Fatigue, pain, and depression are hallmark symptoms of rheumatoid arthritis (RA) that if unrelieved lead to poor quality of life and functional decline.
The first aim of this study is to explore the effects of participation in a low-impact aerobic exercise group program versus participation in a home exercise program using a videotape versus a no-treatment control group on the experience of fatigue, pain, and depression in outpatients with RA.
The second aim i s to determine factors that predict exercise participation during the exercise interventions and 16 weeks after the interventions end.
The third aim i s to test how well a causal model based on self-regulation theory and pilot data explain the experience of fatigue, pain, and depression. The causal model proposes that outcome expectancy is the major drive of intentional human behavior. A positive outcome expectancy is necessary for continued exercise participation. Psychosocial factors can affect outcome expectancies and those to be measured in this study are: optimism, social support, self-efficacy for exercise, perceived benefits of exercise and perceived barriers to exercise. Consistent with self-regulation theory, the model predicts that participation in exercise will produce positive changes in physical and functional status and that these positive effects will lead to decreased levels of fatigue, pain, and depression. The sample will be 270 outpatients with definite RA. Measures will be obtained at 4 major assessment periods (baseline [T1], after 6 weeks of exercise [T2], after 12 weeks of exercise [T3] and 16 weeks after the exercise intervention ended [T4]). Daily ratings of symptoms will be obtained for one week 4 times during the study. The no-treatment control group subjects will come for assessments at the same time intervals as the experimental groups. Symptoms will be measured by subjects' self-report on instruments targeting fatigue, pain, and depression. Physical measures include physical activity, walk time, grip strength, joint count, perceived morning stiffness time, a sleep measure, ratings of perceived exertion and predicted VO2Max. Psychosocial measures are listed above. Biological measures include sedimentation rate, C-reactive protein, complete blood count, hemoglobin, hematocrit, thyroid screen, chemical profile and interleukin-6. Data analyses will include descriptive statistics and MANCOVA for repeated measures to answer the first aim. Structural equation modeling analyses will be used to answer specific aims 2 and 3. Results of this study will provide important data on ways to assist clients with RA in controlling many of their symptoms.
| Jamison, Marian; Neuberger, Geri B; Miller, Peggy A (2003) Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Rheum 49:673-80 |
