Self-efficacy for exercise, more than disease-related factors, is associated with objectively assessed exercise time and sedentary behaviour in rheumatoid arthritis

Abstract

Objectives: Until recently, reports of physical activity in rheumatoid arthritis (RA) were limited to self-report methods and/or leisure-time physical activity. Our objectives were to assess, determine correlates of, and compare to well-matched controls both exercise and sedentary time in a typical clinical cohort of RA.

Method: Persons with established RA (seropositive or radiographic erosions; n = 41) without diabetes or cardiovascular disease underwent assessments of traditional and disease-specific correlates of physical activity and 7 days of triaxial accelerometry. Twenty-seven age, gender, and body mass index (BMI)-matched controls were assessed.

Results: For persons with RA, objectively measured median (25th–75th percentile) exercise time was 3 (1–11) min/day; only 10% (n = 4) of participants exercised for ≥ 30 min/day. Time spent in sedentary activities was 92% (89–95%). Exercise time was not related to pain but was inversely related to disease activity (r = –0.3, p < 0.05) and disability (r = –0.3, p < 0.05) and positively related to self-efficacy for endurance activity (r = 0.4, p < 0.05). Sedentary activity was related only to self-efficacy for endurance activity (r = –0.4, p < 0.05). When compared to matched controls, persons with RA exhibited poorer self-efficacy for physical activity but similar amounts of exercise and sedentary time.

Conclusions: For persons with RA and without diabetes or cardiovascular disease, time spent in exercise was well below established guidelines and activity patterns were predominantly sedentary. For optimal care in RA, in addition to promoting exercise, clinicians should consider assessing sedentary behaviour and self-efficacy for exercise. Future interventions might determine whether increased self-efficacy can increase physical activity in RA.

Acknowledgements

We thank the participants of this investigation as well as the clinical faculty from the Division of Rheumatology and Immunology at Duke University Medical Center who referred patients for this investigation. We appreciate helpful discussions with career award mentors, H Hoenig, G Samsa, and D Muoio. This work was supported by NIH/NIAMS K23AR054904, NIH/NIA NIH/NIA P30AG028716, and an ACR-REF/ASP Junior Career Development Award in Geriatric Medicine funded by Atlantic Philanthropies, ACR-REF, the John A. Hartford Foundation, and ASP.