Abstract
The aim of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) evaluating the effectiveness of interactive digital interventions (IDIs) for physical activity (PA) and health related quality of life (HRQoL) in people with Inflammatory Arthritis [rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) axial Spondyloarthritis (AS) and psoriatic arthritis (PsA)]. Seven electronic databases identified published and unpublished studies. Two reviewers conducted independent data extraction and quality assessment using the Cochrane risk of bias tool (RoB). The primary outcome was change in objective PA after the intervention; secondary outcomes included self-reported PA and HRQoL after the intervention and objective or self-reported PA at least 1 year later. Five manuscripts, reporting four RCTs (three high and one low RoB) representing 492 (459 RA, 33 JIA) participants were included. No trials studying PsA or AS met the inclusion criteria. Interventions ranged from 6 to 52 weeks and included 3–18 Behaviour Change Techniques. Due to heterogeneity of outcomes, a narrative synthesis was conducted. No trials reported any significant between group differences in objective PA at end of intervention. Only one low RoB trial found a significant between group difference in self-reported vigorous [MD Δ 0.9 days (95% CI 0.3, 1.5); p = 0.004], but not moderate, PA in people with RA but not JIA. There were no between group differences in any other secondary outcomes. There is very limited evidence for the effectiveness of IDIs on PA and HRQoL in RA and JIA and no evidence for their effectiveness in PsA or AS.
Highlights
Physical activity (PA) and exercise are key life-long strategies for the management for people with Inflammatory Arthritis (IA) [Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA), Axial Spondyloarthritis (AS) and Juvenile Inflammatory Arthritis (JIA)] and are recommended in clinical guidelines [1–4] to manage symptoms, disability and co morbidity [5–7].Current public health recommendations advise that adults should complete at least 150 min of moderate PA, or 75 min of vigorous PA, or equivalent per week as well as twice weekly strengthening exercise [8]
In cases where a study had more than one intervention or comparison group, results from similar groups were combined for reporting [47]
Due to the clinical heterogeneity of population and outcome measures used by the included studies it was not possible to conduct meta-analyses
Summary
Physical activity (PA) and exercise are key life-long strategies for the management for people with Inflammatory Arthritis (IA) [Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA), Axial Spondyloarthritis (AS) and Juvenile Inflammatory Arthritis (JIA)] and are recommended in clinical guidelines [1–4] to manage symptoms, disability and co morbidity [5–7]. Current public health recommendations advise that adults should complete at least 150 min of moderate PA, or 75 min of vigorous PA, or equivalent per week as well as twice weekly strengthening exercise [8]. Children are recommended to undertake considerably more activity of at least 60 min of moderate to vigorous activity per day, with vigorous activity completed on at least 3 days per week [9]. Personal (e.g., past exercise behaviour) physical (e.g., pain, fatigue), social and psychological (e.g., motivation) [17–19] factors may all influence PA participation and introducing potentially burdensome lifestyle changes to increase PA, is challenging [20, 21]
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