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Lack of conviction and motivation, not pain or depression, appear to be the major factors that deter nearly half of RA patients from moving about enough to ease their symptoms. Chicago researchers suggest what should be done about this.
You know that regular physical activity has replaced bed rest as the recommended response to the stiffness and pain of rheumatoid arthritis (RA). But many patients who have RA do not really believe this, according to a recent study. Lack of conviction and motivation, not pain or mood, appear to be the major factors that deter nearly half of RA patients from moving about enough to help their situation.
There's ample evidence about the benefits of physical activity in RA, but little research into why few RA patients take advantage of it. As part of a randomized trial testing a program to motivate RA patients to exercise, a team at the Northwestern University Feinberg School of Medicine and the Rehabilitation Institute of Chicago examined baseline data to discover why those who get little or no exercise are so inactive.
Unlike previous studies based on self-report of exercise, this one fitted subjects with accelerometers for a week to obtain valid data on their level of physical activity. Among the 176 subjects, 42% never once had more than 10 continuous minutes of moderate to vigorous activity during the week of testing.
For these people, pain and mental health status were not significantly associated with negligible physical activity. Two intertwined factors correlated most closely with inactivity: Lack of belief in the benefits of exercise and lack of motivation.
Obesity was also a deterrent, but not independently so after controlling for other descriptive qualities such as age, race, and gender. (Patients with a BMI greater than 35 were excluded from the study.)
Does this mean that doctors need to spend more time cajoling their RA patients to exercise? That's not the conclusion of the report in Arthritis Care & Research. Entitled The Public Health Impact of Risk Factors for Physical Inactivity in Adults with Rheumatoid Arthritis, it calls for public health interventions to improve RA patients' motivation to get moving.