Self-efficacy for exercise, more than disease-related factors, is associated with objectively assessed exercise time and sedentary behaviour in rheumatoid arthritis

Abstract

Objectives Until recently, reports of physical activity in rheumatoid arthritis (RA) were limited to self-report methods and/or leisure-time physical activity. Our objectives were to assess, determine correlates of, and compare to well-matched controls both exercise and sedentary time in a typical clinical cohort of RA. Methods Persons with established RA (seropositive or radiographic erosions; n=41) without diabetes or cardiovascular disease underwent assessments of traditional and disease-specific correlates of physical activity and seven days of tri-axial accelerometry. Twenty-seven age, gender, and body mass index-matched controls were assessed. Results For persons with RA, objectively-measured exercise time was only 3 (1, 11) min/day; only 10% (n=4) of participants exercised 30+ min/day. Median (25th, 75th %) time spent in sedentary activities was 92% (89%, 95%). Exercise time was not related to pain, but was inversely related to disease activity (r=−0.3, P<0.05) and disability (r=−0.3, P<0.05) and positively related to self-efficacy for endurance activity (r=0.4, P<0.05). Sedentary activity was related only to self-efficacy for endurance activity (r=−0.4, P<0.05). When compared to matched controls, persons with RA exhibited poorer self-efficacy for physical activity but similar amounts of exercise and sedentary time. Conclusions For persons with RA and without diabetes or cardiovascular disease, time spent in exercise was well below established guidelines and activity patterns were predominantly sedentary. For optimal care in RA, in addition to promoting exercise, clinicians should consider assessing sedentary behavior and self-efficacy for exercise. Future interventions might determine whether increased self-efficacy can increase physical activity in RA.

Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care

“…Additional correlations exist between prevailing levels of self-efficacy and extent of activity participation (Baruth et al, 2014; Dekker et al, 2009; Huffman et al, 2014; Hutton et al, 2009; Leveille et al, 2003), an essential component of arthritis management.…”

Physical exercise as non-pharmacological treatment of chronic pain: Why and when

“…In 41 patients with RA, physical activity time was not related to pain but was associated with self-efficacy for physical activity. (98) An RCT of 202 middle-aged to older sedentary adults supports monitoring of adherence and individual tailoring of exercise programs to promote exercise self-efficacy and exercise maintenance. (99)…”

Sedentary behaviour in rheumatoid arthritis: definition, measurement and implications for health

“…accelerometer vs. activPAL), the manner in which sedentary behaviour is defined and subsequently quantified (e.g.,<100cpm (equating to ≤1.5 METS), vs. ≤1 MET vs. time sitting/lying) and the data collection protocol (e.g., inclusion vs. exclusion of sleep time) (Table 4). However, a lack of detailed reporting with regards to sedentary measurement/analysis protocols within studies, means the extent to which each of these factors may contribute towards differing sedentary time estimates in RA is difficult to establish [59,63,64,74,75].…”