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Person-centered physical therapy may ease fatigue in patients with RA
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An intervention with tailored, person-centered physical therapy improved multidimensional fatigue scores in patients with rheumatoid arthritis, according to a recently published study.
A group of 70 patients with rheumatoid arthritis (RA) were recruited from the Swedish rheumatology quality register. Eligible patients were between 20 years and 65 years of age, had a Disease Activity Score (DAS28) of less than 3.8, VAS fatigue scores greater than 50 and had disease duration for more than 3 years with stable pharmacological treatment for more than 6 months.
Thirty-six patients were randomized to an intervention group and 34 patients continued normal care. The intervention was a self-care plan developed between the physical therapist and the patient that focused on balancing life activities and the adoption of a physical activity plan comprised of either moderately intense aerobic activity for more than 30 minutes for 5 days per week, vigorous aerobic activity for more than 20 minutes for 3 days per week or a combination of activities. Balance of life activities was defined as “the way a person’s intentions, resources and environment match his or her life goals.” One patient in the intervention group and three patients in the reference group dropped out of the study.
The intervention group reported reduced general fatigue compared to the reference group with a between-group effect size of 0.37 at post-test. Clinically important improvement in fatigue were observed in both groups after within-group analyses.
Less anxiety, increased leg strength and endurance were reported by patients in the treatment group compared with the reference group. Trends toward improvements in self-rated health, self-efficacy and across all domains of fatigue except cognition were found.
In both groups, multidimensional aspects of fatigue improved except for the emotional subscore. Although physical activity, anxiety, depressive symptoms, self-rated health and self-efficacy improved in the intervention group, no differences were observed in the reference group. – by Shirley Pulawski
Disclosure s : The researchers report no relevant financial disclosures.
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