Abigail L Gilbert1, Jungwha Lee2, Linda Ehrlich-Jones3, Pamela A Semanik4, Jing Song5, Christine A Pellegrini6, Daniel Pinto Pt7, Dorothy D Dunlop8, Rowland W Chang9. 1. Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 2. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 3. Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL; Shirley Ryan AbilityLab, Chicago, IL. 4. Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, IL. 5. Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 6. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 7. Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. 8. Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 9. Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL; Shirley Ryan AbilityLab, Chicago, IL. Electronic address: rwchang@northwestern.edu.
Abstract
BACKGROUND: Arthritis is a leading cause of chronic pain and functional limitations. Exercise is beneficial for improving strength and function and decreasing pain. We evaluated the effect of a motivational interviewing-based lifestyle physical activity intervention on self-reported physical function in adults with knee osteoarthritis (KOA) or rheumatoid arthritis (RA). METHODS: Participants were randomized to intervention or control. Control participants received a brief physician recommendation to increase physical activity to meet national guidelines. Intervention participants received the same brief baseline physician recommendation in addition to motivational interviewing sessions at baseline, 3, 6, and 12 months. These sessions focused on facilitating individualized lifestyle physical activity goal setting. The primary outcome was change in self-reported physical function. Secondary outcomes were self-reported pain and accelerometer-measured physical activity. Self-reported KOA outcomes were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for KOA (WOMAC scores range from 0 to 68 for function and 0 to 20 for pain) and the Health Assessment Questionnaire (HAQ) for RA. Outcomes were measured at baseline, 3, 6, 12, and 24 months. Multiple regression accounting for repeated measures was used to evaluate the overall intervention effect on outcomes controlling for baseline values. RESULTS:Participants included 155 adults with KOA (76 intervention and 79 control) and 185 adults with RA (93 intervention and 92 control). Among KOA participants, WOMAC physical function improvement was greater in the intervention group compared to the control group [difference = 2.21 (95% CI: 0.01, 4.41)]. WOMAC pain improvement was greater in the intervention group compared to the control group [difference = 0.70 (95% CI: -0.004, 1.41)]. There were no significant changes in physical activity. Among RA participants, no significant intervention effects were found. CONCLUSION:Participants with KOA receiving thelifestyle intervention experienced modest improvement in self-reported function and a trend toward improved pain compared to controls. There was no intervention effect for RA participants. Further refinement of this intervention is needed for more robust improvement in function, pain, and physical activity.
RCT Entities:
BACKGROUND:Arthritis is a leading cause of chronic pain and functional limitations. Exercise is beneficial for improving strength and function and decreasing pain. We evaluated the effect of a motivational interviewing-based lifestyle physical activity intervention on self-reported physical function in adults with knee osteoarthritis (KOA) or rheumatoid arthritis (RA). METHODS:Participants were randomized to intervention or control. Control participants received a brief physician recommendation to increase physical activity to meet national guidelines. Intervention participants received the same brief baseline physician recommendation in addition to motivational interviewing sessions at baseline, 3, 6, and 12 months. These sessions focused on facilitating individualized lifestyle physical activity goal setting. The primary outcome was change in self-reported physical function. Secondary outcomes were self-reported pain and accelerometer-measured physical activity. Self-reported KOA outcomes were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for KOA (WOMAC scores range from 0 to 68 for function and 0 to 20 for pain) and the Health Assessment Questionnaire (HAQ) for RA. Outcomes were measured at baseline, 3, 6, 12, and 24 months. Multiple regression accounting for repeated measures was used to evaluate the overall intervention effect on outcomes controlling for baseline values. RESULTS:Participants included 155 adults with KOA (76 intervention and 79 control) and 185 adults with RA (93 intervention and 92 control). Among KOA participants, WOMAC physical function improvement was greater in the intervention group compared to the control group [difference = 2.21 (95% CI: 0.01, 4.41)]. WOMAC pain improvement was greater in the intervention group compared to the control group [difference = 0.70 (95% CI: -0.004, 1.41)]. There were no significant changes in physical activity. Among RAparticipants, no significant intervention effects were found. CONCLUSION:Participants with KOA receiving the lifestyle intervention experienced modest improvement in self-reported function and a trend toward improved pain compared to controls. There was no intervention effect for RAparticipants. Further refinement of this intervention is needed for more robust improvement in function, pain, and physical activity.
Authors: Stephen P Messier; Richard F Loeser; Gary D Miller; Timothy M Morgan; W Jack Rejeski; Mary Ann Sevick; Walter H Ettinger; Marco Pahor; Jeff D Williamson Journal: Arthritis Rheum Date: 2004-05
Authors: Richard P Troiano; David Berrigan; Kevin W Dodd; Louise C Mâsse; Timothy Tilert; Margaret McDowell Journal: Med Sci Sports Exerc Date: 2008-01 Impact factor: 5.411
Authors: Emalie Hurkmans; Florus J van der Giesen; Thea Pm Vliet Vlieland; Jan Schoones; E C H M Van den Ende Journal: Cochrane Database Syst Rev Date: 2009-10-07
Authors: Christine A Pellegrini; Sara M Powell; Nicholas Mook; Katherine DeVivo; Linda Ehrlich-Jones Journal: Curr Rheumatol Rep Date: 2018-10-06 Impact factor: 4.592
Authors: Mohammad Kashif Reza; Mohammad Abu Shaphe; Mohammed Qasheesh; Mudasir Nazar Shah; Ahmad H Alghadir; Amir Iqbal Journal: J Pain Res Date: 2021-01-26 Impact factor: 3.133
Authors: Sally A M Fenton; Joan L Duda; Jet J C S Veldhuijzen van Zanten; George S Metsios; George D Kitas Journal: Mediterr J Rheumatol Date: 2020-03-31
Authors: Evgeniy Nasonov; Saeed Fatenejad; Eugen Feist; Mariana Ivanova; Elena Korneva; Diana G Krechikova; Aleksey L Maslyanskiy; Mikhail Samsonov; Rumen Stoilov; Elena V Zonova; Mark Genovese Journal: Ann Rheum Dis Date: 2021-08-03 Impact factor: 19.103