Non-Pharmacologic Management
Abstract# 2022 - Outcome of a One-year Support Group Program for Healthy Physical Activity Behavior in Patients with Rheumatoid Arthritis
Authors: Sturk et al.
Background: Daily physical activity for persons with rheumatoid arthritis (RA) has been shown to benefit general health and arthritis-specific symptoms. However, promoting sustained physical activity among persons with RA is difficult. Sturk and associates evaluate the effects of a 1-year support group program designed to assist persons with early RA to incorporate physical activity into their daily lives.
Methods: Adults with an RA disease duration of one year (N = 228) were randomized to either an intervention (IG: N = 94) or control group (CG: N = 134). The IG consisted of a cognitive-behavioral program that provided education in self-monitoring, goal setting, problem solving strategies, personal “coaching”. The CG provided usual care with an exercise prescription, but no follow-up. All participants completed measures related to physical activity, health-related quality of life, joint motion, muscle function, balance, pain, activity limitations, general health perception, and inflammation.
Results: The majority of participants were middle aged (median age = 55 years) and female (73%). With the exception of grip strength and functional balance (where IG scored significantly higher) there were no significant differences on study variables. Approximately 82% of participants completed the study. At 1-year there was no significant self-reported change in physical activity in either group. However, IG participants significantly improved their grip strength and timed standing function test compared to CG (p’s <.05). The IG also reported greater improvement in health-related quality of life compared to CG (p<.05).
Conclusions: The IG experienced improved muscle function and health-related quality of life compared to controls.
Editorial Comment: On the surface, these results seem counter-intuitive: the IG and CG groups did not differ in physical activity over the course of the year yet the IG participants significantly improved their quality of life and muscle function. There are several possible explanations for this. First, the assessment of physical activity may not have been sensitive enough to detect subtle differences. Second, the IG participants may not have perceived a marked increase in their physical activity because its increase was gradual and un-dramatic. Third, the physical activity of IG participants may, indeed, not have increased over the year but the social support, education, and increased attention may have driven the improved outcomes. As such, the major limitation of this study was the absence of a direct measure of physical activity (i.e., accelerometer, doubly-labeled water). As, such all we can reasonably conclude from this study is that participation in the IG produced improved some outcomes.