Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis

Abstract

Objective. To determine the effects of participation in a low-impact aerobic exercise program on fatigue, pain, and depression; to examine whether intervention groups compared with a control group differed on functional (grip strength and walk time) and disease activity (total joint count, erythrocyte sedimentation rate, and C-reactive protein) measures and aerobic fitness at the end of the intervention; and to test which factors predicted exercise participation. Methods. A convenience sample of 220 adults with rheumatoid arthritis (RA), ages 40 -70, was randomized to 1 of 3 groups: class exercise, home exercise using a videotape, and control group. Measures were obtained at baseline (T1), after 6 weeks of exercise (T2), and after 12 weeks of exercise (T3). Results. Using structural equation modeling, overall symptoms (latent variable for pain, fatigue, and depression) decreased significantly at T3 (P < 0.04) for the class exercise group compared with the control group. There were significant interaction effects of time and group for the functional measures of walk time and grip strength: the treatment groups improved more than the control group (P < 0.005). There were no significant increases in measures of disease activity. Fatigue and perceptions of benefits and barriers to exercise affected participants' amount of exercise, supporting previous research. Conclusion. This study supported the positive effects of exercise on walk time and grip strength, and demonstrated that fatigue and perceived benefits/barriers to exercise influenced exercise participation. Furthermore, overall symptoms of fatigue, pain, and depression were positively influenced in this selective group of patients with RA ages 40 -70 years.

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). Two recent systematic reviews found that physical activity did have beneficial effects on fatigue (18,19), but most exercise interventions have been resource intensive, requiring specially trained personnel, highly structured activities, and/or attendance at classes or a specified facility.…”

Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta‐analysis of randomized controlled trials

“…Supervised exercise and 60-minute exercise sessions performed biweekly or less had a greater effect on quality of life than home-based exercises and 30-minute exercise sessions performed more than 3 times per week, respectively. Similarly, Neuberger et al showed that patients taking part in a 12-week class exercise program experienced significant amelioration in disease-related parameters, whereas home-based exercise did not have that result, probably because patients in this group exercised at a lower intensity (29). Indeed, most of the studies reporting positive effects of exercises on quality of life were supervised intervention trials (3,20,24), whereas most of the studies in which this outcome was not modified were home-based exercises (25).…”

“…Nine studies, including 228 patients in the intervention group and 209 patients in the control group, evaluated joint count. The Ritchie Articular Index was reported in 2 trials (5,23), swollen joint count in 2 studies (21,27), tender joint count in 2 studies (26,28), and both swollen and tender joint counts in 3 studies (8,22,29) (see Supplementary Table 3, available in the online version of this article at http://www3.interscience.wiley.com/journal/77005015/ home). Intervention tended to provide a positive effect on this outcome, although the difference did not reach the statistical significance (SMD 0.14 [95% CI Ϫ0.05, 0.33], P ϭ 0.14; I 2 ϭ 0%) (Figure 4).…”

Exercises in Inflammatory Rheumatic Diseases

“…Romatoid artritli hastaların da egzersize katılımında engelleyici faktörler olarak yorgunluk ve egzersizin yararı konusunda bilgi eksikliği bulunmuştur (49). Sosyal destek ve hastalık öncesindeki egzersiz alışkanlıkları, egzersize katılımı etkileyen faktörler olarak bildirilmiştir.…”