Exploring the public health impact of an intensive exercise program for patients with rheumatoid arthritis: A dissemination and implementation study

Abstract

Objective. To evaluate the implementation of an intensive group exercise program in patients with rheumatoid arthritis (RA).Methods. In 4 regions in The Netherlands, the Rheumatoid Arthritis Patients In Training exercise program was implemented on a limited scale. Evaluation using the RE-AIM model included: Reach, the proportion of the target population participating; Efficacy, effects on muscle strength, aerobic capacity, functional ability, and psychological functioning; Adoption, program adoption by stakeholders; Implementation, intervention quality (quality audits); and Maintenance, stakeholders' willingness to continue the program in the future. Results. Twenty-five physical therapists from 14 practices were trained to provide the program. In total, 150 RA patients were recruited (by estimation, 2% of the target population). Of the 81 patients who had finished the 12-month intervention and were available for followup directly after the intervention, 62 patients provided clinical data. Muscle strength improved significantly, whereas aerobic capacity, functional ability, psychological functioning, and disease activity did not change. All 9 informed local patient organizations facilitated patient recruitment, and 35 of 51 rheumatologists involved referred one or more patients. All 10 approached health insurance companies funded the program for 12 months. The quality audits showed sufficient quality in 9 of 12 practices. All of the providers of the program were willing to provide the program in the future, whereas future reimbursement by health insurance companies remained unclear. Conclusion. The implementation of an intensive exercise program for RA patients on a limited scale can be considered successful regarding its reach, adoption, and implementation. The limited effectiveness and the limited data regarding maintenance warrant additional research.

Diet and Rheumatoid Arthritis Symptoms: Survey Results From a Rheumatoid Arthritis Registry

“…These questions were included as indicators of whether subjects perceive other lifestyle/environmental factors, aside from diet, to affect RA symptoms. Prior work supports beneficial effects of exercise in RA and an association between poor sleep and RA symptoms . By contrast, little if any data exist on the impact of vitamin/mineral supplements or warm room temperature on RA symptoms.…”

Recommendations and the state of the evidence for physical activity interventions for adults with rheumatoid arthritis: 2007 to present

“…Of these, ten studies (67%) were RCTs [4,36-44], three were follow-up studies to an RCT [45-47] and the remaining studies were clinical trials of interventions (CTs) [48,49]. Ten studies tested an exercise intervention [4,36,37,40-44,48,49]. Of these studies, one was a multicenter study [42] and one used a team approach [37].…”

Assessment of adherence to drug and non-drug treatments and its changes under the influence of an education program in patients with rheumatoid arthritis

“…В нескольких работах была оценена роль регулярных занятий физкультурой в лечении РА [12][13][14]. Оказалось, что пациенты с РА менее физически активны по сравнению с общей популяцией, комплаентность регулярного выполнения физических упражнений с должной частотой и интенсивностью достаточно низка.…”