Influence of Patient Education on Exercise Compliance in Rheumatoid Arthritis: A Prospective 12-month Randomized Controlled Trial

ANNE MAYOUX-BENHAMOU, JANINE-SOPHIE GIRAUDET-LE QUINTREC, PHILIPPE RAVAUD, KARINE CHAMPION, EMMANUELLE DERNIS, DJAMILA ZERKAK, CARINE ROY, ANDRE KAHAN, MICHEL REVEL, and MAXIME DOUGADOS

ABSTRACT.

Objective. To determine the effect of education on the exercise habits of patients with rheumatoid arthritis (RA) after 6 and 12 months.

Methods. We studied 208 outpatients recruited between June 2001 and December 2002. This was a prospective controlled randomized trial. The active group received a multidisciplinary education program, including training in home-based exercises and guidelines for leisure physical activity (PA). The control group received a booklet added to usual medical care. Compliance with home-based exercises was defined as a practice rate ≥ 30% of the prescribed training. Compliance with leisure PA was defined as ≥ 20% increase in Baecke questionnaire score. Additional assessments involved possible predictors of compliance and changes with regard to the compliance.

Results. At 6-month followup, home-based exercise and leisure PA compliance were significantly higher [13.5% vs 1%, respectively (p = 0.001); and 28.2% vs 13.8% (p = 0.02)], but were not at 12 months. Predictors of leisure PA compliance at 6 months included participating in the active group (odds ratio 2.74, 95% CI 1.17 to 6.38) and previous low leisure PA (OR 6.01, 95% CI 2.47 to 14.61), with decreased fatigue (FACIT-F mean –2.94 ± 8.04 vs –0.1 ± 7.25 for noncompliant subjects; p = 0.04) and improved psychological status (Arthritis Impact Measurement Scale mean –1.25 ± 3.12 vs 0.11 ± 3.39; p = 0.03).

Conclusion. Education of patients with RA may increase compliance especially with leisure PA, particularly when it is poor at baseline, but these effects are limited and short-term. (First Release Dec 15 2007; J Rheumatol 2007;35:216-23)

Key Indexing Terms:

RHEUMATOID ARTHRITIS
EDUCATION
PHYSICAL ACTIVITY
EXERCISE
COMPLIANCE
RANDOMIZED TRIAL

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From the Institute of Rheumatology, Assistance Publique–Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris Descartes University, Paris, France.

Supported in part by grants from the direction de la Recherche Clinique, AP-HP, France (PHRC AOM00027).

A. Mayoux-Benhamou, MD, PhD, Department of Rehabilitation, Cochin Hospital; J-S. Giraudet-Le Quintrec, MD, Department of Rheumatology A, Cochin Hospital; P. Ravaud, MD, PhD, Professor, Department of Epidemiology and Biostatistics, Bichat Hospital, Paris 7 University; K. Champion, MD, Department of Rheumatology A, Cochin Hospital; E. Dernis, MD; D. Zerkak, MD, Department of Rheumatology B, Cochin Hospital; C. Roy, Department of Epidemiology and Biostatistics, Paris 7 University; A. Kahan, MD, PhD, Professor, Department of Rheumatology A, Cochin Hospital; M. Revel, MD, Professor, Department of Rehabilitation, Cochin Hospital; M. Dougados, MD, Professor, Department of Rheumatology B, Cochin Hospital.

Address reprint requests to Dr. A. Mayoux-Benhamou, Department of Rehabilitation, Cochin Hospital, 27 Rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France. E-mail: anne.mayoux-benhamou@cch.aphp.fr

Accepted for publication September 18, 2007.

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