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Patients’ experiences of reasons to being physically active in early rheumatoid arthritis – a mixed methods study
Halmstad University, School of Health and Welfare.
Department of Clinical Sciences, Department of Rheumatology, Lund University, Lund, Sweden & FoU Spenshult, Halmstad, Sweden.
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).ORCID iD: 0000-0002-4341-660X
2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 1454-1455Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: The importance of physical activity in rheumatoid arthritis (RA) is well known and patients are informed about the importance of being physically active. Despite this knowledge there is a lack of compliance to this advice. Studies comparing physical activity in different groups of patients with RA and reasons influencing physical activity are needed.

Objectives: The objectives were to compare physical activity (PA) in workers, retired and patients with sick-leave with early RA and further to explore reasons to being physically active in these patients.

Methods: A total of 66 patients with early RA were included in the study. A sequential explanatory mixed methods design was used. The groups were compared with clinical data as: disease activity (DAS28); pain (VAS 0-100, best to worst); health-related quality of life (EQ5D, -0.594-1 worse to best) and a physical function (HAQ, 0-3 best to worst). ESR and CRP. Patients were dichotomized as being active on recommended levels of PA (MVPArec; physically active on a moderate level ≥150min/week (MPA) or on an intense level ≥75min/week (VPA)) or not (sedentary). The patients were grouped on self-reported working ability; workers, patients with sick-leave and retired patients.

Qualitative data was collected by a questionnaire with open-ended questions about reasons influencing PA. The qualitative data was analysed with a manifest qualitative content analysis to gain a greater understanding of patients’ experiences of PA in early RA.

Results: There were no significant differences between the groups in disease activity, physical function, swollen joints, health-related quality of life or inflammatory parameters (ESR, CRP). Patients on sick-leave had more tender joints median (min-max) 9 (2-18) vs. 4 (0-20) and 3 (0-10), p=0.013. Workers reported higher intensity of pain, though not significant. Retired patients fulfilled MVPA criteria to a higher rate (86%) than workers (42%) or patients with sick-leave (40%), p=0.010.

The qualitative content analysis resulted in three categories. Reasons to being physically active in patients with early RA were; limitations (pain, physical function, stiffness, limited strength and fatigue), awareness as motivation (fear of movement and health benefits) and external environment (weather, transports to activity, economy and time, especially for workers).

Conclusion: Knowledge of reasons to being physically active in patients with RA is important to facilitate and support the patients. Joint pain seems to be an issue for patients with sick-leave. This could be associated to fear of movement and in this aspect these patients need to be supported. Time could be a limiting issue for working patients, which need to be highlighted and solved for these patients. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019. Vol. 78, no Suppl 2, p. 1454-1455
Keywords [en]
Rheumatoid Arthritis, physical activity
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:hh:diva-40916ISI: 000472207104299OAI: oai:DiVA.org:hh-40916DiVA, id: diva2:1369760
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2019-12-17Bibliographically approved

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Larsson, Ingrid

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