Comparison of energy expenditure from lifestyle physical activities between patients with rheumatoid arthritis and healthy controls

Abstract

Objective. Low energy expenditure is a risk for cardiovascular morbidity. The goals of this study were to compare energy expenditure between patients with rheumatoid arthritis (RA) and healthy controls. Methods. A total of 121 RA patients and 120 healthy controls in New York City completed the Paffenbarger Physical Activity and Exercise Index at time of enrollment (1999 -2000) and 1 year later to measure energy expenditure from walking, climbing stairs, and exercise/sports. Analyses were adjusted for age, sex, education, pain, social support, and depressive symptoms and were compared with recommended thresholds of energy expenditure. Results. Participants' mean age was 49 years, and 87% were women. Patients with RA expended fewer kilocalories per week than controls (mean ؎ SD 1,474 ؎ 1,198 versus 1,958 ؎ 1,940, P ‫؍‬ 0.003), with most of this difference from less walking as opposed to high-intensity activities. Although similar percents of RA patients and controls met national recommendations for total weekly energy expenditure (56% versus 64% for the lower [>1,000 kilocalories per week] threshold; P ‫؍‬ 0.14, and 41% versus 48% for the higher [>1,400 kilocalories per week] threshold; P ‫؍‬ 0.17), fewer RA patients met the recommendations (>700 kilocalories per week) for walking (32% versus 48%; P ‫؍‬ 0.01). The strongest predictor of more energy expenditure at 1 year for both groups was more energy expenditure at enrollment. Conclusion. Most of the difference in energy expenditure between RA patients and healthy controls was due to less walking. Given that walking is an effective and relatively safe lifestyle activity, increasing walking should be a priority to improve cardiovascular risk in RA.

Physical Activity to Reduce Fatigue in Rheumatoid Arthritis: A Randomized Controlled Trial

“…We also found, similar to other published studies, that many individuals with RA have very low levels of physical activity (10,11) in spite of the demonstrated safety of exercise and published guidelines recommending physical activity for persons with RA (12). Although studies have examined the impact of exercise interventions on RA outcomes, most have focused on pain or function (13)(14)(15)(16)(17).…”

Physical Activity in Rheumatoid Arthritis: A Systematic Review

“…The use of differing measurement tools leads to greatly differing output styles also. They include kJ/day, 10 hrs/week, 49 hrs/day, 42 mins/ day, 42,49 MJ/day, 47 kcals/week, 41 mins/week, 45,50 kcals/ day, 48 METmin per week 51 and METhours/day, 52 as well as exercise level, 38 physical activity level, 47 sum score of outcome measure, 44,46 meeting of national recommendations, 50 daily average number of steps, 48 number of steps taken, 43 vigor of steps, 43 time spent standing, 43 total energy in arbitrary units, 43 participation in activity domains, 39 and % in different physical activity categories. 40 …”

“…Eurenius et al, 44,46 Mancuso et al, 41 and van den Berg et al 50 indicated that the majority of the RA population 28 Furthermore, the ACR also supports these recommendations for people with RA. 29 However, none of the studies took into account the recommendation of the activity to be of minimum 10-minute bout in duration, thereby assessing if the ACSM guidelines were met.…”

Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis

“…Despite the known benefits of physical activity, a cross-sectional study of patients with RA in 21 countries documented that 60-80 % did not engage in regular physical exercise [6]. However, other studies indicate that a majority of patients with RA are meeting the international recommendations for physical activity although still not being as active as their healthy counterparts [7][8][9]. The mixed findings in these studies may be attributable to the use of different measures and types of physical activity.…”