Sedentary behaviour in patients with rheumatoid arthritis: A qualitative study

Abstract

BackgroundDespite increasing interest in investigating sedentary behaviour (SB) in the general population and in patients with rheumatoid arthritis (RA), there is little documentation of the subjective experiences of SB in patients with RA. This study aimed to examine how patients with RA describe their daily SB.MethodsFifteen patients with RA (10 women and 5 men) from 23 to 73 years of age and with a disease duration ranging from 4 to 27 years were interviewed following a semi-structured interview guide. Data were analysed using the content analysis method described by Graneheim.ResultsSB appeared in three categories covering: 1) A constant battle between good and bad days; SB could be a consequence of RA in terms of days with pronounced pain and fatigue resulting in many hours of SB. 2) Adaptation to everyday life; living with the unpredictability of RA included constant modification of physical activity level causing increase in SB, especially during periods of disease flare. Prioritizing and planning of SB also functioned as part of self-management strategies. 3) It has nothing to do with my arthritis; for some patients, SB was not related to RA, but simply reflected a way of living independent of the disease.ConclusionsSB is perceived, motivated, and performed differently in patients with RA. An individually tailored approach may be essential in understanding and encouraging patients’ motivation towards sustainable change in SB and activity patterns.

Diurnal patterns of sedentary time in rheumatoid arthritis: associations with cardiovascular disease risk

“…For example, in a recent qualitative study, RA patients reported that while symptoms such as pain and fatigue sometimes influenced their activity, their decision to engage in sedentary behaviour could also have nothing to do with their RA, and instead reflected a way of living independent of their disease. 32 Social relations were described as to contributing towards increased sedentary behaviour (eg, coffee mornings, film/movie night), and a lack of motivation to ‘move’ was also reported to influence levels of sedentary time engagement in this patient group. As such, in developing interventions to reduce sedentary behaviour in RA, we must work not only work to understand patterns of sedentary time accumulation (ie, identify ‘sedentary windows’ of opportunity) but also to identify salient RA-related and non-RA-related determinants of sedentary behaviour that can be targeted by such interventions, in order to effectively encourage behavioural change.…”

“…Indeed, fatigue and morning stiffness have been identified as two key factors influencing levels of sedentary time engagement among people living with RA. 32 While we were unable to assess diurnal patterning of biological factors in this study, this represents an important and interesting avenue for future research.…”

Sedentary behaviour in rheumatoid arthritis: definition, measurement and implications for health

“…However, as with all crosssectional studies, the causal direction of this association cannot be determined. Indeed, SB could represent both a consequence and a cause of increased disease activity in RA [78][79][80].…”

Correlates of sedentary behaviour and light physical activity in people living with rheumatoid arthritis: protocol for a longitudinal study

“…It has been reported that people living with RA typically spend long periods of time sedentary, 3,29,30 and recent accelerometry studies suggest people with this condition can spend up to 9 waking hours sedentary per day. 31,32 On the basis of emerging evidence for the association between SB and inflammation, Fenton and Kitas 29 hypothesised that high levels of SB in RA may exacerbate already elevated systemic inflammation in these patients, and contribute to the progression of RA outcomes.…”