Objectives: The objectives of this study were to describe exercise levels, types of exercise, and reasons for missing exercise; and to identify functional status, depression, and social support predictors of exercise among subjects with rheumatoid arthritis (RA) controlling for demographics.
Design: A correlational descriptive design was used in this secondary analysis of data from a clinical trial designed to improve adherence to drug regimen.
Population, Sample, Setting, Years: Subjects (N=410) were recruited from rheumatology practices, fulfilled American College of Rheumatology criteria for RA, were > or=30 years of age, and had RA for > or=2 years. Subjects were 59.1 (SD=11.2) years of age, had RA for 14.0 (SD=9.6) years, were white (93%), female (78%), married (72%), and had 12.6 (SD=2.4) years of education.
Variables Studied Together: We examined functional status, depression, and social support as potential predictors of the exercise regimen in RA.
Methods: Subjects completed the Jette Functional Status Inventory (FSI Assistance, Pain, Difficulty scales), Beck Depression Inventory (BDI Affective, Somatic scales), Interpersonal Support Evaluation List (ISEL Appraisal, Belonging, Self-Esteem, Tangible scales), and exercise and demographic questionnaires.
Findings: Fifty-six percent (n=230) of subjects reported some type of regular exercise. These subjects exercised 4.6 (SD=2.2) days based on a 7-day recall. Types of exercises included ROM (55%), walking (36%), cycling (11%), and swimming (7%). Reasons exercise was missed were variation in daily routine (37%), no time for exercise (18%), RA symptoms (17%), forgot (8%), bad weather (7%), too tired (7%), and traveling (7%). Hierarchical stepwise regression with age, sex, and race entered in the first step and FSI, BDI, and ISEL scores entered in the second step in a backward fashion showed that FSI: Assistance and FSI: Difficulty explained the greatest variance in exercise frequency in the past 7 days [DF(2,181)=3.783, DR2=.039, p=.025].
Conclusions: Over half of RA subjects reported exercising. Of these, over half performed ROM (31% of total), and over one-third reported walking (20% of total). Persons with RA face common barriers to exercise as well as the barrier of RA symptoms. Age, assistance used and difficulty involved in performing activities of daily living predicted exercise frequency.
Implications: Interventions to improve adherence to exercise regimen in RA should address exercise barriers, such as variation in daily routine, time constraints, and disease symptoms, and should consider the age and functional status of the participants.
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