Efficacy of a Counselling Program to Promote Physical Activity in People with Inflammatory Arthritis

Linda Li¹, Hui Xie ², Na Lu ³, Chris Shaw ⁴, Diane Gromala ⁴, Catherine L. Backman ⁵, Johnathan Tam ⁶, Noonan Gregory ⁷, Alison Hoens ¹, Anne Townsend ⁸ and Lynne Feehan ¹, ¹University of British Columbia, Vancouver, BC, Canada, ²Arthritis Research Canada and Simon Fraser University, Vancouver, BC, Canada, ³Arthritis Research Canada, Vancouver, BC, Canada, ⁴Simon Fraser University, Surrey, BC, Canada, ⁵University of British Columbia, Vancouver, Canada, ⁶Arthritis Research Canada, Richmond, BC, Canada, ⁷Vancouver General Hospital, Vancouver, BC, Canada, ⁸Lancaster University, Lancaster, United Kingdom

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Counseling, digital technologies, Inflammatory arthritis and rheumatoid arthritis (RA), physical activity

Session Information

Date: Sunday, November 10, 2019

Title: Health Services Research Poster I – ACR/ARP

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Being physically active is key to successful management in people with inflammatory arthritis (IA). This study aimed to assess efficacy of a physical activity counselling program, with the use of a Fitbit® and FitViz (a personalized Fitbit-compatible web-based app), for promoting physical activity and improving health outcomes in people with IA.

Methods: Eligible participants had physician-confirmed diagnosis of rheumatoid arthritis (RA) or systematic lupus erythematosus (SLE). After baseline assessment (T0) and stratified randomization by diagnosis, the Intervention Group (IG) received standardized education, a Fitbit, access to FitViz, and phone calls from a physical therapist (PT) every 2 weeks to counsel activity goals over an 8-week period. The Control Group (CG) received a monthly e-newsletter from the research team. Participants were assessed again at the end of 8 weeks (T1). The primary outcome was time in daily moderate/vigorous physical activity at >3 METS and in bouts of >10 mins (3+ MVPA) measured with a SenseWear® monitor. Secondary outcomes were: 1) daily step count, 2) MVPA at >4 METS and in bouts of >10 mins (4+ MVPA, reflects purposeful activities), 3) time in sedentary activity in bouts of >20 mins, 4) pain (McGill Pain Questionnaire Short Form), 5) fatigue (Fatigue Severity Scale), and 6) self-management capacity (Partners in Health Scale). We used Analysis of Covariance (ANCOVA) to assess the effect of the intervention on outcome measures at T1 after adjusting for T0. Post-hoc subgroup analysis was done to explore the effect of diagnosis on outcomes.

Results: We recruited 118 participants (IG: n=59, 86.4% women; CG: n=59, 91.5% women); of those, 83 had RA (IG: n=42, 71.2%; CG: n=41, 69.5%). Both groups were similar in age [IG: 53.5 (SD 14.7) years; CG: 53.1 (SD 12.6) years] and body mass index [IG: 27.1 (SD 6.5); CG: 28.7 (SD 8.9)].

The adjusted mean difference in 3+ MVPA was 9.4 mins (95% CI: -0.5, 19.3, p=0.06). A significant effect was found in pain [-0.16 (95% CI: -0.32, -0.01, p=0.04)]. The remaining secondary outcomes improved, but not statistically significant — step count: 644.1 (95% CI: -103.8, 1,392.0, p=0.09); 4+ MVPA: 0.5 mins (95%CI: -4.6, 5.6, p=0.85); sedentary time: -10.4 mins (95% CI: -53.4, 32.6, p=0.63); fatigue: -0.31 (95% CI: -0.63, 0.00, p=0.05); self-management capacity: 0.13 (95% CI: -0.09, 0.35, p=0.23). Post-hoc analysis revealed a significant effect in 3+ MVPA (13.1; 95% CI: 1.9, 24.3) and pain (-0.25; 95% CI: -0.4, -0.08) in participants with RA, but not those with SLE.

Conclusion: Counselling by a PT has potential to improve physical activity behaviour in people with IA, but further study is needed to understand the intervention effect on different diagnosis. We found a significant improvement in pain, suggesting the intervention might have a positive effect on symptom management.

Disclosure: L. Li, None; H. Xie, None; N. Lu, None; C. Shaw, None; D. Gromala, None; C. Backman, None; J. Tam, None; N. Gregory, None; A. Hoens, None; A. Townsend, None; L. Feehan, None.

To cite this abstract in AMA style:

Li L, Xie H, Lu N, Shaw C, Gromala D, Backman C, Tam J, Gregory N, Hoens A, Townsend A, Feehan L. Efficacy of a Counselling Program to Promote Physical Activity in People with Inflammatory Arthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/efficacy-of-a-counselling-program-to-promote-physical-activity-in-people-with-inflammatory-arthritis/. Accessed .

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