The clinical utility of accelerometry in patients with rheumatoid arthritis

Prioreschi, Alessandra; Hodkinson, Bridget; Avidon, Ingrid; Tikly, Mohammed; McVeigh, Joanne A.

doi:10.1093/rheumatology/ket216

Cited by 70 publications

(102 citation statements)

References 21 publications

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“…However, when controlled for potential explanatory variables, only reduced activity due to fatigue, physical fatigue and disease activity were found to be statistically significantly lower in patients being regularly physically active. Findings from this study support previous studies documenting low levels of physical activity and increased sitting time in patients with RA compared to controls [9,[28][29][30]. Although no direct comparison was made in the present study, we found that 27 % of the patients in our study reported being primarily sedentary compared to 16.4 % of the Danish general population [31].…”

Section: Discussionsupporting

confidence: 88%

Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis

et al. 2015

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The aim of this study was to examine physical activity behavior in patients with rheumatoid arthritis and to identify potential correlates of regular physical activity including fatigue, sleep, pain, physical function and disease activity. A total of 443 patients were recruited from a rheumatology outpatient clinic and included in this cross-sectional study. Physical activity was assessed by a four-class questionnaire, in addition to the Physical Activity Scale. Other instruments included the Multidimensional Fatigue Inventory (MFI), the Pittsburgh Sleep Quality Index and the Health Assessment Questionnaire. Disease activity was obtained from a nationwide clinical database. Of the included patients, 80 % were female and mean age was 60 (range 21-88 years). Hereof, 22 % (n = 96) were regularly physically active, and 78 % (n = 349) were mainly sedentary or having a low level of physical activity. An inverse univariate association was found between moderate to vigorous physical activity, and fatigue (MFI mental, MFI activity, MFI physical and MFI general), sleep, diabetes, depression, pain, patient global assessment, HAQ and disease activity. The multivariate prediction model demonstrated that fatigue-related reduced activity and physical fatigue were selected in >95 % of the bootstrap samples with median odds ratio 0.89 (2.5-97.5 % quantiles: 0.78-1.00) and 0.91 (2.5-97.5 % quantiles: 0.81-0.97), respectively, while disease activity was selected in 82 % of the bootstrap samples with median odds ratio 0.90. Moderate to vigorous physical activity in patients with rheumatoid arthritis is associated with the absence of several RA-related factors with the most important correlates being reduced activity due to fatigue, physical fatigue and disease activity.

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Section: Discussionsupporting

confidence: 88%

Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis

et al. 2015

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“…This is in contrast to previous reports in RA that did not characterize or report PA across different intensity categories. (5, 19, 31, 32) The findings confirm that individuals with RA are largely sedentary and spend the majority of their PA in light intensities. Only 17% of participants met the PA guidelines, which is similar to other reports in arthritis, (14, 33, 34) but lower than the reported rate of 44–64% in the general population.…”

Section: Discussionsupporting

confidence: 63%

Association of Light‐Intensity Physical Activity With Lower Cardiovascular Disease Risk Burden in Rheumatoid Arthritis

Khoja

Almeida

Wasko

et al. 2016

Arthritis Care & Research

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Objective: To characterize physical activity (PA) in individuals with rheumatoid arthritis (RA) and determine the associations between PA participation in light to moderate intensities and cardiovascular risk factors, disability, and disease activity. Methods: Cross-sectional study using data from two RA cohorts. PA was measured using an accelerometry-based activity monitor, and characterized as minutes/day in sedentary (≤1 metabolic equivalent-MET), very light (1.1–1.9 METs), light (2–2.9 METs), and moderate activities (≥3 METs). Cardiovascular markers included body mass index, blood pressure, insulin resistance, and lipid profile. Disability and disease activity were measured with the Health Assessment Questionnaire (HAQ) and Disease Activity Score-28 (DAS-28), respectively. Associations between PA at each intensity and health-markers were assessed by multiple linear regression models adjusted by age, sex, and cohort. Results: Ninety-eight subjects (58 ± 9 years, 85% female) were included. Subjects spent 9.8 hours/day being sedentary, 3.5 hours/day in very light PA, 2.1 hours/day in light PA and 35 minutes/day in moderate PA. Only 17% were physically active (≥150 minutes/week of moderate PA in 10-minute bouts). Regression models showed that very light, light and moderate PA were inversely associated with most cardiovascular risk factors, the HAQ, and DAS-28 scores (R2Δrange: .04 to .52, p <.05). The associations between PA and cardiovascular markers were either equivalent or stronger at very light- and light-intensities as compared to moderate-intensity. Conclusions: Individuals with RA are mostly active at very light and light intensities. PA at these intensities associate favorably with cardiovascular markers, and lower disability and disease activity in RA.

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“…A recent report using accelerometers (Actical) compared physical activity in persons with RA to gender and BMI-matched controls, but the controls were significantly younger than the persons with RA, calling into question the conclusion that persons with RA engage in more sedentary and less total physical activity than healthy people. [15]…”

Section: Discussionmentioning

confidence: 99%

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

Huffman

Pieper

Hall

et al. 2014

Scandinavian Journal of Rheumatology

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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.

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The clinical utility of accelerometry in patients with rheumatoid arthritis

Cited by 70 publications

References 21 publications

Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis

Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis

Association of Light‐Intensity Physical Activity With Lower Cardiovascular Disease Risk Burden in Rheumatoid Arthritis

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

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