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Abstract Number: 452

The Efficacy of Motivational Counselling and SMS-Reminders on Daily Sitting Time in Patients with Rheumatoid Arthritis: A Randomised Controlled Trial

Tanja Thomsen1, Mette Aadahl2, Nina Beyer3, Merete Lund Hetland4, Katrine Loeppenthin1, Julie Midtgaard5, Robin Christensen6, Mikkel Østergaard7, Poul Jennum8 and Bente Appel Esbensen1, 1Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen, Denmark, 2Research Centre for Prevention and Health, Rigshospitalet, Denmark, Copenhagen, Denmark, 3Musculoskeletal Rehabilitation Research Unit, Bispebjerg and Frederiksberg Hospitals, Denmark, Copenhagen, Denmark, 4Danish Rheumatologic Biobank and DANBIO registry, Rigshospitalet, Glostrup, Gentofte and Herlev University Hospital, Copenhagen, Denmark, 5University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen, Denmark, 6Musculoskeletal Statistics Unit, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark, 7Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Denmark, Copenhagen, Denmark, 8Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Denmark, Copenhagen, Denmark

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: physical activity, prevention and rheumatoid arthritis (RA)

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Session Information

Date: Sunday, November 13, 2016

Session Title: Quality Measures and Quality of Care - ARHP Poster

Session Type: ACR Poster Session A

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

Background/Purpose:  Patients with rheumatoid arthritis (RA) are more sedentary than the general population, which can have serious health consequences. Reducing sedentary behaviour (SB) and increasing light intensity physical activity is advocated as a potentially more achievable health promotion focus in patients with chronic diseases and mobility problems. Intervention studies have shown that behavioural approaches are effective in reducing SB in healthy populations. Whether this applies to patients with RA is yet to be determined. Objective: To test the efficacy of a 16-week individually tailored, behavioural intervention in reducing daily sitting time, pain and fatigue and improving health-related quality of life, self-efficacy, physical function and cardio-metabolic disease risk in patients with RA.

Methods:  Parallel-group, observer-blinded randomized controlled trial (N=150). RA patients >18 years of age, self-reported daily sitting time > 5 hours and Health Assessment Questionnaire (HAQ) score < 2.5 were consecutively recruited from a rheumatology outpatient clinic. The intervention group (n=75) received three individual motivational counselling sessions with a health professional and text messages aiming at improving motivation for light intensity physical activity through reduction of SB. The control group (n=75) was encouraged to maintain usual lifestyle. Primary outcome was change from baseline in daily sitting time measured objectively by ActivPAL, analyzed using ANCOVA with a factor for group and adjustment for the outcome level at baseline. Primary analyses were based on the intention-to-treat population. Secondary outcomes included patient-reported outcomes and cardio-metabolic biomarkers (blood pressure, cholesterol levels, blood glucose, body weight and waist circumference).

Results:  After 16 weeks, three participants were lost to follow-up. There was a mean decrease in daily sitting time of 1.61 hours (h)/day with the intervention and an increase of 0.59 h/day in the control group; between-group difference was -2.20 h/day (95%CI: -2.72 to -1.69; p<.0001) in favor of the intervention group. Most of the secondary outcomes were also in favor of the intervention; VAS-pain: -22.36 (-29.27 to -15.44); VAS-fatigue: -26.80 (-34.32 to -19.30), physical function (HAQ): -0.42, (-0.54 to -0.30) and total cholesterol: -0.37 (-0.50 to -0.24) mmol/l.

Conclusion:  An individually tailored, behavioral intervention effectively reduced daily sitting time by on average more than two hours in patients with RA and additionally improved patient-reported clinical outcomes and cholesterol levels. The results may be important for clinical practise and physical activity recommendations for patients with RA and can most likely be generalized to other populations with chronic disease and mobility limitations.


Disclosure: T. Thomsen, None; M. Aadahl, None; N. Beyer, None; M. Lund Hetland, AbbVie, BMS, MSD, Roche, Pfizer, UCB, Crescendo, 2; K. Loeppenthin, None; J. Midtgaard, None; R. Christensen, R. Christensen Consultant for:, 5; M. Østergaard, None; P. Jennum, None; B. Appel Esbensen, None.

To cite this abstract in AMA style:

Thomsen T, Aadahl M, Beyer N, Lund Hetland M, Loeppenthin K, Midtgaard J, Christensen R, Østergaard M, Jennum P, Appel Esbensen B. The Efficacy of Motivational Counselling and SMS-Reminders on Daily Sitting Time in Patients with Rheumatoid Arthritis: A Randomised Controlled Trial [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-efficacy-of-motivational-counselling-and-sms-reminders-on-daily-sitting-time-in-patients-with-rheumatoid-arthritis-a-randomised-controlled-trial/. Accessed January 28, 2023.
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