Caroline Feldthusen1, Elizabeth Dean2, Helena Forsblad-d'Elia3, Kaisa Mannerkorpi4. 1. Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The University of Gothenburg Centre for Person-centred Care, Gothenburg, Sweden. Electronic address: caroline.feldthusen@vgregion.se. 2. Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden. 3. Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden. 4. The University of Gothenburg Centre for Person-centred Care, Gothenburg, Sweden; Section of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Abstract
OBJECTIVE: To examine effects of person-centered physical therapy on fatigue and related variables in persons with rheumatoid arthritis (RA). DESIGN: Randomized controlled trial. SETTING:Hospital outpatient rheumatology clinic. PARTICIPANTS: Persons with RA aged 20 to 65 years (N=70): intervention group (n=36) and reference group (n=34). INTERVENTIONS: The 12-week intervention, with 6-month follow-up, focused on partnership between participant and physical therapist and tailored health-enhancing physical activity and balancing life activities. The reference group continued with regular activities; both groups received usual health care. MAIN OUTCOME MEASURES: Primary outcome was general fatigue (visual analog scale). Secondary outcomes included multidimensional fatigue (Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire) and fatigue-related variables (ie, disease, health, function). RESULTS: At posttest, general fatigue improved more in the intervention group than the reference group (P=.042). Improvement in median general fatigue reached minimal clinically important differences between and within groups at posttest and follow-up. Improvement was also observed for anxiety (P=.0099), and trends toward improvements were observed for most multidimensional aspects of fatigue (P=.023-.048), leg strength/endurance (P=.024), and physical activity (P=.023). Compared with the reference group at follow-up, the intervention group improvement was observed for leg strength/endurance (P=.001), and the trends toward improvements persisted for physical (P=.041) and living-related (P=.031) aspects of fatigue, physical activity (P=.019), anxiety (P=.015), self-rated health (P=.010), and self-efficacy (P=.046). CONCLUSIONS:Person-centered physical therapy focused on health-enhancing physical activity and balancing life activities showed significant benefits on fatigue in persons with RA.
RCT Entities:
OBJECTIVE: To examine effects of person-centered physical therapy on fatigue and related variables in persons with rheumatoid arthritis (RA). DESIGN: Randomized controlled trial. SETTING: Hospital outpatient rheumatology clinic. PARTICIPANTS: Persons with RA aged 20 to 65 years (N=70): intervention group (n=36) and reference group (n=34). INTERVENTIONS: The 12-week intervention, with 6-month follow-up, focused on partnership between participant and physical therapist and tailored health-enhancing physical activity and balancing life activities. The reference group continued with regular activities; both groups received usual health care. MAIN OUTCOME MEASURES: Primary outcome was general fatigue (visual analog scale). Secondary outcomes included multidimensional fatigue (Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire) and fatigue-related variables (ie, disease, health, function). RESULTS: At posttest, general fatigue improved more in the intervention group than the reference group (P=.042). Improvement in median general fatigue reached minimal clinically important differences between and within groups at posttest and follow-up. Improvement was also observed for anxiety (P=.0099), and trends toward improvements were observed for most multidimensional aspects of fatigue (P=.023-.048), leg strength/endurance (P=.024), and physical activity (P=.023). Compared with the reference group at follow-up, the intervention group improvement was observed for leg strength/endurance (P=.001), and the trends toward improvements persisted for physical (P=.041) and living-related (P=.031) aspects of fatigue, physical activity (P=.019), anxiety (P=.015), self-rated health (P=.010), and self-efficacy (P=.046). CONCLUSIONS:Person-centered physical therapy focused on health-enhancing physical activity and balancing life activities showed significant benefits on fatigue in persons with RA.
Authors: Lilas Ali; Sara Wallström; Emmelie Barenfeld; Andreas Fors; Eva Fredholm; Hanna Gyllensten; Karl Swedberg; Inger Ekman Journal: BMJ Open Date: 2020-07-19 Impact factor: 2.692