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ACR 1999 Highlights from Boston, MA

Non-Pharmacologic Management of Rheumatic Illnesses - New Findings About Exercise - Reducing Inactivity

Susan J. Bartlett, Ph.D.

Abstract 911 Change in Leisure Activities Among Persons with Rheumatoid Arthritis (RA)

I Wikstrom, A Isacsson, LTH Jacobsson, Sweden

Objective:
1) To evaluate the relationship among leisure time activities, disease activity and Quality of Life.

2) To evaluate the change in leisure time activities after disease onset in persons with RA.

Methods:
Participants were 50 patients with RA who were mostly female (78%), married (76%) with a mean age of 37.5 years and disease duration of 9.5 years. Participants were surveyed retrospectively (before disease onset and at present) about leisure time activities, pain, morning stiffness, and quality of life. Leisure time activities were defined as activities performed after all other requisite activities (e.g., work, household activities and activities of daily living) were completed.

Results: Mean leisure activities decreased from 3 (prior to disease onset) to 1. In addition, the nature of current activities changed from those that were very physically active (e.g., exercise training, gymnastics, soccer and tennis) to more sedentary pursuits such as watching TV, sewing, socializing with friends and reading. Decreases in activities were associated with increased age (r = 0.37, p = 0.008), disease duration (r = 0.34, p = 0.002), pain (r = 0.40, p = 0.004), stiffness (r =.41, p = .003) and greater impairments in quality of life (r = -.37, p = 0.008). The investigators concluded that patients with RA had significant reductions in leisure time activities. The reduction in activities was associated with increased disease activity and duration, and had a substantial negative impact on quality of life.

Editorial Comments:
Leisure time activities are important markers of social engagement and physical activity levels. Decrements in activities are likely to result in negative physical and psychological outcomes as well as reduced quality of life.

Bottom line:
Clinicians should monitor participation in leisure time activities as a marker of negative physical and psychological outcomes. The challenge for clinicians is to encourage RA patients to remain physically and socially active by modifying activities appropriately or finding new interests that are compatible with disease severity and activity.