Background Physical inactivity is a major recognized public health challenge. Rheumatoid arthritis (RA) limits physical function, and physical inactivity may contribute to the increased risk of cardiovascular disease in patients with RA. However, limited data are available on the frequency of physical exercise in patients with RA.
Objectives To assess self-reported physical activity in a large sample of patients from a population based RA registry and explore factors associated with no regular versus regular physical exercise.
Methods In a population based RA registry in Oslo, Norway, 868 patients aged 20-79 years (mean (SD) age 59.9 (12.3) years, disease duration 13.0 (10.8) years, 77.1% females, 57.0% RF+ or CCP+) responded in 2009 to a mailed questionnaire (response rate 60.6%). 829 patients responded to a question on frequency of physical exercise of at least half an hour with shortness of breath and sweating. Response options were exercise ≥3 times weekly, 1-2 times weekly, 1-2 times monthly, no regular exercise, and none because of reduced function or handicap.
Other patient reported outcomes included pain, fatigue and patient reported global disease activity (PatGlob) on 100 mm visual analogue scales, HAQ, SF-36 with physical (PCS) and mental component summary (MCS) (low scores=poor health), SF-6D derived from SF-36 and EQ-5D utility (0-1), Rheumatoid Arthritis Disease Activity Index (RADAI 0-10), Rheumatoid Arthritis Impact of Disease (RAID) score (0-10), and self management on Self-Efficacy Scales (SES 10-100, 100 best).
Results High level regular activity (≥3 times weekly) and low level regular activity (1-2 times weekly) were reported by 174 (21.0%) patients and 354 (30.6%) patients. Very few patients (N=22, 2.7%) reported some physical activity (1-2 times monthly), while 292 (35.2%) were inactive with no regular exercise, and 87 (10.5%) inactive due to reduced function or handicap. Inactive patients with no regular exercise (45.7%) compared to patients with regular exercise (51.6%) had higher age, longer disease duration, more pain, fatigue, PatGlob, worse physical (HAQ and SF-36 PCS) and mental (SF-36 MCS) function, higher disease activity (RADAI), higher disease impact (RAID), lower utility (SF-6D and EQ-5D), and worse self management scores (all p<0.01). In multivariate logistic regression analyses and with adjustment for age and gender in the final model, years of education (OR 1.20, 95%CI 1.10-1.20), self-efficacy for arthritis symptoms (1.02; 95%CI 1.015-1.025), and physical function SF-36 PCS (OR 1.017, 95%CI 1.002-1.032) were independently associated with regular physical exercise in RA patients.
Conclusions About half of RA patients are physically inactive, and inactivity is independently associated with worse health status and low levels of self-efficacy and education. Physical activity should be encouraged in patients with RA, especially when these factors associated to inactivity are present, to comply with recommendations for physical exercise to improve quality of life and to prevent cardiovascular morbidity.
Disclosure of Interest None Declared
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