Physical Activity in Rheumatoid Arthritis: A Systematic Review

Tierney, Marie; Fraser, Alexander; Kennedy, Norelee

doi:10.1123/jpah.9.7.1036

Cited by 110 publications

(87 citation statements)

References 56 publications

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“…Other studies (2,3,8,15) have shown either comparable or lower PA levels in RA patients than the general population, but these vary widely in disease activity, disease duration, age, sex, measurement tools, and cutoff values of national PA guidelines. Furthermore, some differences might be partly explained by cultural influences.…”

Section: Discussionmentioning

confidence: 99%

Effective Treatment for Rapid Improvement of Both Disease Activity and Self‐Reported Physical Activity in Early Rheumatoid Arthritis

Konijn

Tuyl

Boers

et al. 2016

Arthritis Care & Research

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Objective. To investigate the longitudinal relationship between disease activity and self-reported physical activity (PA) in patients with early rheumatoid arthritis during the first year of treatment with combination therapy. Methods. PA was measured with the Short Questionnaire to Assess Health-Enhancing Physical Activity at baseline, 13 weeks, 26 weeks, and 52 weeks after start of treatment in the context of the Combinatietherapie Bij Reumato€ ıde Artritis-Light trial. The reported PA classified patients as meeting or not meeting the World Health Organization (WHO) PA guideline (cutoff: 150 minutes of moderate-to-intense activity per week). Other measurements included the Disease Activity Score (DAS). Since both treatment arms showed equal treatment effect, these were analyzed as 1 group with simple before-after analyses and generalized estimating equations (GEE). Results. In these analyses, 140 patients (86% of the trial population, 66% women, mean age 52 years) with complete data were included. At entry, 69% of the patients met the WHO PA guideline, increasing to 90% at week 13, and remaining stable at 89% after 1 year (P < 0.001). Mean DAS improved from 4.0 to 1.8 during the first year of treatment (P < 0.001). In GEE analyses, DAS decreases were significantly associated with PA increases (P 5 0.008). Patients with clinically relevant responses (expressed as DAS remission, European League Against Rheumatism good response or American College of Rheumatology criteria for 70% improvement response) showed higher PA levels compared to nonresponders, regardless of the definition of response, for both the WHO and Dutch PA guideline. Conclusion. Early rheumatoid arthritis patients using combination therapy improved both disease activity and PA, a beneficial effect persisting for at least 1 year.

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Section: Discussionmentioning

confidence: 99%

Effective Treatment for Rapid Improvement of Both Disease Activity and Self‐Reported Physical Activity in Early Rheumatoid Arthritis

Konijn

Tuyl

Boers

et al. 2016

Arthritis Care & Research

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“…Thus, our sample may represent a population between 2 extremes and provide a base for clinical decision-making and recommendations about HEPA. Obviously, there are several other studies on physical activity levels in RA, but the use of different measurement tools impedes specific comparisons between the studies (10). Established HEPA at baseline predicted being in the stable high trajectory versus the 2 other groups, and self-efficacy for exercise predicted being in the stable high versus the stable low group.…”

Section: Discussionmentioning

confidence: 99%

“…Many people with RA do not reach or maintain the recommended HEPA levels (8,9) and are less physically active than the general population (10,11). To explain and possibly influence physical activity behavior, numerous correlates in different domains have been identified in the general population (12) and in RA (13).…”

Section: Introductionmentioning

confidence: 99%

Trajectories of Physical Activity Over Two Years in Persons With Rheumatoid Arthritis

Demmelmaier

Dufour

Nordgren

et al. 2016

Arthritis Care & Research

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Objective. To identify and describe different trajectories of physical activity over 2 years and to identify baseline predictors for each trajectory within a large cohort of people with rheumatoid arthritis (RA). Methods. The sample included 2,752 people ages 18-75 years and independent in daily living. Data on sociodemographic, disease-related, and psychosocial variables and physical activity (total weekly hours of vigorously/moderately intense activity and walking) were collected from registers and by questionnaires at baseline, and at 14 and 26 months. K-means cluster analysis was used to identify different physical activity trajectories. Multinomial logistic regression was used to identify predictors of trajectory membership. Results. Three trajectories were identified: 1 stable high (n 5 272; with an average of 25 hours of physical activity/week), 1 decreasing (n 5 564; changing from 22 to 8 hours), and 1 stable low (n 5 1,916; with an average of 3 hours). Predictors of the stable high trajectory versus the other 2 were male sex and already established physical activity at baseline. Predictors of the stable high trajectory versus decreasing trajectory were lower age and less social support for exercise, while predictors of stable high versus the stable low trajectory were less activity limitation and higher exercise self-efficacy. Conclusion. The results indicate that distinct trajectories of physical activity over 2 years in people with RA exist, and that stable, high physical activity is mainly predicted by male sex and already established physical activity at baseline. Additional predictors, amenable to change, include activity limitation, social support, and self-efficacy for exercise, suggesting a wide perspective on maintained physical activity in RA.

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“…A well-established example is in patients with chronic inflammatory disorders such as arthritis and multiple sclerosis; exercise improves their mobility, lessens their pain and improves their mood (Motl and Pilutti, 2012;Tierney et al, 2012). Data from studies of rats suggest that running wheel exercise can enhance innate immune function by modulating the expression of cytokines and chemokines in white adipose cells (Speaker et al, 2013).…”

Section: Challenge 2: Runningmentioning

confidence: 99%

Challenging Oneself Intermittently to Improve Health

Mattson

2014

Dose-Response

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h Humans and their predecessors evolved in environments where they were challenged intermittently with: 1) food scarcity; 2) the need for aerobic fitness to catch/kill prey and avoid or repel attackers; and 3) exposure to biological toxins present in foodstuffs. Accordingly, cells and organ systems acquired and retained molecular signaling and metabolic pathways through which the environmental challenges enhanced the functionality and resilience of the cells and organisms. Within the past 60 years there has been a precipitous diminution of such challenges in modern societies because of the development of technologies that provide a continuous supply of energy-dense processed foods and that largely eliminate the need for physical exertion. As a consequence of the modern 'couch potato' lifestyle, signaling pathways that mediate beneficial effects of environmental challenges on health and disease resistance are disengaged, thereby rendering people vulnerable to obesity, diabetes, cardiovascular disease, cancers and neurodegenerative disorders. Reversal of the epidemic of diseases caused by unchallenging lifestyles will require a society-wide effort to re-introduce intermittent fasting, exercise and consumption of plants containing hormetic phytochemicals into daily and weekly routines.

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Physical Activity in Rheumatoid Arthritis: A Systematic Review

Cited by 110 publications

References 56 publications

Effective Treatment for Rapid Improvement of Both Disease Activity and Self‐Reported Physical Activity in Early Rheumatoid Arthritis

Effective Treatment for Rapid Improvement of Both Disease Activity and Self‐Reported Physical Activity in Early Rheumatoid Arthritis

Trajectories of Physical Activity Over Two Years in Persons With Rheumatoid Arthritis

Challenging Oneself Intermittently to Improve Health

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