Background/Purpose:

Physical activity (PA) reduces disability, comorbidity, and risk of premature mortality in people with rheumatic diseases, and clinical guidelines recommend that PA should be integral to rheumatic disease management (NICE 2008, 2009). Updated PA guidelines (published: US 2008, UK 2011) recommend that adults complete ≥150 minutes of moderate intensity PA or ≥75 minutes of vigorous intensity PA (or equivalent) in bouts of ≥10 minutes/week. Currently, the PA levels of adults with rheumatic diseases, assessed against these guidelines, are unknown. This study evaluates the PA levels of adults with rheumatic diseases against the updated guidelines. It assesses respondents’ PA preferences and the proportion who report ever receiving PA advice from a healthcare professional (HCP).

Methods:

508 rheumatology outpatients (24% male, 76% female; 53% rheumatoid arthritis, 13% osteoarthritis, 7% psoriatic arthritis, 6% systemic lupus erythematosis, 5% fibromyalgia, 18% other; disease duration: 27% ≤1 year, 30% >1 to ≤5 years, 15% >5 to ≤10 years, 28% >10 years) were recruited from an inner city UK hospital (July-October 2010). Participants completed the short International PA Questionnaire, and 3 questions: “Has a doctor or other HCP ever suggested PA or exercise to help your arthritis or joint symptoms?” (Answers: yes, no, don’t know), “Would you like help from your doctor or health service to become more physically active?” (Answers: yes, no, don’t know), and “Which PAs do you enjoy?” (Answers: multiple options including free text response). Descriptive statistics were completed on all data, energy expenditure calculated (metabolic equivalent (MET) minutes/week = METs x weekly minutes x weekly days; walking = 3.3 METs, moderate = 4 METs, vigorous = 8 METs), and associations evaluated with Pearson’s chi-square test. Respondents were categorized as: 1) Meeting guidelines (≥500 metabolic equivalent (MET) minutes/week; equivalent to ≥150 minutes of moderate intensity PA/week or ≥75 minutes of vigorous intensity PA/week), 2) Low (<500 MET minutes/week), or 3) Inactive (no PA ≥10 minutes (per activity bout)/week).

Results:

61% of respondents met the updated PA guidelines, and 39% did not meet the guidelines (12% low, 27% inactive). Physical inactivity increased with age (P<0.01). 43% of respondents reported that they had discussed PA with a HCP, and 50% that they would “like help” to become more physically active. Those diagnosed within the last year and those categorized as ‘low’ PA were least likely to report ever receiving PA advice (both P<0.05). Walking was the most preferred PA (65%), and accounted for 70% of respondents’ total weekly energy expenditure.

Conclusion:

Two thirds of urban UK adults with rheumatic diseases meet the updated public health guidelines for PA. However, despite the potential health benefits related to even low levels of PA, many are entirely inactive. PA advice may not be routinely included in the management of rheumatic diseases, despite patients reporting that they would like help to become more physically active. HCPs need to increase awareness of PA guidelines, and actively encourage regular PA. Walking may provide an easy and accessible form of exercise for people with rheumatic diseases.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/are-patients-meeting-the-updated-physical-activity-guidelines-physical-activity-participation-recommendation-and-preferences-among-adults-with-rheumatic-diseases/