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.
Keywords
List of abbreviations:
BRAF-MDQ (Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire), DAS-28 (disease activity score), HADS (Hospital Anxiety and Depression Scale), RA (rheumatoid arthritis), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 16, 2015
Footnotes
Supported by the University of Gothenburg Centre for Person-Centred Care, the Swedish Research Council, and the Medical Faculty of University of Gothenburg Sahlgrenska University Hospital, Gothenburg, Sweden.
Clinical Trial Registration No.: NCT02120963.
Disclosures: none.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
