Background Rheumatoid arthritis (RA) is associated with an increased risk of osteoporosis and cardiovascular disease, a reduction in physical fitness, and consequently a reduction in quality of life. Scientific evidence now supports various forms of exercise as both safe and even beneficial for RA patients. In RA, physical activity appears to play a central role in the management of the disease, maintenance of muscular function, joint range of motion and the ability to perform activities of daily life.
Objectives The present study aimed to examine the perceived exercise benefits and barriers in a cross-section of patients diagnosed with RA, with the hope to tailor physical activity interventions to this group of patients.
Methods Utilising a cross sectional study design thirty-seven participants (age, 58 ± 13 yrs) completed a self-administered survey. Participants were convenience-sampled from patients diagnosed with RA, attending the day-case unit for regular biologic intravenous infusions. Exercise barriers and perceived benefits of exercise were assessed using the exercise benefits/barriers scale (EBBS), with added questions in a rheumatology specific subscale. Physical activity guidelines (PAG's) were assessed using the single question physical activity questionnaire. Data are presented as means ± SD. Statistically significant differences reported by those meeting, and those not meeting PAG's was assessed using independent samples t-tests.
Results The greatest perceived benefit of exercise was the physical performance subscale (score, 3.0 ± 0.4), and the greatest perceived barrier was the physical exertion subscale (score, 3.0 ± 0.6).Within the rheumatology specific subscale, “Exercise keeps my joints moving” was the highest perceived benefit, whereas “Exercise causes pain” was the highest perceived barrier. Despite attending regular intravenous biologic drug infusion sessions, patients disagreed that they do not have enough time to exercise (score, 2.1 ± 0.6) as presented by the time expenditure subscale. Of 37 participants, 43.2% (n=16) do not meet current PAG's. Such patients reported significantly lower overall perceived benefits of exercise than those meeting PAG's (respective scores, 2.6 ± 0.3 vs. 3.0 ± 0.4, P<0.05), and significantly higher overall barriers (respective scores, 2.5 ± 0.4 vs. 2.1 ± 0.4, P<0.05). Of the various specific EBBS subscales, statistically significant (P<0.05) differences were reported across life enhancement, physical performance, psychological outlook and physical exertion subscales, between those meeting, and those not meeting PAG's. Furthermore, those not meeting PAG's reported significantly greater perceived barriers in the rheumatoid specific subscale (score,3.1± 0.5 vs. 2.4± 0.4, P<0.001).
Conclusions Less than half of the sample currently meet PAG's, with significant differences in perceived benefits/barriers between who meet and those who do not meet guidelines. Fatigue related to exercise was the greatest perceived barrier overall, which is also regarded as an extra-articular symptom of the disease. Contrary to the traditional advice, exercise is an intervention targeted against fatigue and has a critical bearing on wellbeing and quality of life in RA patients. Patients attending for biologic drug infusions represent a key opportunity to promote physical activity in this population.
Disclosure of Interest None declared