2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis

Abstract

Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.

Combating physical inactivity during the COVID-19 pandemic

“…However, compelling evidence shows that disuse actually leads to joint destruction, muscle weakness and atrophy, causing reduced physical function 2,3 . Such evidence has led to the contemporary abrogation of the 'bed rest paradigm' for rheumatic diseases and has guided new approaches to clinical practice that emphasize physical activity as an important part of therapy to improve patients' symptoms 7 . Given that physical inactivity and sedentary behaviour will potentially increase as a function of social distancing measures during the COVID-19 pandemic, patients with rheumatic diseases who are already hypoactive might be at particular risk of worsened disease activity and symptoms, general comorbidities and poor quality of life (Fig.…”

The outcomes of bariatric surgery on rheumatoid arthritis disease activity: a prospective cohort study

“…Even so, the disease activity measurements were performed by different trained evaluators who were unaware of the specific therapeutic regimen to make the study more objective. Second, previous studies demonstrated that metabolic factors, including dietary intake and physical activity, were associated with the occurrence and disease activity [34][35][36] . However, as the setup of the parameters was mainly focused on the change in RA disease activity before and after treatment, data on these metabolic factors were not collected in this study.…”

Fri0713-Hpr comparison of Biopsychosocial Status of Patients With Ankylosing Spondylitis With and Without Anti-TNF Treatment

“…Altering the intervention in response to patient's pain levels improved completion rates of the intervention. Conclusion: When designing PA programs for people with RA, the EULAR PA guidelines for people who have inflammatory arthritis [3] should be followed. However, it should be noted that engagement and participation in PA interventions is increased when the intervention is of low impact PA and starts at a low-moderate intensity.…”

“…The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression levels. Biopsychosocial status of the patients was evaluated by the BETY-Biopsychosocial Questionnaire (BETY-BQ) (2,3). The same evaluations were repeated after 3 months in 36 patients using anti-TNF.…”