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

Abstract

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.

Physical activity in rheumatoid arthritis: relationship to cardiovascular risk factors, subclinical atherosclerosis, and disease activity

“…In the present study, older patients, women, and those more functionally disabled spent less time in physical activity, in line with previous research on associations with age (39), gender (39), and functional disability (8,21,39,40). Higher disease activity, measured by ESR, was associated with less time spent being physically active.…”

Trajectories of Fear‐Avoidance Beliefs on Physical Activity Over Two Years in People With Rheumatoid Arthritis

“…Low physical activity levels, i.e., not performing current HEPA, were a predictor identified in the present study, representing a behavioral component in the fear‐avoidance model. Furthermore, this finding is in line with studies on patients with low‐back pain , while it is contradicted by the results in previous cross‐sectional studies on people with RA , possibly due to differences in samples and methods.…”

“…In RA, the role of fear‐avoidance and its development over time have been minimally explored and the few existing studies are inconclusive, reporting positive correlations with pain intensity but not with physical activity . RA is a long‐term condition, characterized by unpredictable flares and remissions with subsequent variations in pain, that also affects many other physical, psychological, and contextual aspects of health and functioning.…”

Physical Activity Assessment Using an Activity Tracker in Patients with Rheumatoid Arthritis and Axial Spondyloarthritis: Prospective Observational Study

“…We assumed that patients may have different evolution of their physical activity over 3 months; some patients may tend to increase or decrease their physical activity because of the motivational aspect of the activity tracker or because of loss of this motivation. For each physical activity pattern, patients’ trajectories were partitioned using the K-means method adapted to longitudinal data in the R package Kml [ 31 , 32 ]: three clusters of patients with homogeneous trajectories of physical activity were identified. The K-means method is an explanatory analysis and needs no assumption about trajectories before running the algorithm.…”