Positive associations with PA were found for motivation, self-efficacy, health perception, and previous PA levels. Negative associations were found for fatigue, a coerced regulation style and certain physiological variables. In addition differences between correlates of PA in the adult RA population and other chronic disease and healthy adult populations have been demonstrated.

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The activPAL activity monitor underestimated step and transition counts and, therefore, is not valid for measuring these outcomes in people with RA. Relative to direct observation, the activPAL activity monitor is valid for measuring time spent in sedentary, standing, and walking behaviors in people with RA.

Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.

To date, behaviour change interventions conducted in RA populations to increase physical activity levels have not had a strong theoretical underpinning. It is proposed that an intervention utilising the theory of planned behaviour is developed with the aim of increasing physical activity in people with RA. Implications for Rehabilitation Interventions to promote physical activity in the rheumatoid arthritis (RA) population have failed to change participants' behaviour. A small number of studies have used behaviour change theories in the development and delivery of interventions. The theory of planned behaviour is recommended as the theoretical basis for an intervention to promote physical activity in the RA population.

Abstract:Many people who have Rheumatoid Arthritis (RA) report low levels of physical activity. We conducted 17 interviews with people who have RA to gain insight into how they view physical activity and to explore how their levels of activity may be increased. Interviews were transcribed verbatim and analysed using thematic analysis. Four main themes were generated: being active, barriers and facilitators, information and advice, and supporting physical activity. A lack of information about being active fostered negative emotions limiting physical activity participation. Improved provision of physical activity advice is warranted to promote physical activity in people who have RA.http://mc.manuscriptcentral.com/jhealthpsychology Journal of Health Psychology F o r P e e r R e v i e w "it might hurt, but still it's good": people with rheumatoid arthritis beliefs and expectations about physical activity interventions AbstractMany people who have Rheumatoid Arthritis (RA) report low levels of physical activity. We conducted 17 interviews with people who have RA to gain insight into how they view physical activity and to explore how their levels of activity may be increased.Interviews were transcribed verbatim and analysed using thematic analysis. Four main themes were generated: being active, barriers and facilitators, information and advice, and supporting physical activity. A lack of information about being active fostered negative emotions limiting physical activity participation. Improved provision of physical activity advice is warranted to promote physical activity in people who have RA.

Health professionals believe physical activity is important for people who have RA, although there is uncertainty regarding physical activity recommendations for this population. Thus, there is scope to increase health professionals' knowledge of recent evidence. Views varied on how an intervention to promote physical activity should be delivered, but consideration of barriers to delivery in clinical practice is important. Implications for Rehabilitation Physical activity is an important aspect of disease management for people who have rheumatoid arthritis. Health professionals need to acknowledge the "mixed messages" received by people who have RA about being physically active thus further education for health professionals is suggested to standardize physical activity advice in clinical practice. Health professionals may benefit from education about behavior change theory and techniques. When designing future physical activity interventions consideration of the practical challenges of implementing research in a clinical setting is necessary.

BackgroundPeople who have Rheumatoid Arthritis (RA) report low levels of physical activity despite the many health benefits of being physically active [1,2]. Involving key stakeholders is important when designing interventions which target behaviour change as it allows consideration of particular issues that may influence the delivery of complex interventions [3,4].ObjectivesThis study aimed to explore the views of people who have RA on being physically active and the design of a future physical activity intervention.MethodsA qualitative methodology using a constructivist approach was employed. Recruitment was through an outpatient rheumatology clinic in an urban hospital. Interviews were conducted by telephone, with an interview question guide being used by the interviewer. Interviews were transcribed and analysed using thematic analysis. Transcripts were read, notes made and ideas formulated to facilitate coding. The research team searched for patterns, analysed and coded the data, and generated sub-themes and themes. Themes were reviewed by the research team to check if the themes worked in relation to the coded extracts and the entire data set.ResultsTwelve females and five males participated in the study. Their mean age was 59.8 years (range 35–83, SD 12.5) and mean disease duration was 13.7 years (range 1–47, SD 15.3). Four main themes were generated: “Being active”, “Barriers and facilitators”, “Information and advice”, and “Supporting physical activity”. “Being active” encapsulated the participants' understanding of physical activity, their perceptions' that they could be active and their physical activity limits due to having RA. Beliefs and emotions were highlighted as both key barriers and facilitators to being active, e.g. fear about increasing disease activity by “overdoing it” whilst locating an intervention in a hospital setting was discussed as being negative. The need for accurate information about being physically active from a credible source was highlighted in “Information and advice”, whilst goal setting, monitoring and social support were thought to be important to support physical activity.ConclusionsThere is a lack of information and knowledge about being physically active amongst people who have RA, which contributes to uncertainty about being active. Future interventions should consider delivery in a group, community setting and should incorporate methods which support and monitor behaviour. This study highlights the importance of involving key stakeholders when designing future physical activity interventions as such contributions can help to ensure that such interventions are successful.ReferencesSokka et al (2008) Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study. Arthritis Rheum (Arthritis Care & Res) 59(1):42–50Cooney et al (2011) Benefits of exercise in rheumatoid arthritis. Journal of Aging Research Article ID 681640Medical Research Council (2008) Developing and evaluating complex interventions: new g...