Understanding how to determine the intensity of physical activity–An interview study among individuals with rheumatoid arthritis

Brodin, Nina; Swärdh, Emma; Biguet, Gabriele; Opava, Christina H.

doi:10.1080/09638280802131853

Cited by 10 publications

(10 citation statements)

References 26 publications

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“…Furthermore, despite clear instructions, they might not have maintained the recommended intensity levels of (the mainly unsupervised) physical activity performed within the study for 2 years. The difficulty to maintain recommended levels of intensity is also supported by our previous study, which found that individuals with RA determine physical activity intensity by standards other than those of health professionals [ 37 ]. Studies of aerobic exercise [ 20 , 38 ] and of resistance exercises [ 21 , 39 ] indicate that participants with RA seldom maintain high enough levels of physical activity without supervision.…”

Section: Discussionmentioning

confidence: 80%

Long-term, health-enhancing physical activity is associated with reduction of pain but not pain sensitivity or improved exercise-induced hypoalgesia in persons with rheumatoid arthritis

et al. 2018

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BackgroundWe aimed to evaluate the 1-year and 2-year outcome of a health-enhancing physical activity (HEPA) support program on global pain, pressure pain sensitivity, and exercise-induced segmental and plurisegmental hypoalgesia (EIH) in persons with rheumatoid arthritis (RA).MethodsThirty participants (27 women and 3 men) were recruited from a larger intervention cohort that engaged in strength training and moderate-intensity aerobic activity. Assessments were performed before the HEPA intervention and at 1-year and 2-year follow-ups. Global pain was assessed on a visual analogue scale (0–100). Pressure pain thresholds (PPTs) and suprathreshold pressure pain at rest corresponding to 4/10 (medium pain) (SP4) and 7/10 (strong pain) (SP7) on Borg CR 10 scale were assessed by algometry. In a subsample (n = 21), segmental and plurisegmental EIH were assessed during standardized submaximal static contraction (30% of the individual maximum), by algometry, alternately at the contracting right M. quadriceps and the resting left M. deltoideus.ResultsGlobal pain decreased from before the intervention to 2-year follow-up (median 11 to median 6, P = 0.040). PPTs and SP4 pressure pain at rest did not change from before the intervention to 2-year follow-up, while SP7 decreased from mean 647 kPa to mean 560 kPa (P = 0.006). Segmental EIH during static muscle contraction increased from the assessment before the intervention (from mean 1.02 to mean 1.42, P = 0.001), as did plurisegmental EIH (from mean 0.87 to mean 1.41, P <0.001). There were no statistically significant changes in segmental or plurisegmental EIH from before the intervention to 2-year follow-up.ConclusionParticipation in a long-term HEPA support program was associated with reduced global pain, whereas pressure pain sensitivity at rest was not reduced and EIH did not change. Thus, our results do not favor the hypothesis that long-term HEPA reduces pain by improving descending pain inhibition in persons with RA.Trial registrationISRCTN25539102, ISRCTN registry, date assigned March 4, 2011. The trial was retrospectively registered.

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Section: Discussionmentioning

confidence: 80%

Long-term, health-enhancing physical activity is associated with reduction of pain but not pain sensitivity or improved exercise-induced hypoalgesia in persons with rheumatoid arthritis

et al. 2018

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“…Fifteen primary studies with qualitative designs including a total of 233 individuals with RA (177 women, 56 men, aged 21–87 years) were included in the review and synthesis 14–17 27–37 ( table 2 ). The studies were conducted in Denmark, Ireland, New Zealand, Sweden and the UK.…”

Section: Resultsmentioning

confidence: 99%

“…The studies were conducted in Denmark, Ireland, New Zealand, Sweden and the UK. All studies captured patient perspectives on PA but varied in terminology, with eight studies using the term ‘PA’ 14–16 33–37 and seven using ‘exercise’. 17 27–32 The focus of the studies varied between perceptions of specific PA programmes, future PA programme designs, barriers and facilitators, maintenance, attitudes, effects, intensity, as well as PA in everyday life.…”

Section: Resultsmentioning

confidence: 99%

Physical activity in patients with rheumatoid arthritis - an agile lifelong behaviour: a qualitative meta-synthesis

2021

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BackgroundPhysical activity (PA) in rheumatoid arthritis (RA) is considered a cornerstone in the treatment. To highlight aspects involved in supporting a positive PA behaviour, it is important to understand the patients’ perceptions of the phenomenon.ObjectiveThe aim of this qualitative meta-synthesis was to explore and synthesise patient perceptions of PA in RA.MethodsA purposeful search was conducted across three online databases (PubMed, CINAHL and Web of Science). The methodological quality of the included studies was appraised, and data were extracted and analysed using an interpretive inductive thematic synthesis.ResultsFifteen studies met the inclusion criteria and were included. PA was identified as an agile lifelong behaviour, with one main theme: The disease as a persistent catalyst for or against PA illustrating how the constant presence of the disease itself underlies the entire process of a life with or without regular PA. Seven subthemes: ‘considering aggravated symptoms’, ‘acknowledging the impact on health’, ‘becoming empowered and taking action’, ‘keeping informed to increase awareness’, ‘creating body awareness’, ‘dealing with social support’ and ‘feeling satisfied with circumstances and achievements’ were interpreted as facilitators and/or challenges.ConclusionThis synthesis has identified PA as an agile lifelong behaviour in which the disease pervades all aspects of an individuals’ perception of PA. Placed in a theoretical context, our findings outline a model for tailoring PA support to the drivers and determinants of a certain individual, which will improve clinical practice for the benefit of both health professionals and patients with RA.

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“…The use of self‐reported physical activity data is subject to several types of bias and the IPAQ and the ESAI represent no exceptions to this. Concerns as to recall bias and individual differences in understanding the various intensity levels of physical activity have been raised (). The rationale for using 2 HEPA assessment methods was to gain knowledge, not only on current HEPA, but also on maintained HEPA, and to contrast the 2 methods to each other.…”

Section: Discussionmentioning

confidence: 99%

Current and Maintained Health‐Enhancing Physical Activity in Rheumatoid Arthritis: A Cross‐Sectional Study

Demmelmaier

Bergman

Nordgren

et al. 2013

Arthritis Care & Research

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Objective. To describe and identify the explanatory factors of variation in current and maintained health-enhancing physical activity (HEPA) in persons with rheumatoid arthritis (RA). Methods. In this cross-sectional study, current HEPA was assessed with the International Physical Activity Questionnaire and maintained HEPA with the Exercise Stage Assessment Instrument, the latter explicitly focusing on both aerobic physical activity and muscle strength training. Sociodemographic, disease-related, and psychosocial data were retrieved from the Swedish Rheumatology Quality (SRQ) registers and a postal questionnaire. The explained variations in the respective HEPA behaviors were analyzed with logistic regression. Results. In all, 3,152 (58.5%) of 5,391 persons identified as eligible from the SRQ registers responded to the questionnaire. Current HEPA was reported by 69%, and maintained HEPA by 11% of the respondents. The most salient and consistent factors explaining variation in both current and maintained HEPA were self-efficacy, social support, and outcome expectations related to physical activity. Conclusion. To our knowledge, this is the first study exploring maintained physical activity in a large well-defined sample of persons with RA. Our results indicate that a minority perform maintained HEPA, including both aerobic physical activity and muscle strength training, and that psychosocial factors are the most salient and consistent in the explanation of HEPA variation.

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Understanding how to determine the intensity of physical activity–An interview study among individuals with rheumatoid arthritis

Cited by 10 publications

References 26 publications

Long-term, health-enhancing physical activity is associated with reduction of pain but not pain sensitivity or improved exercise-induced hypoalgesia in persons with rheumatoid arthritis

Long-term, health-enhancing physical activity is associated with reduction of pain but not pain sensitivity or improved exercise-induced hypoalgesia in persons with rheumatoid arthritis

Physical activity in patients with rheumatoid arthritis - an agile lifelong behaviour: a qualitative meta-synthesis

Current and Maintained Health‐Enhancing Physical Activity in Rheumatoid Arthritis: A Cross‐Sectional Study

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