Using internet technology to deliver a home‐based physical activity intervention for patients with rheumatoid arthritis: A randomized controlled trial

Abstract

Objective. To compare the effectiveness of 2 Internet-based physical activity interventions for patients with rheumatoid arthritis (RA). Methods. A total of 160 physically inactive patients with RA who had a computer with Internet access were randomly assigned to an Internet-based physical activity program with individual guidance, a bicycle ergometer, and group contacts (individualized training [IT] group; n ‫؍‬ 82) or to an Internet-based program providing only general information on exercises and physical activity (general training [GT] group; n ‫؍‬ 78). Outcome measures included quantity of physical activity (questionnaire and activity monitor), functional ability, quality of life, and disease activity (baseline, 3, 6, 9, and 12 months). Results. The proportion of physically active patients was significantly greater in the IT than in the GT group at 6 (38% versus 22%) and 9 months (35% versus 11%; both P < 0.05) regarding a moderate intensity level for 30 minutes in succession on at least 5 days a week, and at 6 (35% versus 13%), 9 (40% versus 14%), and 12 months (34% versus 10%; all P < 0.005) regarding a vigorous intensity level for 20 minutes in succession on at least 3 days a week. In general, there were no statistically significant differences regarding changes in physical activity as measured with an activity monitor, functional ability, quality of life, or disease activity.Conclusion. An Internet-based physical activity intervention with individually tailored supervision, exercise equipment, and group contacts is more effective with respect to the proportion of patients who report meeting physical activity recommendations than an Internet-based program without these additional elements in patients with RA. No differences were found regarding the total amount of physical activity measured with an activity monitor.

Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta‐analysis of randomized controlled trials

“…Similarly, Neuberger et al showed that patients taking part in a 12-week class exercise program experienced significant amelioration in disease-related parameters, whereas home-based exercise did not have that result, probably because patients in this group exercised at a lower intensity (29). Indeed, most of the studies reporting positive effects of exercises on quality of life were supervised intervention trials (3,20,24), whereas most of the studies in which this outcome was not modified were home-based exercises (25). It is likely that supervised exercises result in higher adherence to the exercise program and positive group enthusiasm, explaining the trend of higher SMDs in subsets of trials with supervised intervention.…”

“…Among the 14 trials with cardiorespiratory aerobic exercise conditioning, the intervention fulfilled the dynamic exercise program criteria in 5 studies (5,8,20 -22). The control group underwent range of motion exercises in 3 studies (5,22,23), non-aerobic exercises in 1 study (24), education programs in 2 studies (3,25), and usual care in 8 studies (8,20,21,26 -30).…”

A systematic review of the effects of dynamic exercise in rheumatoid arthritis

“…Lyngberg et al 43 Numerical values, estimates of variability and p values not given for outcome measures 28 Linking powered by eXtyles Marcora et al 44 Not randomised Minor et al 45 Mixed RA / osteoarthritis groups Minor, Hewett 46 Not randomised Moffet et al 47 Observational study (no control group) Nordemar 49 Nordemar et al 48 Not randomised Noreau et al 50 Not randomised Neuberger et al 51 Observational study (no control group) Stenstrom et al 52 Not randomised Stenstrom et al 53 Intervention compared is cognitive therapy Stenstrom et al 54 Study group with mixed types of inflammatory arthritis van den Berg et al 55 Internet study; primary outcome measure is physical activity 29 Linking powered by eXtyles…”

Supporting stepwise change: improving health behaviors in rheumatoid arthritis with the example of physical activity

“…So far, intervention studies of HEPA in RA have been evaluated in two randomized controlled studies with partially contradictory results. One study reported increased HEPA levels but no effects on health-related outcome [10], while the other found improvements in perceived health and muscle function without being able to demonstrate any change in HEPA levels [11]. Thus, the mechanisms behind the positive outcome were unclear and the providers´ coaching skills were not measured.…”