Background/Purpose: For people with inflammatory arthritis, the health benefits of physical activity (PA) and negative impact of sedentary lifestyle are clear. However, it is unclear how daily physical (in)activity and sleep may be affected in people with early rheumatoid arthritis (RA) (1). The purpose of this study was to examine measures of daily PA and sleep in people with early RA, compared to age and gender matched peers.
Methods: We recruited 30 adults diagnosed with RA in the past year and 30 age and gender matched healthy volunteers. Physical activity and sleep were measured with SenseWear MiniTM (SW) accelerometers worn over the triceps of the dominant arm for 6 days. We fit a multivariate analysis of variance model with RA status as the independent variable and a dependent variable of minutes spent in 8 categories [night – sleep; day – off body, sedentary (< 1.6), light [1.6, 3), 3, 4, 5 and ≥ 6 MET activities] across 24-hours. Overall difference (Multivariate Wilks’ Lambda F-test) and post hoc differences (F-tests / Least Square Mean) in sleep and PA intensity were examined. Differences in four PA behaviours [Bouted (≥10 minutes) Moderate to Vigorous PA (MVPA, ≥ 3 METs), Intensity of Bouted MVPA, Bouted (≥ 20 minutes) Sedentary time and Overall Sleep (night + day)] were also examined with paired Student T-tests.
Results: Average age 53 y (21-73 y). Females – 24 of 30 / group. 3 RA / NRA pairs excluded [non-adherence (n=2), mechanical failure (n=1)]. Mean SW wear time 5.8 d (SD: 0.02) RA Participants: 73% RF or anti-CCP positive. Time since diagnosis 8 m (SD: 5). Health Assessment Questionnaire [Disability Index: Mean 0.6 (SD: 0.6), Pain VAS100: Mean 21 (SD: 16)]; Tender & Swollen Joints: Mean 3 (SD: 3). Sleep and PA Intensity Comparisons (Table 1): People with early RA had a significantly different (p = 0.03) overall pattern of nighttime sleep and daytime physical (in)activity. The primary differences were significantly fewer minutes of higher PA intensity (≥ 4 METs, Mean Diff: 37m, P < 0.03), as well as a tendency for more nighttime sleep (Mean Diff: 17m, p = 0.26) and more daytime sedentary (Mean Diff: 37m, p=0.33) and light physical activity (Mean Diff: 15m, p = 0.39). PA Behavior Comparisons (Table 1): RA participants spent significantly less time in bouted MVPA (Mean Diff: – 65m, p = 0.01) at a lower intensity (Mean METs: RA 3.5 vs. NRA 4.1, p = 0.01). RA participants also accumulated significantly more overall sleep (Mean Diff: 29m, p = 0.02).
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Table 1: Summary of Average Daily Sleep and Physical Activity (PA) Intensity and Selected PA Behaviours in People Living With and Without Rheumatoid Arthritis (RA)
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Sleep and PA Intensity Comparison: (n=54, 27 Pairs)
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Post hoc Component Examined
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RA [LS Mean (95% CI)] |
Non-RA [LS Mean (95% CI)] |
P value
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Nighttime Sleep (Min) |
454 (432, 476) |
437 (415, 459) |
0.27 |
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Off-body Time (Min) |
29 (18, 39) |
28 (17, 38) |
0.91 |
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Sedentary (< 1.6) METs (Min) |
642 (588, 695) |
605 (551, 659) |
0.33 |
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Light PA [1.6, 3) METs (Min) |
207 (183, 231) |
192 (168, 216) |
0.39 |
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3 METs (Min) |
78 (49, 107) |
111 (82, 140) |
0.11 |
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4 METs (Min) |
25 (14, 35) |
47 (37, 58) |
0.004 |
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5 METs (Min) |
4 (0.2, 8) |
13 (9, 17) |
0.002 |
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6+ METs (Min) |
2 (-2, 5) |
8 (4, 11) |
0.02 |
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Selected PA Behaviour Comparison: (n=54, 27 Pairs)
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PA Behaviour Examined
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RA [Mean (SEM)]
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Non-RA [Mean (SEM)]
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* Difference (RA – Non-RA). [Mean (SEM)]
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P value
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Bouted (≥ 10 min) MVPA (Min) |
72 (19) |
137 (18) |
– 65 (25) |
0.01 |
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Average Intensity of MVPA (METs) |
3.5 (0.2) |
4.1 (0.1) |
– 0.6 (0.2) |
0.01 |
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Bouted (≥ 20 min) Sedentary (Min) |
393 (32) |
359 (29) |
33 (42) |
0.43 |
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Overall (Night + Day) Sleep (Min) |
482 (10) |
453 (11) |
29 (12) |
0.02 |
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* Negative value indicates RA less than Non-RA |
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Conclusion: People living with recently diagnosed RA have markedly different patterns of sleep and physical (in)activity than age and gender matched healthy peers. These findings suggest that people living with early RA would benefit from education and support to enhance physical activity related health behaviours.
1: Tierney et al. (2012) Physical activity in rheumatoid arthritis: a systematic review. J Phys Act Health.
Disclosure:
C. Feehan,
None;
E. C. Sayre,
None;
E. Carruthers,
None;
L. M. Feehan,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessing-24-hour-physical-inactivity-and-sleep-in-people-with-early-rheumatoid-arthritis/