Background Physical activity (PA) is important to preserve functioning and avoid co morbidity in people with RA. To better understand how to tailor PA programs it is important to identify characteristics of those eligible versus those who are not. However, recruitment processes prior to PA programs are often poorly described in people with RA.
Objectives The objective of our study, including a large well defined sample of individuals with RA at target for a PA trial, was to compare those that were finally included in the trial with those that were not as regards socio-demographic, disease-related, and psychosocial factors and current PA levels.
Methods In this cross-sectional survey 3152 individuals (1), of which 12 were excluded due to participation in another study, below age 75 years and independent in daily activities (HAQ>2) answered questionnaires on socio-demographic, disease-related, and psychosocial factors and current PA levels. Differences between individuals making it to the baseline assessments of the trial and those who did not were analyzed in three steps.
Results In a first step, 1932 individuals were identified as eligible for the trial as they were interested, not enough physically active and had good Swedish language skills. They were mainly female, younger, better educated, having higher income and more likely to live with children, had better social support for exercise and higher outcome expectations on PA compared to the 1208 that were not eligible. In a second step, 286 individuals consented to participate. They were better educated and had higher income, more social support for exercise, less fear avoidance beliefs and higher outcome expectations on PA compared to the 1646 that declined participation. Reasons for declining were ‘training centre too distant’, ‘no time due to family, work or other reasons’, ‘too expensive’, ‘feel very well and not in need for exercise’, ‘bothered by injury/co morbidity’, ‘RA too active/disabling’, ‘no energy’. In a third step, 244 individuals showed up for baseline assessments and reported less fatigue compared to the 42 that did not show up for assessments. Reasons for withdrawal included ‘dislike training center’, ‘prefer yoga’, ‘changed mind about participation’, ‘recent cancer diagnosis’, ‘recent foot injury’, ‘foot ulcer’, ‘aortic aneurysm’, ‘too expensive’, ‘time constraints’ and logistic problems related to time or place of assessments or training.
Conclusions To our knowledge this is the first study to describe the entire selection procedure from a target sample for a PA trial to baseline assessment in individuals with RA. Our results indicate that factors other than those related to the disease seem to determine participation and largely resemble those seen in the general population. Based on our results caregivers may be able to identify factors that are essential for supporting PA in people with RA that are reluctant to participate in various programs.
Demmelmaier I et al. Current and maintained health-enhancing physical activity in rheumatoid arthritis - the PARA 2010 study. Arthritis Care Res 2013 Jan 17 [Epub ahead of print]
Acknowledgements We would like to acknowledge the contribution of the rheumatology clinics at Danderyd Hospital, Stockholm, Karolinska University Hospital, Solna and Huddinge, Linköping University Hospital, Linköping and Norrköping, Mälarsjukhuset, Eskilstuna, östersund Hospital, Sunderby Hospital, Luleå, and the Swedish Rheumatology Quality Registers.
Disclosure of Interest None Declared