Background/Purpose: The benefits of exercise for patients with rheumatoid arthritis are widely reported and include sustained improvements in pain, fatigue and self-efficacy.¹ Despite this, the rates of physical activity in patients with arthritis are often lower than is recommended.^2,3 Assessment of self-reported exercise frequency and of barriers to participation in exercise can be facilitated by use of the Multidimensional Health Assessment Questionnaire (MDHAQ) and may assist in encouraging appropriate exercise participation in these patients.

Methods: All patients with RA seen at one academic rheumatology centre complete an MDHAQ at all visits. The MDHAQ queries the frequency of physical exercise (>30 minutes with at least some shortness of breath, sweating) with 5 response options: >3 times weekly, 1–2 times weekly, 1–2 times monthly, no exercise and cannot exercise due to disability or handicap. For analysis, the first two categories were grouped into “regular exercise” and the last three into “no regular exercise”. Scores for a range of variables including physical function, pain, patient global estimate (PATGL), fatigue, BMI and dealing with feelings of depression or anxiety were also recorded. Multilevel models were used to analyse the frequency of physical exercise, adjusting for these variables and time.

Results: 194 patients with RA and a total of 1593 clinic visits were included in the analysis (mean 8.2 visits per patient). The mean age (+/-SD) was 56 +/- 14.5 years at the first visit. 79.9% were female. Patient reported ethnicity was 52% White, 19% Asian and 29% Other. The average BMI was 28.2 +/- 6 kg/m². Only 33.2% reported regular exercise participation. In multivariable modelling, corrected for age, sex, time from first visit and ethnicity, patients whose average physical function score was higher (indicating worse function) demonstrated a significantly increased odds of non-participation in regular exercise (OR 1.43; p<0.0002). In contrast, improved function was associated with exercise participation of at least once per week compared with no regular exercise.

Conclusion: Despite the known safety and benefits of exercise in people with RA, self-reported exercise participation remains low. Poorer physical function reduces the odds of regular exercise participation. Routine assessment of physical function and exercise participation may assist clinicians to address the importance of exercise as part of usual clinical care in patients with RA.

1. Callahan LF, Mielenz T, Freburger J, et al. A randomized controlled trial of the people with arthritis can exercise program: symptoms, function, physical activity, and psychosocial outcomes. Arthritis Rheum 2008;59:92–101.
2. Farr JN, Going SB, Lohman TG, et al. Physical activity levels in patients with early knee osteoarthritis measured by accelerometry. Arthritis Rheum 2008;59:1229–1236.
3. Sokka T, Hakkinen A, Kautiainen H, et al. Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study. Arthritis Rheum 2008; 59:42–50.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-of-barriers-to-exercise-participation-in-patients-with-ra/