Pain rather than self-reported sedentary time explains variation in perceived health and activity limitation in persons with rheumatoid arthritis: a cross sectional study in Sweden

Abstract

To investigate (1) the amount of self-reported time spent sedentary among a large cohort of persons with rheumatoid arthritis (RA), and (2) the contribution of sedentary time to explain perceived health and activity limitation in RA beyond that of previously known correlates. This cross-sectional study used data from a postal questionnaire and the Swedish Rheumatology Quality registers (SRQ). The International Physical Activity Questionnaire was used to assess sedentary time (sitting) and moderate, vigorous and walking activity (MVPA). Sociodemographics, pain, fatigue, fear-avoidance beliefs, anxiety/depression, disease duration, MVPA and sedentary time were included in multiple regression models with perceived health (Visual Analogue Scale 0–100) and activity limitation (Stanford Health Assessment Questionnaire) as dependent variables. Results: In all 3152 (59%) of 5391 persons identified as eligible from the SRQ, responded to the questionnaire. 2819 individuals with complete data on all study variables were analysed. Mean time (SD) spent sedentary was 257 (213) minutes per day. Sedentary time did not contribute significantly to explain perceived health and only minimally to explain activity limitation. Instead, variation was mainly explained by pain; for perceived health (Beta = 0.780, p < 0.001) and for activity limitation (Beta = 0.445, p < 0.001).The results indicate a non-significant role of sedentary time and a need for increased focus on pain in the management of RA. Future studies should use prospective designs and objective assessment methods to further investigate the associations between sedentary time and health outcomes in persons with RA.

Physical activity in established rheumatoid arthritis and variables associated with maintenance of physical activity over a seven-year period – a longitudinal observational study

“…Being physically active, defined as meeting moderate-to-vigorous physical activity (MVPA) recommendations, has the possibility of reducing disease burden in RA and may contribute to an improved quality of life (QoL) [12]. Factors that negatively affect the possibility of being physically active according to the recommendations are higher disease activity, worse pain and function, lower mental health, older age, worse health status, lower education, lower self-efficacy, and lack of social support [16][17][18]. While the prevalence of meeting physical activity recommendations has been well studied, there have been few larger studies on maintenance over longer periods of time [16,18].…”

Self‐Report Measures of Physical Activity

“…Although it would be beneficial to use self‐report PA measures to determine whether an individual or group is meeting current PA guidelines or to allow for clinically useful categorization of PA levels (eg, inactive, low activity, meeting recommendations), of all the measures included in this review, only the IPAQ and SQUASH allow for this. The impact of sedentary behavior on MSK conditions has gained increasing interest in recent years ; however, of the measures included in this review, only the IPAQ forms assess sedentary time (sitting time). In addition, the SQUASH actually discounts low‐level activities (less than 2.0 METs), which may be particularly important to some MSK populations because they may only be able to perform low‐level activities.…”

Influence of pain score measured by a visual analog scale (PS‐VAS) on the Health Assessment Questionnaire Disability Index and 28‐joint Disease Activity Index with C‐reactive protein in rheumatoid arthritis patients

“…In Japanese post hoc analyses from two Phase III clinical trials, some patients had residual pain that remained after attaining clinical remission or light disease activity . This also suggests the importance of pain management as well as disease activity monitoring …”