scholarly journals Physical activity in established rheumatoid arthritis and variables associated with maintenance of physical activity over a seven-year period – a longitudinal observational study

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Ann Bremander ◽  
◽  
Karina Malm ◽  
Maria L. Andersson

Abstract Background A large number of patients with RA do not adhere to the recommended levels of physical activity to enhance health. According to EULAR recommendations, physical activity should be part of standard care in people with rheumatic diseases. There have been few larger studies on maintenance of physical activity over longer periods of time. The aim was to study self-reported physical activity levels over 7 years in patients with established rheumatoid arthritis (RA). In addition, to determine variables associated with maintenance or change of physical activity behavior. Methods Questionnaires were sent to the BARFOT cohort in 2010 (n = 1525) and in 2017 (n = 1046), and 950 patients responded to both questionnaires. Patients were dichotomized according to meeting MVPA recommendations (physically active at a moderate level ≥ 150 min/week or at an intense level ≥ 75 min/week) or not. Body mass index, smoking habits, tender joint count (TJC), swollen joint count (SJC), Patient Global Assessment (PatGA), pain intensity and distribution, fatigue, physical function (HAQ), health-related quality of life (EQ. 5D), comorbidities, and medical treatment were assessed. We used logistic regression analysis to study variables associated with maintenance and/or change of MVPA behavior. Results Forty-one per cent (n = 389) of the patients met MVPA recommendations on both occasions. Patients who met MVPA recommendations over 7 years were younger and a higher proportion were never-smokers. There was a negative association with being overweight or obese, having cardiovascular or pulmonary diseases, pain, fatigue, and physical function, whereas there was a positive association between QoL and maintaining MVPA recommendations. Similar factors were positively associated with a deterioration in physical activity level over time. Conclusions Maintenance of physical activity over a long period of time is challenging for patients with established RA. Reports of high quality of life supported maintenance of physical activity while disease related and unhealthy lifestyle factors had a negative effect. Health professionals should consider the patient’s standpoint when encouraging maintenance of physical activity, preferably using coordinated lifestyle interventions.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1011.2-1011
Author(s):  
Y. Olyunin ◽  
V. Rybakova ◽  
E. Likhacheva ◽  
E. Nasonov

Background:The patient-reported outcomes are important components of quantitative methods of rheumatoid arthritis (RA) activity assessment which are used to choose the appropriate drug therapy. The value of these parameters can be significantly affected not only by the inflammatory process, but also by the psychological characteristics of the patient and, in particular, by hardiness [1].Objectives:To study the relationship between psychological factors and signs of RA activity.Methods:Patients with RA who met the EULAR/ACR 2010 criteria, and observed at the V. A. Nasonova Research Institute of Rheumatology were included. Clinical examination was performed including patient global assessment (PGA), physician global assessment (PhGA), pain measurement on a visual analog scale, tender joint count (TJC), swollen joint count (SJC). The functional status was determined by HAQ, the quality of life – by SF-36 EQ-5D, the nature of pain – by painDETECT, the presence of anxiety and depression – by HADS. Patients also completed Hardiness Survey questionnaire to assess hardiness (HDS) and 3 components of the HDS – commitment (CMT), control (CT) and challenge (CLN). Disease activity was evaluated with DAS28, CDAI, and RAPID3. All patients signed informed consent to participate in the study. Analysis of the data was performed using Spearman’s rank test, Fisher exact test, qui-square and t-tests.Results:85 patients with RA were included. There were 69 women and 16 men. Mean age was 56.7±13.1 years, disease duration – 7.6±2.7 years. 72 patients were positive for rheumatoid factor, 75 – for anti-cyclic citrullinated peptide antibody. CDAI showed high activity in 15, moderate – in 37, low – in 30, and remission in 3 patients, DAS 28 – in 10, 55, 12, and 8, and RAPID3 – in 24, 25, 15, and 21, respectively. 24 patients had subclinically or clinically expressed anxiety and 15 –subclinically or clinically expressed depression (≥8 according to HADS). In 31 patients, the painDETECT questionnaire revealed possible or probable neuropathic pain. Mean HDS was 84.8±21.7, CMT – 38.9±9.2, CT – 29.4±8.6, CLN – 17.3±7.1. These values were comparable with the corresponding population data for this age group. There was a significant inverse correlation between HDS and RA activity measures, including SJC, TJC, DAS28 (p<0.05), pain, PGA, PhGA, CDAI, RAPID3, and HAQ (p<0.01). In addition, HDS and all its components positively correlated with quality of life, assessed by SF-36 and EQ-5D (p<0.01). In patients with subclinically and clinically expressed anxiety and depression, HDS, CMT, and CT were significantly lower than in patients without anxiety and depression (p<0.01), while the values of CLN in these groups did not differ significantly.Conclusion:The results of the present study suggest that low HDS may be one of the significant factors determining RA activity level because it does not allow patients to adapt adequately to a stressful situation produced by the disease.References:[1]Maddi SR. Am Psychol. 2008 Sep;63(6):563-4.Disclosure of Interests:None declared


2017 ◽  
Vol 22 (3) ◽  
pp. 300-308
Author(s):  
Marina Ribovski ◽  
Adriana Coutinho de Azevedo Guimarães ◽  
Leonessa Boing ◽  
Fabiana Flores Sperandio ◽  
Mirella Dias ◽  
...  

The objective was to investigate the relation between quality of life and physical activity level in women with breast cancer undergoing treatment at the Oncologic Research Center (CEPON). A total of 158 women (56±9 years) answered a structured questionnaire, at a standardized interview, about sociodemographic and clinical information; economic situation (IBGE – Instituto Brasileiro de Geografia e Estatística); physical activity (IPAQ – International Physical Activity Questionnaire); and quality of life (QLQ-C30 – Quality of Life Questionnaire; QLQ-BR23). Most of the women was not sufficiently active (71.5%) and reported better global quality of life, with a score of 73±25. There was a significant difference on the functional scale for the items physical function (p=0.007) and role performance (p=0.048), with better quality of life values for active women, as well as on the symptom scale for the items loss of appetite (p=0.005) and pain (p=0.040). There was a positive association between total physical activity and quality of life in physical function (r=0.23; p=0.01) and role performance (r=0.023; p=0.01) and a negative association in the symptom scale (r=-0.24; p=0.01) and item loss of appetite (r=- 0.25; p=0.01). We conclude that women with breast cancer were not sufficiently active and showed good global quality of life scores, being that the actives presented better physical function, role performance and less loss of appetite and pain.


2020 ◽  
Author(s):  
Safaa Mahran ◽  
Nihal Fathi ◽  
Maha Seddek ◽  
Samar H. Goma

Abstract Background Patients with rheumatic disease are assumed to have low muscle performance, but few studies have been performed to prove this. Objective To investigate and compare muscle performance in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients and detect its correlation with disease activity, physical function level and quality of life. Patients and Methods Fifty RA patients, 50 SLE patients and 50 healthy controls were recruited for this observational, cross-sectional study. Muscle performance tests for the upper and lower limbs and the fatigue severity score were recorded. Assessments of the physical activity level using the frequency intensity time index and quality of life using the SF36 questionnaire were performed. The study was conducted over 4 months from January to April 2019. Results SLE patients showed better results of muscle performance than RA patients; however, both had lower results as compared to control. Disease activity was correlated to muscle performance tests in both diseases, except for the 30-second chair stand test in SLE (p=0.247). All domains of SF36 had a significant correlation with the performance tests in SLE (p≤0.05); however, only domains of physical function correlated with the tests in the RA group. Conclusion RA patients tend to have a lower muscle performance and physical activity level as compared to SLE patients and control.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pazit Levinger ◽  
Maya Panisset ◽  
Jeremy Dunn ◽  
Terry Haines ◽  
Briony Dow ◽  
...  

Abstract Background Many research studies evaluate physical activity interventions for older people in the community, however relatively few successfully promote maintenance of physical activity beyond the completion of the intervention. This study aimed to implement and evaluate the effects of sustained engagement in physical activity on mental, social and physical health outcomes through the use of the Seniors Exercise Park physical activity program for older people (the ENJOY project). Method People aged ≥60 years underwent a 12-week structured supervised physical activity program using outdoor exercise park equipment followed by 6 months unstructured independent use of the exercise park. Participants were assessed at baseline, 3 months and 9 months and completed a test battery evaluating physical activity, physical function and health related quality of life measures. Repeated measures ANOVA was used to compare differences between baseline, 3 and 9 months. Results Of the 95 participants, 80 (84.2%) completed the 3 months supervised program, and 58 (61%) completed the 9 month assessment (the latter impacted by COVID-19 restrictions). A significant increase in physical activity level was demonstrated following the 12 weeks intervention (p < 0.01). Significant improvements were also demonstrated in all physical function measures (p < 0.01), self-rated quality of life (p < 0.05), wellbeing (p < 0.01), fear of falls (p < 0.01), falls risk (p < 0.01), depressive symptoms (p = 0.01) and loneliness (p = 0.03) at 3 months. At the 9 months follow up, significant improvements from baseline were demonstrated in the frequency, duration and total of physical activity level (p < 0.05), and all physical function measures (p < 0.05), with no decline in these measures from 3 to 9 months. At 9 months, significant changes were observed in the health related quality of life mobility and self care domains with reductions in both fear of falls and falls risk (p < 0.05). Conclusion The Seniors Exercise Park may be an effective modality for improving and sustaining older people’s physical function and wellbeing and can be an important public health infrastructure investment in promoting physical activity for older people. Future work should focus on wider implementation of the program and on scaling up this initiative to achieve public health benefit for the community. Trial registration Trial registration number ACTRN12618001727235, Date of registration 19th October 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375979


2020 ◽  
Author(s):  
Christian Arinze Okonkwo ◽  
Peter Olarenwaju Ibikunle ◽  
Izuchukwu Nwafor ◽  
Andrew Orovwigho

BACKGROUND Quality of life (QoL), physical activity (PA) level and psychological profile (PF) of patients with serious mental illness have been neglected during patient’s management OBJECTIVE The purpose of this study was to determine the effect of selected psychotropic drugs on the QoL, PA level and PF of patients with serious mental illness METHODS A cross sectional survey involving one hundred and twenty-four subject [62 Serious Mental Illness (SMI) and 62 apparently healthy subjects as control] using purposive and consecutive sampling respectively .Questionnaires for each of the constructs were administered to the participants for data collation. Analysis of the data was done using non parametric inferential statistics of Mann-Whitney U independent test and Spearman’s rho correlation with alpha level set as 0.05. RESULTS Significant difference was recorded in the QoL (p<0.05) of patient with SMI and apparently healthy psychotropic naive participants. There was a significant correlation between the QoL (p<0.05) and PF of participants with SMI. Participants with SMI had significantly lower QoL than apparently healthy psychotropic naive subject. QoL of the healthy psychotropic naive group was better than those of the participants with SMI. Female participants with SMI had higher PA than their male counterparts CONCLUSIONS Psychological profiles of male participants with SMI were lower than male healthy psychotropic naive participants. Clinicians should take precaution to monitor the QoL, PA level and PF because the constructs are relevant in evaluation of treatment outcome.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1270.1-1270
Author(s):  
S. Baglan Yentur ◽  
D. C. Saraç ◽  
N. G. Tore ◽  
F. Sarİ ◽  
N. Atas ◽  
...  

Background:Behçet’s Disease (BD) is a chronic, inflammatory, rheumatic disease that is characterized by mucocutaneous lesions and can be seen major organ involvement such as eyes, musculoskeletal system, gastrointestinal system and central nervous system. Impaired quality of life, aerobic capacity, respiratory function and life satisfaction, sleep disorders, depression, anxiety and fatigue are seen commonly in BD patients like the other rheumatic diseases. Considering that regular physical activity effects survival for patients and healthy people, it is important to determine the factors affecting physical activity level and exercise barriers.Objectives:The aim of this study is to investigate physical activity level and exercise barriers in patients with BD.Methods:45 patients were included in the study. Physical activity level, exercise barriers, fatigue, depression, pain, quality of life and aerobic capacity were evaluated with International Physical Activity Questionnaire (IPAQ), Exercise Barriers and Benefits Scale (EBBS), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Visual Analog Scale (VAS), Behçet’s Disease Quality of Life Questionnaire (BDQoL) and 6 minutes walk test, respectively. Spaerman’s Correlation Coefficient were used to investigate the relationships between exercise barriers and other parameters.Results:IPAQ demonstrated that 22 (48.8%) of the patients had low level physical activitiy. Additionally, physical activity levels significantly correlated with both exercise barriers (rho= -0.345) and exercise benefits (rho= 0.320) (p<0.05). BDQoL scores also correlated significantly with exercise barrier scores (rho= 0.338), (p<0.05). No significant relationships were observed for other parameters.Conclusion:Exercise and physical activity are of great importance because of its positive contribution to the musculoskeletal system for BD patients’ rehabilitation. Thinking of negative effects of physical inactivity, patients with Behçet disease should be encouraged to exercise. Also, reasons of physical inactivity should be investigated and treated.References:[1]Ilhan B, Can M, Alibaz-Oner F, Yilmaz-Oner S, Polat-Korkmaz O, Ozen G et al. Fatigue in patients with Behcet’s syndrome: relationship with quality of life, depression, anxiety, disability and disease activity. International journal of rheumatic diseases. 2018;21(12):2139-45.[2]Alder NM, Fisher M, Yazici Y. Behçet’s syndrome patients have high levels of functional disability, fatigue and pain as measured by a Multi-dimensional Health Assessment Questionnaire (MDHAQ). Clin Exp Rheumatol. 2008;26(Suppl 50):S110-3.Disclosure of Interests:None declared


2021 ◽  
Vol 8 ◽  
pp. 205435812098705
Author(s):  
Kathryn Wytsma-Fisher ◽  
Stefan Mustata ◽  
Theresa Cowan ◽  
Manuel Ester ◽  
S. Nicole Culos-Reed

Background: Low physical activity levels and poor physical functioning are strongly associated with poor clinical outcomes and mortality in adult kidney failure patients, regardless of treatment modality. Compared with the general population, individuals with chronic kidney disease are physically inactive, have reduced physical abilities and difficulties performing routine daily tasks, lower health-related quality of life, and higher cardiovascular morbidity and mortality. In addition, frail kidney failure patients have higher hospitalization and mortality rates as compared with other kidney failure patients. Evidence suggests that assessment and recommendations for physical activity should be part of standard care for kidney failure patients. Structured exercise can improve physical function and quality of life in frail older adults and may be used specifically for management of frailty in kidney failure. However, research is needed to determine best practices for implementation of physical function measurements and physical activity promotion in standard kidney failure care. Objective: The proposed Move More study will assess the feasibility of a physical activity intervention offered to the kidney failure inpatients in Calgary, Alberta. Specifically, this study is designed to examine the effects of an early physical activity/mobility intervention led by a kinesiologist, and supported by the clinical care team including physiotherapists (PT) and nurse clinicians. Methods: The Move More study is a single-arm pilot intervention examining feasibility and optimal improvement in real-world conditions. Kidney failure inpatients at the Foothills Medical Centre will be recruited to participate. Patients will receive an individualized in-hospital physical activity/mobility intervention. Frailty and physical function will be assessed at baseline and postintervention prior to hospital discharge. The goal is to recruit 24 to 36 patients. Conclusions: Evidence needed to support the inclusion of mobility and physical activity as part of standard care will be gathered, with knowledge gained used to help direct future physical activity programming for kidney failure inpatients.


2020 ◽  
Author(s):  
Anett Vincze ◽  
Levente Bodoki ◽  
Katalin Szabó ◽  
Melinda Nagy-Vincze ◽  
Orsolya Szalmás ◽  
...  

Abstract Background: The prevalence of osteoporosis and risk of fractures is elevated in rheumatoid arthritis, but we have little information about the bone mineral density and fracture risk in patients with inflammatory myopathies. We intended to ascertain and compare fracture risk, bone mineral density (BMD) and the prevalence of vertebral fractures in patients with inflammatory myositis and rheumatoid arthritis (RA) and to assess the effect of prevalent fractures on the quality of life and functional capacity. Methods: Fifty-two patients with myositis and 43 patients with rheumatoid arthritis were included in the study. Fracture Risk was determined using FRAX® Calculation Tool developed by the University of Sheffield. Dual energy X-ray absorptiometry and bidirectional thoracolumbar radiographs were performed to assess BMD and vertebral fractures. Quality of life was measured with Short Form-36 (SF-36) and physical function assessment was performed using Health Assessment Questionnaire (HAQ). Results: We found a significantly elevated fracture risk in RA compared to myositis patients if the risk assessment was performed without the application of the BMD results. If BMD results and glucocorticoid dose adjustment were taken into account, the differences in fracture risk were no longer significant. The prevalence of osteoporosis was found to be significantly higher in the myositis group (7% vs. 13.5%, p: 0,045), but the fracture prevalence was similar in the two groups (75% vs. 68%). The fractures rates were associated with age in both groups, but not with cumulative dose of steroid and BMD results correlated with fracture prevalence only in the RA patients. The number of prevalent fractures was significantly correlated to poorer physical function in both groups, and poorer health status in the myositis group, but not in the RA group. Conclusions: Our findings suggest that inflammatory myopathies carry significantly elevated risk for osteoporosis and fractures. This higher risk is comparable to one detected with RA in studies and strongly affects the physical function and quality of life of patients. Therefore further efforts are required to make the fracture risk assessment reliable and to facilitate the use early preventive treatments.


2021 ◽  
Vol 38 (3) ◽  
pp. 247-256
Author(s):  
Sonja Stojanović ◽  
Bojana Stamenković ◽  
Jovan Nedović ◽  
Ivana Aleksić ◽  
Jovana Cvetković

Nowadays, the appropriate control of rheumatoid arthritis (RA) involves the absence of clinical disease activity, delaying joint destruction as long as possible and adequate quality of life of the affected. With currently available therapeutic modalities, this therapeutic goal can be achieved in a large number of patients. The aim of this research was to determine the effectiveness of an IL-6 blocker (Tocilizumab) in patients with RA in everyday clinical practice. We also analyzed whether a change in the mode of drug administration (switching from intravenous to subcutaneous drug formulation) had an impact on drug effectiveness (using the DAS 28 SE and CDAI indexes) and quality of life of patients with RA (HAQ, Beck Depression Inventory, FACIT F score and SF 36 questionnaire). The study included 53 subjects diagnosed with RA, treated with Tocilizumab. After a six-month use of subcutaneous Tocilizumab, we concluded that the method of drug administration did not have an impact on its effectiveness and on all the examined parameters of quality of life assessment.


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