Different types of physical activity are positively associated with indicators of mental health and psychological wellbeing in rheumatoid arthritis during COVID-19

Abstract

Nationwide lockdowns during SARS-CoV-2 (COVID-19) can compromise mental health and psychological wellbeing and limit opportunities for physical activity (PA), particularly in clinical populations, such as people with rheumatoid arthritis (RA), who are considered at risk for COVID-19 complications. This study aimed to investigate associations between PA and sedentary time (ST) with indicators of mental health and wellbeing in RA during COVID-19 lockdown, and examine the moderation effects of self-isolating. 345 RA patients completed an online questionnaire measuring PA (NIH-AARP Diet and Health Study Questionnaire), ST (International Physical Activity Questionnaire-Short Form), pain (McGill Pain Questionnaire and Visual Analogue Scale), fatigue (Multidimensional Fatigue Inventory), depressive and anxious symptoms (Hospital Anxiety and Depression Scale), and vitality (Subjective Vitality Scale) during the United Kingdom COVID-19 lockdown. Associations between PA and ST with mental health and wellbeing were examined using hierarchical multiple linear regressions. Light PA (LPA) was significantly negatively associated with mental fatigue (β = − .11), depressive symptoms (β = − .14), and positively with vitality (β = .13). Walking was negatively related to physical fatigue (β = − .11) and depressive symptoms (β = − .12) and positively with vitality (β = .15). Exercise was negatively associated with physical (β = − .19) and general (β = − .12) fatigue and depressive symptoms (β = − .09). ST was positively associated with physical fatigue (β = .19). Moderation analyses showed that LPA was related to lower mental fatigue and better vitality in people not self-isolating, and walking with lower physical fatigue in people self-isolating. These findings show the importance of encouraging PA for people with RA during a lockdown period for mental health and wellbeing.

Mental health and quality of life for people with rheumatoid arthritis or ankylosing spondylitis in Aotearoa New Zealand following the COVID-19 national lockdown

“…When mental health variables were removed from the QOL regression, participants' HAQ scores reached statistical significance, suggesting a higher disability score predicts a lower QOL. Previous research demonstrated light exercise is positively associated with vitality in those with rheumatoid arthritis [30] and with lockdown confining individuals to a 2 km radius around their home, the opportunities for exercise were limited. The present study did not assess the amount of exercise an individual conducted over lockdown, and so data obtained cannot determine whether reduced exercise exacerbated an individual's pain and fatigue (increasing their level of disability and reducing their QOL).…”

“…One study demonstrated 60% of RD patients experienced flares following stressful events [28]. It is expected the pandemic will increase disease flares, due to greater levels of distress driven by COVID-19-related fears such as perceived risk of SARS-CoV-2 infection, actual risk of infection, or the action of being tested for the virus [30,31].…”

Physical Activity and Health-Related Quality of Life in Adults With a Neurologically-Related Mobility Disability During the COVID-19 Pandemic: An Exploratory Analysis

“…Physical activity (PA) is a behavioral factor, which has been shown to improve mental health in the general population, as well as in individuals with neurologically-related mobility disabilities (11,12). Indeed, higher levels of PA have been related to better mental health during the COVID-19 pandemic (13,14). However, as a result of the restrictions to contain the spread of COVID-19, opportunities for being physically active have been limited.…”

The importance of physical activity in COVID-19 times

“…Sedentary time was positively associated with physical fatigue. These findings show the importance of encouraging physical activity for people with rheumatoid arthritis during a period of lockdown for mental health and well-being [31].…”