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Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review

  • Review Article - Outcomes Research
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Abstract

Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.

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References

  1. Aletaha D, Neogi T, Silman AJ et al (2010) Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 69:1580–1588

    Article  PubMed  Google Scholar 

  2. Plasqui G (2008) The role of physical activity in rheumatoid arthritis. Physiol Behav 94:270–275

    Article  CAS  PubMed  Google Scholar 

  3. Aviña-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D (2008) Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Care Res 59(12):1690–1697

    Article  Google Scholar 

  4. Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE, Stampfer MJ, Curhan GC (2003) Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 107:1303–1307

    Article  PubMed  Google Scholar 

  5. Del Rincón I, Williams K, Stern MP, Freeman GL, Escalante A (2001) High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum 44(12):2737–2745

    Article  PubMed  Google Scholar 

  6. Aadahl M, von Huth Smith L, Pisinger C, Toft UN, Glümer C, Borch-Johnsen K, Jørgensen T (2009) Five-year change in physical activity is associated with changes in cardiovascular disease risk factors: the Inter99 study. Prev Med 48(4):326–331

    Article  CAS  PubMed  Google Scholar 

  7. McGuire KA, Janssen I, Ross R (2009) Ability of physical activity to predict cardiovascular disease beyond commonly evaluated cardiometabolic risk factors. Am J Cardiol 104(11):1522–1526

    Article  PubMed  Google Scholar 

  8. Caspersen CJ, Powell KE, Christenson GM (1985) physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 100(2):126–131

    PubMed Central  CAS  PubMed  Google Scholar 

  9. Taylor HL (1983) Physical activity: is it still a risk factor? Prev Med 12:20–24

    Article  PubMed  Google Scholar 

  10. Noreau L, Martineau H, Roy L, Belzile M (1995) Effects of a modified dance-based exercise on cardiorespiratory fitness, psychological state and health status of persons with rheumatoid arthritis. Am J Phys Med Rehabil 74(1):19–27

    Article  CAS  PubMed  Google Scholar 

  11. Metsios GS, Stavropoulos-Kalinoglou A, Veldhuijzen van Zanten JJCS, Treharne GJ, Panoulas VF, Douglas KMJ, Koutedakis Y, Kitas GD (2008) Rheumatoid arthritis, cardiovascular disease and physical exercise: a systematic review. Rheumatol 47(3):239–248

    Article  CAS  Google Scholar 

  12. Metsios GS, Stavropoulos-Kalinoglou A, Sandoo A, Veldhuijzen van Zanten JJCS, Toms TE, John H, Kitas GD (2010) Vascular function and inflammation in rheumatoid arthritis: the role of physical activity. Open Cardiovasc Med J 4:89–96

    PubMed Central  PubMed  Google Scholar 

  13. Hurkmans E, van der Giesen FJ, Vliet Vlieland TPM, Schoones J, Van den Ende ECHM (2009). Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD006853. doi:10.1002/14651858.CD006853.pub2

  14. Finckh A, Iversen M, Liang MH (2003) The exercise prescription in rheumatoid arthritis: primum non nocere. Arthritis Rheum 48:2393–2395

    Article  PubMed  Google Scholar 

  15. Larkin, L (2013) An examination of self-report physical activity and its relationship with psychological factors in inflammatory arthritis. (MSc.) University of Limerick

  16. Tierney M, Fraser A, Kennedy N (2012) physical activity in rheumatoid arthritis: a systematic review. J Phys Act Health 9:1036–1048

    PubMed  Google Scholar 

  17. Sokka et al (2008) Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study. Arthritis Rheum (Arthritis Care & Res) 59(1):42–504

    Article  Google Scholar 

  18. Orleans CT (2000) Promoting the maintenance of health behavior change: recommendations for the next generation of research and practice. Health Psychol 19:76–83

    Article  CAS  PubMed  Google Scholar 

  19. Ezzat AM, MacPherson K, Leese J, Li CL (2014) The effects of interventions to increase exercise adherence in people with arthritis: a systematic review. Musculoskelet Care. doi:10.1002/msc.1084

    Google Scholar 

  20. World Health Organization (2003) Adherence to long term therapies: evidence to action. World Health Organization Library, Geneva

    Google Scholar 

  21. Bauman AE, Sallis JF, Dzewaltowski DA, Owen N (2002) Toward a better understanding of the influences on physical activity the role of determinants, correlates, causal variables, mediators, moderators, and confounders. Am J Prev Med 23(2S):5–14

    Article  PubMed  Google Scholar 

  22. Larkin L, Kennedy N (2014) Correlates of physical activity in adults with rheumatoid arthritis: a systematic review. J Phys Act Health 11(6):1248–1261

    Article  Google Scholar 

  23. Darker CD, French DP, Evesc FF, Sniehotta FF (2010) An intervention to promote walking amongst the general population based on an ‘extended’ theory of planned behaviour: a waiting list randomised controlled trial. Psychol Health 25(1):71–88

    Article  CAS  PubMed  Google Scholar 

  24. Cramp F, Berry J, Gardiner M, Smith F, Stephens D (2013) Health behaviour change interventions for the promotion of physical activity in rheumatoid arthritis: a systematic review. Musculoskeletal Care. Published online in Wiley Online Library (wileyonlinelibrary.com). doi:10.1002/msc.1049

  25. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(6):e1000097. doi:10.1371/journal.pmed1000097

    Article  PubMed Central  PubMed  Google Scholar 

  26. Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Eccles MP, Cane J, Wood CE (2013) The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med 46(1):81–95

    Article  PubMed  Google Scholar 

  27. Warren JM, Ekelund U, Besson H et al (2010) Assessment of physical activity—a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil 17(2):127–139

    Article  PubMed  Google Scholar 

  28. Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  CAS  PubMed  Google Scholar 

  29. Aletaha D, Neogi T, Silman AJ et al (2010) Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 69:1580–1588

    Article  PubMed  Google Scholar 

  30. Cairns AP, McVeigh JG (2009) A systematic review of the effects of dynamic exercise in rheumatoid arthritis. Rheumatol Int 30:147–158. doi:10.1007/s00296-009-1090-5

    Article  PubMed  Google Scholar 

  31. Van den Ende CH, Vliet Vlieland TP, Munneke M, Hazes JM (1998) Dynamic exercise therapy in rheumatoid arthritis: a systematic review. Br J Rheumatol 37(6):677–687

    Article  PubMed  Google Scholar 

  32. Higgins JPT, Green S (eds) (2011) Cochrane handbook for systematic reviews of interventions, Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. http://www.cochrane-handbook.org

  33. Van den Berg MH, Roday HK, Peeters J, Le Cessie F, Van der Giesen FJ, Breedveld FC, Vliet Vlieland TPM (2006) Using internet technology to deliver a home-based physical activity intervention for patients with rheumatoid arthritis: a randomized controlled trial. Arthritis Rheum (Arthritis Care & Research) 55(6):935–945

    Article  Google Scholar 

  34. John H, Hale ED, Treharne GJ, Kitas GD, Carroll D (2013) A randomized controlled trial of a cognitive behavioural patient education intervention vs a traditional information leaflet to address the cardiovascular aspects of rheumatoid disease. Rheumatology 52:81–90

    Article  PubMed  Google Scholar 

  35. Mayoux-Benhamou A, Giraudet-Le Quintrec JS, Ravaud P, Champion K, Dernis E, Zerkak D, Roy C, Kahan A, Revel M, Dougados M (2008) Influence of patient education on exercise compliance in rheumatoid arthritis: a prospective 12-month randomized controlled trial. J Rheumatol 35:216–223

    PubMed  Google Scholar 

  36. Brodin N, Eurenius E, Jensen I, Nisell R, Opava CH, the PARA Study Group (2008) Coaching patients with early rheumatoid arthritis to healthy physical activity: a multicenter, randomized, controlled study. Arthritis Rheum (Arthritis Care & Res) 59(3):325–331

    Article  Google Scholar 

  37. Knittle, K, De Gucht, V, Hurkmans, E, Peeters, A, Ronday, K, Maes, S, Vliet Vlieland, T (2013) Targeting motivation and self-regulation to increase physical activity among patients with rheumatoid arthritis: a randomised controlled trial. Clin Rheumatol. Epub ahead of print. http://link.springer.com/article/10.1007%2Fs10067-013-2425-x. Accessed 01 Apr 2014

  38. Sjöquist ES, Brodin N, Lampa J, Jensen I, Opava CH, the PARA study group (2011) physical activity coaching of patients with rheumatoid arthritis in everyday practice: a long-term follow-up. Musculoskelet Care 9:75–85

    Article  Google Scholar 

  39. Bandura A (1977) Self-efficacy: toward a unifying theory of behavioural change. Psychol Rev 84:191–215

    Article  CAS  PubMed  Google Scholar 

  40. Prochaska JO, Diclemente CC, Norcross JC (1992) Search of how people change. Applications to addictive behaviors. Am Psychol 47:1102–1114

    Article  CAS  PubMed  Google Scholar 

  41. Hurkmans EJ, van den Berg MH, Ronday KH, Peeters AJ, le Cessie S, Vlieland TP (2010) Maintenance of physical activity after Internet-based physical activity interventions in patients with rheumatoid arthritis. Rheumatology (Oxford) 49(1):167–172. doi:10.1093/rheumatology/kep285

    Article  Google Scholar 

  42. Baecke JAH, Burema J, Frijters ER (1982) A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 36:936–942

    CAS  PubMed  Google Scholar 

  43. Michie S, Prestwich A (2010) Are interventions theory-based? Development of a theory coding scheme. Health Psychol 29:1–8

    Article  PubMed  Google Scholar 

  44. Craig P, Dieppe P, Macintyre S et al (2008) Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 337:a1655

  45. Michie S, Van Stralen MM, West R (2011) The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 23(6):42. doi:10.1186/1748-5908-6-42

    Article  Google Scholar 

  46. Larkin L, Kennedy N, Gallagher S (2015) Promoting physical activity in rheumatoid arthritis: a narrative review of behaviour change theories. Disabil Rehabil 27:1–18

    Article  Google Scholar 

  47. Sallis JF, Saelens BE (2000) Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport 71(2 Suppl):S1–S14

    Article  CAS  PubMed  Google Scholar 

  48. Semanik P, Lee J, Manheim L, DiPietro L, Dunlop D, Chang RW (2011) relationship between accelerometer-based measures of physical activity and the Yale Physical Activity Survey in adults with arthritis. Arthritis Care Res 63(12):1766–1772

    Article  Google Scholar 

  49. Tierney M, Fraser A, Purtill H, Kennedy N (2013) Study to determine the criterion validity of the SenseWear Armband as a measure of physical activity in people with rheumatoid arthritis. Arthritis Care Res 65:888–895

    Article  Google Scholar 

  50. Munneke M, de Jong Z, Zwinderman AH, Tijhuis GJ, Hazes JM, Vliet Vlieland TP (2001) The value of a continuous ambulatory activity monitor to quantify the amount and intensity of daily activity in patients with rheumatoid arthritis. J Rheumatol 28:745–750

    CAS  PubMed  Google Scholar 

  51. Kennedy T, McCabe C, Struthers G, Sinclair H, Chakravaty K, Bax D, Shipley M, Abernethy R, Palferman T, Hull R, British Society for Rheumatology Standards, Guidelines and Audit Working Group (SGAWG) (2005) BSR guidelines on standards of care for persons with rheumatoid arthritis. Rheumatology (Oxford) 44(4):553–556

    Article  CAS  Google Scholar 

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland

    Louise Larkin, Charles Brand & Norelee Kennedy

  2. Department of Psychology, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland

    Stephen Gallagher

  3. Faculty of Health and Life Sciences, University of the West of England, Bristol, UK

    Fiona Cramp

  4. University of Limerick Medical School, University of Limerick, Limerick, Ireland

    Alexander Fraser

  5. University Hospital Limerick, Limerick, Ireland

    Alexander Fraser

Authors
  1. Louise Larkin
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  2. Stephen Gallagher
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  3. Fiona Cramp
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  4. Charles Brand
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  5. Alexander Fraser
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  6. Norelee Kennedy
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Correspondence to Louise Larkin.

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Larkin, L., Gallagher, S., Cramp, F. et al. Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review. Rheumatol Int 35, 1631–1640 (2015). https://doi.org/10.1007/s00296-015-3292-3

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