October 12, 2017
2 min read

Physical activity recommendations met by small proportion of patients with RA

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A small percentage of patients with rheumatoid arthritis meet recommendations of at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity per week, even in cases of well-controlled disease, according to recently published findings.

Maura D. Iverson

Using a longitudinal RA registry at a large tertiary care hospital, researchers evaluated 573 patients. The mean age of patients was 61 years and they had RA for about 19.5 years.

Eligible patients had attended at least one annual registry visit with complete physical activity data and filled out a physical activity questionnaire at baseline. The researchers recorded baseline and annual measures, including demographics, medical history, self-efficacy for disease management, quality of life, patient/physician global assessment, physical function and self-reported physical activity. They evaluated the correlations between disease activity and minutes of vigorous physical activity (MVPA) using a logistic repeated-measures model.

Researchers found that among the study population, the average disease activity (as quantified by the three-variable DAS28 using the C-reactive protein level) was 3.1 ±1.4. Thirty-six percent of patients were physically inactive and 29% met weekly MVPA targets. A negative borderline correlation was seen between disease activity and MVPA during a period of 3 years (OR: 0.89).

The percentage of patients who met MVPA recommendations varied by disease activity, with fewer patients with highly active disease achieving MVPA recommendations.

An analysis adjusted for disease activity (DAS28-CRP) revealed the following individual variables were significantly correlated with meeting MVPA recommendations: age, white race, being married or cohabitating with a significant other, full-time employment, college education, any use of alcohol, patient global health assessment, physician global assessment of health, mental health, self-efficacy for arthritis management, quality of life, fatigue, undergoing surgeries related to RA and BMI.

In  a multivariable model including all significant variables and adjusting for disease activity, white race was identified as the factor associated with fulfilling MVPA recommendations (OR: 2.95). Older age (ages older than 69 years, OR: 0.58), poor mental health (OR: 0.63); patient global assessment scores of 10 to 20 (OR: 0.57) being overweight or obese (BMI 25 kg/m2 to 30 kg/m2, OR: 0.69; BMI 30 kg/m2 to 39.9 kg/m2, OR: 0.60 and BMI greater than 40 kg/m2, OR: 0.24); poor physical function (OR 0.59), were linked to not meeting the MVPA recommendations.

“This study examined physical activity participation over 3 years in a large group of patients with RA. We found few adults with RA met the national guidelines for minutes of moderate to vigorous physical activity per week, despite well-controlled disease,” study author Maura D. Iversen, PT, DPT, SD, MPH, FNAP, FAPTA, told Healio Rheumatology. “These data indicate that patients with RA need counseling to promote physical activity to reduce their risk of cardiovascular disease.  Lifestyle factors, mental health and patient perceptions of their disease appeared to be the strongest correlates of physical activity participation.” -by Jennifer Byrne

Disclosures:  Please see the full study for a list of relevant financial disclosures.