Behavioral interventions that combine text message reminders and counseling sessions to encourage rheumatoid arthritis patients to be more physically active lead to better clinical outcomes, according to a study presented at the recent European League Against Rheumatism Annual Congress (EULAR 2016). The intervention was found to lessen daily sitting time by over two hours and reduce patients’ cholesterol levels.
Sedentary behavior (SB) is increasingly prevalent in industrialized countries. Objective measurements of physical activity in patients with rheumatoid arthritis (RA) show that these people spend a high proportion of the day being sedentary. Evidence shows that SB is associated with increased risk of cardiovascular diseases, obesity, type 2 diabetes, and all-cause mortality in the general population. Patients with RA are known to be at higher risk of cardiovascular disease and premature death triggered by their chronic inflammatory rheumatic disease.
Daily moderate to vigorous physical activity (MVPA) covers activities from brisk walking and gardening to competitive sports.
Since pain is often a barrier to keeping a physically active routine for people with RA, an effective approach to improving their health and well-being would be in reducing sedentary behavior and increasing light activity, rather than only focusing on increasing MVPA.
“We know that behavioural approaches are effective to reduce sedentary behaviour in healthy populations,” Tanja Thomsen of the Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Rigshospitalet, Denmark, said in a news release. “Our findings support the introduction of behavioural approaches as an effective way to improve the health of rheumatoid arthritis patients, which may also be applicable in other populations with chronic disease and limited mobility.”
A total of 75 RA patients with a self-reported daily sitting time of greater than five hours and a Health Assessment Questionnaire score less of than 2.5 underwent an individualized behavioral intervention for 16 weeks that included regular text messages and three counseling sessions with a health professional. The intervention was designed to improve patients’ motivation to reduce daily sitting time and replace it with light-intensity physical activity. Researchers also included a matched control group of 75 healthy adults who were encouraged to maintain their usual daily routine.
After the 16 weeks, there was a statistically significant difference between the two groups of 2.20 hours per day in average daily sitting time in favor of the intervention group. Secondary outcomes, including self-assessment scores of fatigue, pain, physical function, and total cholesterol also improved in the group of patients in the behavioral intervention program.
EULAR 2016 took place June 8–11 in London.