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Certain mobility limitations reversible in patients with RA
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Patients with rheumatoid arthritis with better body composition were more likely to complete a 400-meter walk and at higher speeds than those with worse body composition, suggesting that interventions to increase muscle strength and decrease body fat could reduce patient symptoms, according to researchers.
The researchers reviewed data from 132 patients with rheumatoid arthritis (RA), including demographic information (mean age 62, 37% male, 87% white), detailed information about body composition and BMI, serum inflammatory markers, and the results of a series of health questionnaires. Questionnaire results included information on disease activity score (DAS28), use of anti-rheumatic disease-modifying drugs (DMARDS), Center for Epidemiologic Studies Depression Scale (CES-D) score and Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale score.
Participants were asked to complete a 400-meter walk for analysis. Of the group, 107 completed the walk, 16 did not attempt the activity and nine did not complete the entire assessment.
Those who completed the walk were more likely to be younger, have better body composition and more likely to be male. Those who did not complete or attempt the walk had longer disease duration (greater than 10 years), higher levels of disease activity and disease severity, and scored three times higher on the CES-D than those in the fastest tertile of completers, according to the researchers.
Those in the slowest tertile among completers were a mean 6 years older, reported more depressive symptoms and had worse DAS28, FACIT and other scores. The researchers reported no differences in treatment methods between the two groups.
After multivariate analysis, indicators of slower walking speeds were associated with higher age, higher CES-D scores, the presence of more swollen or replaced joints, higher reported pain and fatigue, and poorer body composition. These indicators were reported to account for 60% of the total variability in walking speed.
The presence of interstitial lung disease, disease duration, antibody status, presence of inflammatory markers or radiographic scores did not affect the results.
Better body composition was described as a robust modifier between the presence of joint symptoms and walking speed, and lifestyle modifications to improve body composition may be an important part of treatment, the researchers concluded. – by Shirley Pulawski
Disclosure: The authors have no relevant financial disclosures.
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