Use of the Behavioral Regulation in Exercise Questionnaire-2 to assess motivation for physical activity in persons with rheumatoid arthritis: an observational study

Abstract

Arthritis patients may show little motivation for physical activity (PA), resulting in a sedentary lifestyle. The primary objective of the study was to investigate whether motivation for PA and fulfillment of PA recommendations were associated with cardiorespiratory fitness in patients with RA. The exploratory objective was to study whether university students could be used as controls for RA patients in future studies of PA motivation. Peak oxygen uptake (VO2peak) was measured in 93 RA patients. The patients and 354 students filled in the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Data were analyzed using structural equation modeling with adjustment for age and sex. The BREQ-2 scores were also compiled to an overall motivational style “Relative Autonomy Index” as previously published. Mean VO2peak for the RA patients was 32.2 (SD: 9.6) mL × min−1 × kg−1. Only 29 patients (31%) fulfilled the current recommendations for PA. BREQ-2 scores were associated with measured VO2peak (standardized coefficient 0.33, p < 0.001). Whether a person fulfilled the current recommendations for PA was a significant mediator of this effect (standardized coefficients: mediated effect; 0.22, p = 0.001, remaining direct effect; 0.11, p = 0.18). The Relative Autonomy Index also significantly predicted measured VO2peak (standardized coefficient 0.30, p < 0.001). The underlying BREQ-2 factor structure was significantly different between RA patients and university students, and comparison of scores would not be adequate. Motivation for PA was significantly associated with measured VO2peak in RA patients. The effect was mediated by whether the patient fulfilled the current recommendations for PA. Addressing and stimulating motivation is important when intervening to increase PA and cardiovascular fitness in RA patients.

Associations between cardiovascular risk factors, disease activity and cardiorespiratory fitness in patients with inflammatory joint disease: a cross-sectional analysis

“…In the context of IJD, motivation to exercise can enhance level of physical activity and CRF [54]. Our data signals lower exercise beliefs and self-efficacy in the least fit patients and supports the notion of superior CRF in patients that are motivated to exercise on a regular basis and believe exercise can benefit their IJD.…”

The association between rheumatoid arthritis and reduced estimated cardiorespiratory fitness is mediated by physical symptoms and negative emotions: a cross-sectional study

“…Other factors than physical symptoms and negative emotions probably also mediate the relationship between RA and low CRF. Potential mediators might include fatigue, comorbidities, lung function, body composition, inflammation, exercise habits, anxiety, motivation, self-efficacy, coping strategies, and sarcopenia [ 11 , 32 , 43 , 44 ]. We focused on factors that are common both in RA patients and the general population, though generally more prevalent in RA patients.…”

Persons with rheumatoid arthritis have higher barriers to physical activity than controls: a cross-sectional study using the Facilitators and Barriers to Physical Activity Questionnaire (FasBarPAQ)

“…Many factors may act as facilitators or barriers to performance of PA, including demographic factors like age and sex, physical factors and comorbidity, and social factors like family and peer support, economy, and access to suitable venues [12][13][14]. Psychological aspects also play an important role, including exercise self-efficacy, i.e., the extent to which one feels capable of performing PA, motivation, and the levels of perceived stress and depression [12,15,16].…”