Factors Associated with Objectively Measured Physical Activity in Patients with Seropositive Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease, which is associated with low levels of physical activity (PA). However, the factors related to low physical activity levels have rarely been studied. Methods: In this cross-sectional study, 70 seropositive RA patients were included. Physical activity was objectively assessed with an ActiGraph GT3X+ accelerometer. In addition, body mass index, smoking status, work ability, and clinical parameters (functional disabilities, disease activity, disease duration, pain, and inflammation parameters) were measured. Results: RA patients performed a mean of 215.2 (SD: 136.6) min a week of moderate physical activity and 9.1 (SD: 26.3) min of vigorous physical activity. The total amount of moderate and vigorous physical activity (MVPA) was associated with BMI, and functional disabilities. In addition, non-smokers and patients with better work ability did more MVPA. No association could be seen with disease activity, disease duration, pain, and inflammatory markers. After mutual adjusting of all the variables, only BMI showed a significant relationship with MVPA. Conclusions: RA patients perform de facto no physical activity with vigorous intensity. Factors related to low physical activity are BMI, functional disabilities, workability and smoking status, whereas due to the study design no causal and temporal link could be made.

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POS1465-HPR THE RELATIONSHIP BETWEEN SEDENTARY BEHAVIOR AND SLEEP IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.641 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1017.2-1018

Author(s):

N. Kelly ◽

E. Hawkins ◽

H. O’leary ◽

K. Quinn ◽

G. Murphy ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Sleep Quality ◽

Sedentary Behavior ◽

Disease Duration ◽

Cross Sectional Study ◽

P Value ◽

Poor Sleep ◽

Cross Sectional ◽

The Relationship

Background:Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory condition that affects 0.5% of the adult population worldwide (1). Sedentary behavior (SB) is any waking behavior characterized by an energy expenditure of ≤1.5 METs (metabolic equivalent) and a sitting or reclining posture, e.g. computer use (2) and has a negative impact on health in the RA population (3). Sleep is an important health behavior, but sleep quality is an issue for people living with RA (4, 5). Poor sleep quality is associated with low levels of physical activity in RA (4) however the association between SB and sleep in people who have RA has not been examined previously.Objectives:The aim of this study was to investigate the relationship between SB and sleep in people who have RA.Methods:A cross-sectional study was conducted. Patients were recruited from rheumatology clinics in a large acute public hospital serving a mix of urban and rural populations. Inclusion criteria were diagnosis of RA by a rheumatologist according to the American College of Rheumatology criteria age ≥ 18 and ≤ 80 years; ability to mobilize independently or aided by a stick; and to understand written and spoken English. Demographic data on age, gender, disease duration and medication were recorded. Pain and fatigue were measured by the Visual Analogue Scale (VAS), anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and sleep quality was assessed using the Pittsburgh Sleep Quality Index. SB was measured using the ActivPAL4™ activity monitor, over a 7-day wear period. Descriptive statistics were calculated to describe participant characteristics. Relationships between clinical characteristics and SB were examined using Pearson’s correlation coefficients and regression analyses.Results:N=76 participants enrolled in the study with valid data provided by N=72 participants. Mean age of participants was 61.5years (SD10.6) and the majority 63% (n = 47) were female. Participant mean disease duration was 17.8years (SD10.9). Mean SB time was 533.7 (SD100.1) minutes (8.9 hours per day/59.9% of waking hours). Mean sleep quality score was 7.2 (SD5.0) (Table 1). Correlation analysis and regression analysis found no significant correlation between sleep quality and SB variables. Regression analysis demonstrated positive statistical associations for SB time and body mass index (p-value=0.03846, R2 = 0.05143), SB time and pain VAS (p-value=0.009261, R2 = 0.07987), SB time and HADS (p-value = 0.009721, R2 = 0.08097) and SB time and HADSD (p-value = 0.01932, R2 = 0.0643).Conclusion:We found high levels of sedentary behavior and poor sleep quality in people who have RA, however no statistically significant relationship was found in this study. Future research should further explore the complex associations between sedentary behavior and sleep quality in people who have RA.References:[1]Carmona L, et al. Rheumatoid arthritis. Best Pract Res Clin Rheumatol 2010;24:733–745.[2]Anon. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab = Physiol Appl Nutr Metab 2012;37:540–542.[3]Fenton, S.A.M. et al. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 18, 131 (2017).[4]McKenna S, et al. Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis. Rheumatol Int. 2018 May;38(5):845-853.[5]Grabovac, I., et al. 2018. Sleep quality in patients with rheumatoid arthritis and associations with pain, disability, disease duration, and activity. Journal of clinical medicine, 7(10)336.Table 1.Sleep quality in people who have RASleep variableBed Time N(%) before 10pm13(18%) 10pm-12pm43 (60%) after 12pm16 (22%)Hours Sleep mean(SD)6.56 (1.54)Fall Asleep minutes mean(SD)33.3(27.7)Night Waking N(%)45(63%)Self-Rate Sleep mean(SD)2.74 (0.90)Hours Sleep mean(SD)6.56 (1.54)Disclosure of Interests:None declared

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How Is the Self-Perceived Work Ability Affected by the Duration of Unemployment, Heart Rate Variability and the Amount of Physical Activity in Older Long-Term Unemployed Persons?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17062039 ◽

2020 ◽

Vol 17 (6) ◽

pp. 2039

Author(s):

Anke Bumann ◽

Daniel Niederer ◽

Constanze Santarossa ◽

Winfried Banzer ◽

Lutz Vogt

Keyword(s):

Physical Activity ◽

Heart Rate ◽

Heart Rate Variability ◽

Work Ability ◽

Vigorous Physical Activity ◽

Total Power ◽

Work Ability Index ◽

Cross Sectional ◽

Perceived Work Ability ◽

Duration Of Unemployment

Background: This study investigated whether work ability is associated with the duration of unemployment, heart rate variability (HRV), and the level of physical activity. Methods: Thirty-four unemployed persons (mean 55.7 ± standard deviation 33.3 years, 22 female, 12 male, unemployed: range 1–22.5 years) participated in the cross-sectional study. The Work Ability Index (WAI) and International Physical Activity Questionnaire (IPAQ) were applied. Short-term (five minutes) resting HRV (Low Frequency (LF), High Frequency (HF), Total Power (TP)) was collected. Results: Work ability was positively associated with the HRV: LF (r = 0.383; p = 0.025), HF (r = 0.412; p = 0.015) and TP (r = 0.361; p = 0.036). The WAI showed a positive linear correlation with the amount of total physical activity (r = 0.461; p = 0.006) as well as with the amount of moderate to vigorous physical activity (r = 0.413; p = 0.015). No association between the WAI and the duration of unemployment occurred. Conclusions: the relation between self-perceived work ability, health-associated parameters, the HRV and the level of physical activity points out the relevance of health-care exercise and the need of stress-reducing interventions to improve perceived work ability. Our results point out the need for the further and more holistic development of healthcare for the unemployed.

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Environmental Influences on Physical Activity in Rural Adults: The Relative Contributions of Home, Church, and Work Settings

Journal of Physical Activity and Health ◽

10.1123/jpah.9.7.996 ◽

2012 ◽

Vol 9 (7) ◽

pp. 996-1003 ◽

Cited By ~ 18

Author(s):

Michelle C. Kegler ◽

Deanne W. Swan ◽

Iris Alcantara ◽

Louise Wrensford ◽

Karen Glanz

Keyword(s):

Physical Activity ◽

Social Support ◽

Rural Communities ◽

Vigorous Physical Activity ◽

Moderate Physical Activity ◽

Activity Levels ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Home Setting ◽

Relative Contribution

Background:This study examines the relative contribution of social (eg, social support) and physical (eg, programs and facilities) aspects of worksite, church, and home settings to physical activity levels among adults in rural communities.Methods:Data are from a cross-sectional survey of 268 African American and Caucasian adults, ages 40–70, living in southwest Georgia. Separate regression models were developed for walking, moderate, vigorous, and total physical activity as measured in METs-minutes-per-week.Results:Social support for physical activity was modest in all 3 settings (mean scores 1.5–1.9 on a 4-point scale). Participants reported limited (<1) programs and facilities for physical activity at their worksites and churches. An interaction of physical and social aspects of the home setting was observed for vigorous and moderate physical activity and total METs. There were also interactions between gender and social support at church for vigorous activity among women, and between race and the physical environment at church for moderate physical activity. A cross-over interaction was found between home and church settings for vigorous physical activity. Social support at church was associated with walking and total METs.Conclusions:Homes and churches may be important behavioral settings for physical activity among adults in rural communities.

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DISEASE ACTIVITY PREDICTS WHOLE BODY AND REGIONAL LEAN TISSUE IN RHEUMATOID ARTHRITIS – A CROSS-SECTIONAL STUDY

Romanian Journal of Rheumatology ◽

10.37897/rjr.2015.2.3 ◽

2015 ◽

Vol 24 (2) ◽

pp. 74-83

Author(s):

Claudiu Popescu ◽

◽

Violeta Bojinca ◽

Daniela Opris ◽

Ruxandra Ionescu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Disease Activity ◽

Statistical Tests ◽

Normal Subjects ◽

Whole Body ◽

Lean Tissue ◽

Cross Sectional ◽

Rheumatoid Cachexia ◽

Postmenopausal Female

Aim. The study aims to assess the potential influences of rheumatoid arthritis (RA) and its specific disease measures on lean body composition phenotypes of female patients. Methods. The study was cross-sectionally designed to include Caucasian postmenopausal female RA patients and age-matched postmenopausal female controls. All the subjects gave written informed consent and the study was approved by the local ethics committee. Each subject underwent in the same day a clinical examination, laboratory tests, whole body dual X-ray absorptiometry (DXA) composition and physical activity estimation using a self-administered questionnaire. Correlations, differences and predictive power were analyzed with appropriate statistical tests. Results. The study included 107 RA patients and 104 controls. Compared to the normal subjects, who recorded higher levels of physical activity, the RA patients had significantly lower appendicular lean tissue absolute and relative indices and higher prevalence of sarcopenia. The whole body and appendicular lean tissue indices showed significant negative correlations with measures of disease severity (duration, inflammation, quality of life and radiographic progression), independent of age, levels of physical activity, body mass index and smoking. Conclusions. The measures of disease activity and severity independently predict lean tissue phenotypes in RA patients, behaving as risk factors for sarcopenia and rheumatoid cachexia. The diagnosis of RA in itself is a significant predictive factor of sarcopenia.

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Relationship Between Disease Activity Level and Physical Activity in Rheumatoid Arthritis Using a Triaxial Accelerometer and Self-reported Questionnaire

10.21203/rs.3.rs-151804/v1 ◽

2021 ◽

Author(s):

Yoichi Toyoshima ◽

Nobuyuki Yajima ◽

Tetsuya Nemoto ◽

Osamu Namiki ◽

Katsunori Inagaki

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Disease Activity ◽

Cross Sectional Study ◽

Activity Level ◽

Moderate Intensity ◽

Triaxial Accelerometer ◽

Cross Sectional ◽

Fatigue Score ◽

The Relationship

Abstract Objective: This study evaluated the relationship between rheumatoid arthritis (RA) disease activity level and physical activity (PA) by using an accelerometer and self-reported questionnaire.Results: The cross-sectional study included 34 patients with RA. We classified patients with a Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) of less than and higher than 3.2 into the low-disease-activity (LDA) group and moderate/high-disease-activity (MHDA) group, respectively. PA was assessed using a triaxial accelerometer. We measured the wear time, time of vigorous-intensity PA (VPA), moderate-intensity PA (MPA), light-intensity PA (LPA), and sedentary behavior per day by using this device. Moreover, we evaluated the relationship between accelerometer-measured and self-reported PAs in each group. The accelerometer-measured moderate-to-vigorous PA (MVPA) was 17.2 min/day and 10.6 min/day in the MHDA group and LDA group (p < .05), respectively. No significant association was observed between RA disease activity level and accelerometer-measured PA with adjustment for age and Functional Assessment of Chronic Illness Therapy-Fatigue score. No correlation was noted between accelerometer-measured MVPA and self-reported MVPA in the MHDA group, but these factors were correlated in the LDA group (rs = 0.5, p < .05). The RA disease activity level and accelerometer-measured PA were not correlated.

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Association between physical activity pain and injuries in children

10.21203/rs.2.16774/v1 ◽

2019 ◽

Author(s):

João Paulo de Aguiar Greca ◽

Thomas Korff ◽

Jennifer Ryan

Keyword(s):

Physical Activity ◽

Weight Status ◽

Negative Binomial ◽

Vigorous Physical Activity ◽

Weight Bearing ◽

Lower Limbs ◽

Moderate Physical Activity ◽

Moderate Activity ◽

Cross Sectional ◽

Paediatric Obesity

Abstract Background Children are advised to engage in physical activity to improve health. However, recent literature suggests an association between weight bearing activities, e.g. walking, and excessive joint loading in lower limbs of children. Excessive stress in joints of children may lead to pain or even cause injuries. The aim of this study was to investigate the relationship between pain, injury and physical activity in children.Methods This study had a cross-sectional design. 112 children aged 8-12 yr. (68 with normal weight, 38 with overweight or obesity) participated in the study. Moderate and vigorous physical activity were assessed using accelerometry over 7 days. Questionnaires were used to report pain (over 7 days) and injuries (over 12 months). Linear regression and negative binomial models were used to examine association between moderate activity, vigorous activity, and pain and injuries, respectively. Models were adjusted for potential confounders. Effect modification according to weight status was explored.Results There was no association between moderate physical activity and pain (β=0.0004, 95% CI -0.007 to 0.008; p=0.915) or between vigorous physical activity and pain (β=0.0069, 95% CI -0.08 to 0.22; p=0.354). Similarly, no association was found between moderate physical activity and injuries (Rate Ratio [RR]=1.00, 95% CI 0.99 to 1.01; p=0.995) or vigorous physical activity and injuries (RR=1.00, 95% CI 0.99 to 1.02; p=0.798). There was no evidence that associations between physical activity and pain or physical activity and injuries, respectively, differed according to weight status.Conclusions Although paediatric obesity is linked to a higher incidence of pain and injuries in children, this study did not find that moderate and vigorous physical activity are associated with pain or injuries in children, regardless of their weight status.

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Leisure-Time Physical Activity and Metabolic Syndrome in Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183358 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3358 ◽

Cited By ~ 2

Author(s):

Gallardo-Alfaro ◽

Bibiloni ◽

Mateos ◽

Ugarriza ◽

Tur

Keyword(s):

Physical Activity ◽

Older Adults ◽

Metabolic Syndrome ◽

Energy Expenditure ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Vigorous Physical Activity ◽

Cross Sectional Study ◽

Moderate Physical Activity ◽

Cross Sectional

Background: Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease, atherosclerosis and diabetes mellitus type 2 which may be reduced by practicing regular physical activity. Objective: To assess the leisure-time physical activity (LTPA) of older adults with MetS and without MetS. Methods: Cross-sectional study of older adults (55–80 years old) from Balearic Islands (Spain) with MetS (n = 333; 55% men) and without MetS (n = 144; 43.8% men). LTPA was assessed with the validated Spanish version of the Minnesota LTPA Questionnaire. Two criteria of physically active were used: >150 min/week of moderate physical activity or >75 min/week of vigorous physical activity or a combination of both, and total leisure-time energy expenditure of >300 MET·min/day. Sociodemographic and lifestyle characteristics, anthropometric variables, MetS components, and adherence to the Mediterranean diet (MD) were also measured. Results: MetS subjects showed lower energy expenditure in LTPA, lower adherence to the MD, higher obesity and waist circumference, and were less active than non-MetS peers. LTPA increased as participants got older and there was higher LTPA intensity as educational level increased. Adherence to MD was as high as LTPA was. Conclusions: MetS is associated with physical inactivity and unhealthy diet. To increase LTPA recommendations and raise awareness in the population about the health benefits of PA and high adherence to MD is highly recommended.

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Engagement in physical activity, suicidal thoughts and suicide attempts among older people in five developing countries

PeerJ ◽

10.7717/peerj.7108 ◽

2019 ◽

Vol 7 ◽

pp. e7108 ◽

Cited By ~ 3

Author(s):

Bishwajit Ghose ◽

Ruoxi Wang ◽

Shangfeng Tang ◽

Sanni Yaya

Keyword(s):

Physical Activity ◽

Elderly People ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Suicide Ideation ◽

Vigorous Physical Activity ◽

Moderate Physical Activity ◽

Older Individuals ◽

Suicidal Thoughts ◽

Cross Sectional

Background Suicide causes rising economic costs and public health risks for communities in the worldwide. Physical activity (PA) is considered a potentially feasible approach to reduce risk of suicide with low cost and high accessibility, and therefore attracting increasing attention. However, current literature on the association between PA and suicidal behavior amongst elderly people in low- and middle-income countries (LMICs) are scarce. Therefore, in this study we aimed to examine the relationship between suicidal thoughts (ST) and suicidal attempts (SA) with PA among elderly people in five LMICs. Methods Cross-sectional data were collected from WHO’s Study of Global Ageing and Adult Health (SAGE) with 2,861 participants aged 50 years or above. Variables included: self-reported occurrence of ST and SA during past 12 months and four types of PA (vigorous physical activity (VPA), moderate physical activity (MPA), walking/bike riding, moderate leisure time physical activity (MLPA)). Results The overall prevalence of taking >75 min of VPA/week, >150 min/week, MLPA and walking/bike riding were, respectively, 85.4% (95% CI [81.3–88.7]), 61.6% (95% CI [52.9–69.6]), 9.6% (95% CI [7.2–12.6]) and 75.1% (95% CI [68.7–80.6]). Respectively, 31.0% (95% CI [24.3–38.7]) and 5.5% (95% CI [3.9–7.5]) of the respondents reported having morbid thoughts and SA during last 12 months. In adjusted multivariable regression analysis, not engaging in PA revealed positive association with higher odds of having morbid thoughts and SA, however, with varying degrees for different types of PA among men and women and across countries. The adjusted odds ratio among elderly who encountered ST increased significantly with PA levels (1.265 in male and 1.509 in female with VPA, 1.292 in male and 1.449 in female with MPA, 1.669 in female with LMPA and 3.039 in women with walk/bike); similarly, with SA (1.526, 1.532, 1.474 and 1.392 in women with VPA, MPA, LMPA and Walk/bike, respectively). The degree of adjusted odds ratio varied between genders and among countries. Conclusion Although the data were cross-sectional, and no linear dose-response relationship was observed between PA and morbid thought and suicide ideation, the findings provide important indications of potential harmful effects of no/inadequate PA on psychological morbidities among older individuals. Promoting adequate PA among older individuals through community-based suicide prevention programs can potentially contribute to reduction in the burden of PA in LMICs.

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Relationship between disease activity level and physical activity in rheumatoid arthritis using a triaxial accelerometer and self-reported questionnaire

BMC Research Notes ◽

10.1186/s13104-021-05666-w ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Yoichi Toyoshima ◽

Nobuyuki Yajima ◽

Tetsuya Nemoto ◽

Osamu Namiki ◽

Katsunori Inagaki

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Disease Activity ◽

Cross Sectional Study ◽

Activity Level ◽

Moderate Intensity ◽

Triaxial Accelerometer ◽

Cross Sectional ◽

Fatigue Score ◽

Chronic Illness Therapy

Abstract Objective This study evaluated the relationship between rheumatoid arthritis (RA) disease activity level and physical activity (PA) by using an accelerometer and self-reported questionnaire. Results The cross-sectional study was part of a cohort study designed to determine disease activity is associated with PA in RA patients. We classified patients with a Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) of less than and higher than 3.2 into the low-disease-activity (LDA) group and moderate/high-disease-activity (MHDA) group, respectively. We measured the wear time, time of vigorous-intensity PA, moderate-intensity PA, light-intensity PA, and sedentary behavior per day using a triaxial accelerometer. 34 patients were included in the study. The accelerometer-measured moderate-to-vigorous PA (MVPA) was 17.2 min/day and 10.6 min/day in the LDA group and MHDA group (p < 0.05), respectively. There was no significant association between RA disease activity level and accelerometer-measured PA with adjustment for age and Functional Assessment of Chronic Illness Therapy-Fatigue score. There was no correlation between accelerometer-measured MVPA and self-reported MVPA in the MHDA group, but these factors were correlated in the LDA group (rs = 0.57, p < 0.05). In conclusion, no significant association was noted between RA disease activity level and accelerometer-measured PA.

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Osteoporosis in patients with rheumatoid arthritis: trends in the German National Database 2007–2017

Rheumatology International ◽

10.1007/s00296-020-04593-6 ◽

2020 ◽

Vol 40 (12) ◽

pp. 2005-2012 ◽

Cited By ~ 1

Author(s):

Lisa Lindner ◽

Johanna Callhoff ◽

Rieke Alten ◽

Andreas Krause ◽

Wolfgang Ochs ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Age Groups ◽

Density Measurement ◽

National Database ◽

Bone Density Measurement ◽

Cross Sectional ◽

Drug Prophylaxis

Abstract Osteoporosis is a frequent comorbidity in rheumatoid arthritis (RA). Due to the improved treatment options for RA, we expect a long-term decrease in osteoporosis as an accompanying disease. Data from the German National Database (NDB) were used to investigate whether the frequency of osteoporosis has changed in the last 10 years. From 2007 to 2017, approximately 4000 patients were documented annually with data on therapy and comorbidity. The cross-sectional data were summarised descriptively. Age, sex, disease duration, disease activity and glucocorticoids were considered as influencing factors. The Cochrane-Armitage test for trend was used to test whether the frequency of osteoporosis at the first visit changed from 2007 to 2017. Osteoporosis frequency in RA patients (mean age 63 years, 75% female) decreased from 20% in 2007 to 6% in 2017 (p < 0.001). The decrease affected women (22% to 17%) and men (14% to 8%) in all age groups and both short-term (≤ 2-year disease duration: 9% to 3%) and long-term RA patients (> 10-year disease duration: 28% to 20%). Patients with high disease activity and patients who took glucocorticoids (GC) were more often affected by osteoporosis than patients in remission or without GC. Drug prophylaxis in patients without osteoporosis increased (20% to 41% without GC, 48% to 55% with GC). Men with GC received less prophylactic treatment than women (48% vs. 57% in 2017). In this cohort, osteoporosis in patients with RA is less frequently observed compared to former years. RA-specific risk factors for osteoporosis such as disease activity and GC therapy have declined but long-term GC use is still present. Assessment of osteoporosis in RA patients should be investigated more consistently by bone density measurement. Male RA patients still need to be given greater consideration regarding osteoporosis drug prophylaxis, especially when GC therapy is needed.

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