Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study

Feldthusen, Caroline; Grimby-Ekman, Anna; Forsblad-d’Elia, Helena; Jacobsson, Lennart; Mannerkorpi, Kaisa

doi:10.2340/16501977-2090

Cited by 31 publications

(33 citation statements)

References 32 publications

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“…The subgroup analysis indicates that the participants with a lower disease activity at baseline got the best effects of moderate-to-high intensity exercise on fatigue and depression. Disease activity has been found to correlate with fatigue [32], but has not been documented as a stronger predictor for fatigue in RA [12,33]. However, patients have described struggling with the unpredictability of the disease activity to be physically active [34] and reduced physical health is a barrier for exercise among older persons with RA [35].…”

Section: Discussionmentioning

confidence: 99%

Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis

et al. 2019

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Fatigue is described as a dominant and disturbing symptom of rheumatoid arthritis (RA) regardless of the advances in pharmacological treatment. Fatigue is also found to correlate with depression. The objective was to evaluate the impact of moderate-to-high intensity, aerobic and resistance exercise with person-centered guidance on fatigue, anxiety and depression, in older adults with RA. Comparisons were made between older adults (> 65 years) with RA taking part in a 20-week moderate-to-high intensity exercise at a gym (n = 36) or in home-based exercise of light intensity (n = 38). Assessments were performed at baseline, at 20 weeks, and at 52 weeks. Outcomes were differences in Multidimensional Fatigue Inventory (MFI-20), Visual Analog Scale Fatigue (VAS fatigue), and Hospital Anxiety and Depression Scale (HADS). Analysis of metabolomics was also performed. The subscales "physical fatigue" and "mental fatigue" in MFI-20 and symptoms of depression using HADS depression scale improved significantly at week 20 in the exercise group compared with the control group. Exercise did not influence global fatigue rated by VAS or subscales "reduced motivation", "reduced activity" and "general fatigue" in MFI-20. No significant change was found on the anxiety index of HADS. The improvements in physical fatigue were associated with changes in the metabolism of lipids, bile acids, the urea cycle and several sugars. Moderateto-high intensity exercise with person-centered guidance decreased fatigue and improved symptoms of depression and were accompanied by metabolic changes in older adults with RA.

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Section: Discussionmentioning

confidence: 99%

Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis

et al. 2019

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“…29e31, 33 One participant described how their family and friends did not fully grasp the profoundness of their fatigue, They can somehow understand [fatigue] intellectually, but you still know that they have not really understood what I'm talking about. 35 Another described how their clinicians did not inquire about fatigue or understand how to treat it, Nobody says ''what are you doing for the fatigue?'' The health professionals don't understand how to treat it either.…”

Section: Metasummariesmentioning

confidence: 99%

A Qualitative Metasynthesis of the Experience of Fatigue Across Five Chronic Conditions

Jaime-Lara

Koons

Matura

et al. 2020

Journal of Pain and Symptom Management

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Context. Fatigue is a symptom reported by patients with a variety of chronic conditions. However, it is unclear whether fatigue is similar across conditions. Better understanding its nature could provide important clues regarding the mechanisms underlying fatigue and aid in developing more effective therapeutic interventions to decrease fatigue and improve quality of life. Objectives. To better understand the nature of fatigue, we performed a qualitative metasynthesis exploring patients' experiences of fatigue across five chronic noninfectious conditions: heart failure, multiple sclerosis, rheumatoid arthritis, chronic kidney disease, and chronic obstructive pulmonary disease. Methods. We identified 34 qualitative studies written in the last 10 years describing fatigue in patients with one of the aforementioned conditions using three databases (Embase, PubMed, and CINAHL). Studies with patient quotes describing fatigue were synthesized, integrated, and interpreted. Results. Across conditions, patients consistently described fatigue as persistent overwhelming tiredness, severe lack of energy, and physical weakness that worsened over time. Four common themes emerged: running out of batteries, a bad life, associated symptoms (e.g., sleep disturbance, impaired cognition, and depression), and feeling misunderstood by others, with a fear of not being believed or being perceived negatively. Conclusion. In adults with heart failure, multiple sclerosis, rheumatoid arthritis, chronic kidney disease, and chronic obstructive pulmonary disease, we found that fatigue was characterized by severe energy depletion, which had negative impacts on patients' lives and caused associated symptoms that exacerbated fatigue. Yet, fatigue is commonly misunderstood and inadequately acknowledged.

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“…Even though anti-rheumatic therapies have improved tremendously during the last few decades and disease activity is reduced in most patients, pain, disability and/or fatigue are in too many cases persistent [ 2 , 3 , 4 ]. Pain and fatigue are associated with each other, as well as with depression [ 5 ] and are significant predictors for high health care costs, loss of employment and physical functioning and poor quality of life [ 4 ]. Lifestyle interventions such as physical activity provide evidence of benefit in relation to self-reported fatigue and pain in adults with RA [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Blue Mussel (Mytilus edulis) Intake on Disease Activity in Female Patients with Rheumatoid Arthritis: The MIRA Randomized Cross-Over Dietary Intervention

et al. 2018

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Rheumatoid Arthritis (RA) is a chronic inflammatory disease. This study evaluates the effect of blue mussel intake on disease activity and quality of life in women with RA. Thirty-nine women with established RA and a disease activity score 28 (DAS28) >3.0 were recruited to a randomized 2 × 11-week cross-over dietary intervention. The participants continued with their medication and habitual diet and exchanged one cooked meal a day, five days a week, with a meal including 75 g blue mussels or 75 g meat. Diets were switched after an eight week washout period. Data regarding quality of life (SF-36), blood lipids, erythrocyte sediment rate (ESR), C-reactive protein (CRP) and tender and swollen joints were examined at the start and end of each dietary period. Thirty women completed one period, and twenty-three completed both. Intake of the blue mussel diet led to a significant reduction of DAS28-CRP (p = 0.048), but not DAS28. The number of EULAR (European League Against Rheumatism) criteria moderate and good responders were higher when consuming blue mussel diet (p = 0.036). Blood lipids did not change. To conclude, blue mussel intake reduced disease symptoms in women with RA and improved perceived health. The reported effects need to be confirmed by non-patient reported outcomes, such as inflammation markers.

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Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study

Abstract: Pain threshold and depressive mood were the most important factors for fatigue in persons with rheumatoid arthritis.

Cited by 31 publications

References 32 publications

Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis

Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis

A Qualitative Metasynthesis of the Experience of Fatigue Across Five Chronic Conditions

Influence of Blue Mussel (Mytilus edulis) Intake on Disease Activity in Female Patients with Rheumatoid Arthritis: The MIRA Randomized Cross-Over Dietary Intervention

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