXER-Yes; EXER-Yes, EXER-No; and EXER-No, EXER-No. These groups were compared using the chi square and Kruskal-Wallis tests and analysis of variance (ANOVA).ResultsPatients who reported regular exercise at baseline were younger, had higher formal education, and better clinical status than other patients. The EXER-No, EXER-Yes group had greater improvement in other MDHAQ variables than patients in the other three groups. By contrast, the EXER-Yes, EXER-No group was the only group with poorer status one year later.ConclusionsThe MDHAQ exercise query indicates that regular exercise is associated with better clinical status. Patients in the EXER-No, EXER-Yes group reported the best clinical improvement, although it is not known whether exercise preceded or followed the improved clinical status.
Highlights
Exercise is associated with major benefits in patients with rheumatic diseases for both cardiovascular and rheumatic status
Exercise performance and clinical status at baseline and one year later Participation in exercise at baseline and one year later (EXER-Yes, EXER-Yes) was reported by 324 patients (40.2 %), compared to 126 (15.8 %) who reported no exercise at baseline and exercise one year later (EXER-No, EXER-Yes), 77 (9.7 %) who reported exercise at baseline and no exercise at one year (EXER-Yes, EXER-No), and 268 (33.7 %), who reported no exercise at both time points (EXER-No, EXER-No) (Table 1)
The highest level of improvement in RAPID3 and other multidimensional health assessment questionnaire (MDHAQ) scores (23.2–40 %) was in patients who reported no exercise at baseline but did report exercise one year later (EXER-No, EXER-Yes) (Table 2)
Summary
Exercise is associated with major benefits in patients with rheumatic diseases for both cardiovascular and rheumatic status. Information about exercise generally is not collected systematically in routine rheumatology care. Over the last two decades exercise has been recognized as beneficial to people with RA and other rheumatic diseases, for cardiovascular and general fitness, and for better rheumatologic clinical status [3,4,5]. In most busy clinical settings, data on exercise in individual patients generally are not collected systematically, if at all, and few data are available on levels of exercise. The capacity to collect information from patients on exercise in a pragmatic, feasible manner, without additional effort on the part of a rheumatologist, could advance the care and outcomes of patients with RA and other rheumatic diseases
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