An outsourced health-enhancing physical activity programme for people with rheumatoid arthritis: exploration of adherence and response

Abstract

Objectives. The aims of this study were to document adherence to and changes in health-enhancing physical activity (HEPA) levels and self-reported and assessed functioning and to explore aspects of adherence and response during the first year of an outsourced 2-year HEPA programme in people with RA.Methods. Two-hundred and twenty patients participated in this observational cohort study, which included daily physical activity, twice-weekly circuit training and biweekly support group meetings. Self-reported data included current (past week) and maintained (past 6 months) HEPA levels, sociodemographics and disease-related and psychosocial factors. Tests of aerobic capacity and muscle function were performed and anthropometric data were collected.Results. Eighty-eight per cent of the participants completed 1 year assessments. Self-reported current and maintained HEPA increased. General health perception and a number of other self-reported disease-related and psychosocial factors improved, while exercise self-efficacy declined. Aerobic capacity, timed standing and grip strength improved and waist circumference decreased. The mean number of circuit training sessions performed was 48, the mean number of days with HEPA was 189 and the mean number of support group meetings attended was 9. Better adherence to circuit training improved general health, and better adherence to group meetings improved timed standing. Exercise self-efficacy improved among those adhering more to circuit training or support group meetings.Conclusion. The outsourced HEPA programme had high retention and reasonable adherence. A number of health outcomes improved. Relationships between adherence to the programme components and response were not clear-cut and need further attention.Trial registration: ISRCTN register; http://www.controlled-trials.com. Trial registration number ISRCTN25539102.

Enhanced ventricular‐arterial coupling during a 2‐year physical activity programme in patients with rheumatoid arthritis: a prospective substudy of the physical activity in rheumatoid arthritis 2010 trial

“…Third, 2 years’ supported physical activity improved the ventricular‐arterial coupling. Taken together, these results indicate that improved arterial and cardiac function over time are interconnected, and may contribute to the beneficial effects of physical activity in patients with RA even in individuals without apparent CVD.…”

“…The physical activity support programme has been described in detail in previous reports from PARA 2010 . In brief, participants were encouraged to perform moderate‐intensity physical activity for 30 min on most days of the week for 1 year.…”

Physical Fitness, Exercise Self-Efficacy, and Quality of Life in Adulthood: A Systematic Review

“…Figure 1 presents all the articles that were selected for this systematic review. Of the 37 articles reviewed focused on clarifying the relationship between fitness parameters and exercise self-efficacy, 32 articles were focused on populations with some type of pathology [ 6 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. Five articles focused on the pathology-free middle-aged population [ 62 , 63 , 64 , 65 , 66 ].…”

Effects of a two-year health-enhancing physical activity program on skeletal muscle protein profiles in people with rheumatoid arthritis

“…A two-year program of Physical Activity in RA (PARA) 2010 was designed to investigate its feasibility and to study changes in self-reported variables, physical capacity measurements, in ammation, pain modulation and cardiovascular risk 11 . Positive changes during the two-year study period were observed for HEPA participants concerning symptoms and physical capacity [12][13] and cardiovascular risk factors [14][15] , while pain modulation did not change 16 . In this context we performed a pilot study with focus on protein adaptations in muscle tissue in a subgroup of people with RA who consented to repeated muscle biopsies.…”

“…Participants in the PARA 2010 study were recruited from the Swedish Rheumatology Quality registers (SRQ). They were asked to participate in a two-year program aimed to increase and maintain HEPA levels among people with RA in line with public health recommendations [11][12][13] For this sub-study six women who consented to donate muscle biopsies at baseline, at one-and two-year follow-ups were included. The participants were independent in daily living, interested in physical activity support, uent in Swedish, not already obtaining HEPA as per recommendations and without major diseases preventing HEPA 11 .…”