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Predicting Physical Activity and General Health Perception Among Patients with Rheumatoid Arthritis
EVA EURENIUS, NINA BRODIN, STAFFAN LINDBLAD, CHRISTINA H. OPAVA, and THE PARA STUDY GROUP ABSTRACT. Objective. To describe changes over one year in physical activity, body functions, and disease activity in patients with rheumatoid arthritis (RA) and to identify predictors for physical activity and general health perception. Methods. One hundred two patients with RA were recruited for the study (median age 57 yrs, range 19–84; median disease duration 15 mo, range 4–78; 76% women). Self-reported data on physical activity and health locus of control, tests of lower extremity function, grip force, joint range of motion, balance, and measures of disease activity, including pain, general health perception, Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28), were collected on 2 occasions, one year apart. Each variable was dichotomized to fit logistic regression models, performed to identify which variables predicted physical activity and general health perception over one year. Results. Physical activity was stable, while lower extremity function, grip force, and range of motion improved and DAS28 decreased significantly over one year. A high physical activity level at baseline was the only predictor of high physical activity (odds ratio 3.85, 95% confidence interval 1.67–9.09) one year later. Low pain (OR 8.47, 95% CI 2.97–24.39), high physical activity (OR 3.72, 95% CI 1.39–10.10), and good lower extremity function (OR 2.94, 95% CI 1.04–8.33) were identified as predictors of good general health perception. Conclusion. While pain is a well known predictor of general health perception, to our knowledge, this is the first study to identify predictive factors related to physical activity and lower extremity function as important for perceived health among patients with RA. (J Rheumatol 2007;34:10–15) Key Indexing Terms:
ARTHRITIS From the Rehabcentrum, Skellefteå Hospital, Skellefteå; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge; Department of Medicine, Division of Rheumatology, Karolinska University Hospital, Solna, Stockholm; and the Karolinska Institutet, LIME Department, Division of Medical Management, Solna, Sweden. Supported by the Västerbotten County Council Research Fund, the Research Unit of the Department of Medicine and Geriatrics at Skellefteå County Hospital, the Swedish Rheumatism Association, the Vårdal Foundation, the Gävleborg County Council Forum for Research and Development, the Signe and Reinhold Sund Foundation, Dalarna Research Council, the Rune and Ulla Almlöv Foundation, the Research Council in the Southeast of Sweden (FORSS), the Föreningssparbanken Sjuhärad Foundation for Research at Southern Älvsborg Hospital, and the Health Care Sciences Postgraduate School at Karolinska Institutet. E. Eurenius, PhD, PT, Rehabcentrum, Skellefteå Hospital and the Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; N. Brodin, MScPT, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; S. Lindblad, PhD, MD, Department of Medicine, Division of Rheumatology, Karolinska University Hospital and the Karolinska Institutet, LIME Department, Division of Medical Management; C.H. Opava, Professor, PT, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and the Department of Medicine, Division of Rheumatology, Karolinska University Hospital. The PARA Study Group includes L.A. Munters, Karolinska University Hospital/Huddinge; I. Almin, Örebro University Hospital; B. Andersson, Karolinska University Hospital/Solna; E. Bengtsson, Spenshult Rheumatology Hospital; Å. Björklund, Västerås Hospital; S. Genberg, Danderyd Hospital; M. Heikenberg, Sahlgrenska University Hospital, Mölndal; L. Kopp, Borås Hospital; E. Liberg, Skövde Hospital; G. Linder, Uppsala University Hospital; L. Markman, Linköping University Hospital; V. Pålsson, Trelleborg Hospital; M. Signeul, Falun Hospital; and M. Åberg, Gävle-Sandviken Hospital. Address reprint requests to Dr. E. Eurenius, Rehabcentrum, Skellefteå Hospital, SE-931 86 Skellefteå, Sweden. E-mail: eva.eurenius@vll.se Accepted for publication August 8, 2006.
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