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- Kucharski, Daniel, et al.
(författare)
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Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis
- 2019
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Ingår i: Rheumatology International. - : Springer Science and Business Media LLC. - 0172-8172 .- 1437-160X. ; 39:9, s. 1585-1594
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Tidskriftsartikel (refereegranskat)abstract
- Fatigue is described as a dominant and disturbing symptom of rheumatoid arthritis (RA) regardless of the advances in pharmacological treatment. Fatigue is also found to correlate with depression. The objective was to evaluate the impact of moderate-to-high intensity, aerobic and resistance exercise with person-centered guidance on fatigue, anxiety and depression, in older adults with RA. Comparisons were made between older adults (> 65 years) with RA taking part in a 20-week moderate-to-high intensity exercise at a gym (n = 36) or in home-based exercise of light intensity (n = 38). Assessments were performed at baseline, at 20 weeks, and at 52 weeks. Outcomes were differences in Multidimensional Fatigue Inventory (MFI-20), Visual Analog Scale Fatigue (VAS fatigue), and Hospital Anxiety and Depression Scale (HADS). Analysis of metabolomics was also performed. The subscales "physical fatigue" and "mental fatigue" in MFI-20 and symptoms of depression using HADS depression scale improved significantly at week 20 in the exercise group compared with the control group. Exercise did not influence global fatigue rated by VAS or subscales "reduced motivation", "reduced activity" and "general fatigue" in MFI-20. No significant change was found on the anxiety index of HADS. The improvements in physical fatigue were associated with changes in the metabolism of lipids, bile acids, the urea cycle and several sugars. Moderate-to-high intensity exercise with person-centered guidance decreased fatigue and improved symptoms of depression and were accompanied by metabolic changes in older adults with RA.
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| 2. |
- Lange, Elvira, et al.
(författare)
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Aspects of exercise with person-centred guidance influencing the transition to independent exercise: a qualitative interview study among older adults with rheumatoid arthritis
- 2019
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Ingår i: European Review of Aging and Physical Activity. - : Springer Science and Business Media LLC. - 1813-7253 .- 1861-6909. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Besides being health enhancing and disease preventing, exercise is also an important part of the management of chronic conditions, including the inflammatory joint disease rheumatoid arthritis (RA). However, older adults with RA present a lower level of physical activity than healthy older adults. The aim of this qualitative study was to explore aspects of participation in moderate- to high-intensity exercise with person-centred guidance influencing the transition to independent exercise for older adults with RA. Methods: A qualitative interview study was conducted. In-depth interviews with 16 adults with RA aged between 68 and 75years, who had taken part in the interventionarm of a randomized controlled trial performing moderate-to-high-intensity exercise with person-centred guidance, were analysed using qualitative content analysis. Results: The analysis resulted in six main categories: A feasible opportunity to adopt exercise, Experiencing positive effects of exercise, Contextual factors affect the experience of exercise, Developing knowledge and thinking, Finding one's way, and Managing barriers for exercise. The exercise with person-centred guidance was described as a feasible opportunity to start exercising as a basis for the transition to independent exercise. They described developing knowledge and thinking about exercise during the intervention enabling them to manage the transition to independent exercise. Finding one's own way for exercise became important for sustaining independent exercise. Lastly, barriers for exercise and strategies for overcoming these were described. Reduced physical health, both temporary and permanent, was described as a considerable barrier for exercise. Conclusion: The participants described several aspects of participating in exercise that influenced and facilitated their transition to independent exercise. The exercise was experienced as manageable and positive, by a careful introduction and development of an individual exercise routine in partnership with a physiotherapist. This seems to have favored the development of self-efficacy, with importance for future independent exercise. Reduced physical health, both temporary and permanent, was described as a considerable barrier for exercise. The personal process of trying to make the exercise one's own, and developing knowledge about exercise and new thoughts about oneself, seemed to prepare the participants for managing independent exercise and overcoming barriers.
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| 3. |
- Lange, Elvira, et al.
(författare)
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Effects of aerobic and resistance exercise in older adults with rheumatoid arthritis: A randomized controlled trial.
- 2019
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Ingår i: Arthritis care & research. - : Wiley. - 2151-4658 .- 2151-464X. ; 71:1, s. 61-70
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the effect of a person-centered, moderate-to-high intensity, aerobic and resistance exercise protocol on older adults with rheumatoid arthritis (RA), through a randomized controlled multi-center trial.Older adults (65-75 years) with RA (n=74) were randomized to either a 20-week person-centered exercise intervention at a gym (n=36) or to home-based exercise of light intensity (n=38). Assessments were performed at baseline, at 20 weeks, and at 12 months. Primary outcome was the difference in the Health Assessment Questionnaire - Disability Index (HAQ-DI), and the secondary outcomes were the differences in physical fitness assessed by a cardiopulmonary exercise test, an endurance test, Timed Up and Go, Sit To Stand test and isometric elbow flexion force.No significant differences between the groups were found for the primary outcome HAQ-DI. Within the intervention group there was a significant improvement of HAQ-DI when compared to baseline (p=0.022). Aerobic capacity (p<0.001) and three out of four additional performance-based tests of endurance and strength significantly improved (p<0.05) in the intervention group when compared to the control group. In the intervention group 71% rated their health as much or very much improved compared to 24% of the control group (p<0.001). At the 12-month follow-up, there were no significant difference of change between the two groups on HAQ-DI. A significant between-group difference was found for change in an endurance test (p=0.022).Person-centered aerobic and resistance exercise improved physical fitness in terms of aerobic capacity, endurance and strength in older adults with RA. This article is protected by copyright. All rights reserved.
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| 4. |
- Lange, Elvira
(författare)
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Exercise in older adults with rheumatoid arthritis - a person-centred approach
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Physical activity and exercise are well known to enhance health and are recommended as part of the management of rheumatoid arthritis (RA). However, the level of physical activity among older adults with RA is found to be low and little research focuses on physical activity and exercise in older adults with RA. The overall aim of this thesis was to study different aspects of exercise with person-centred guidance in older adults with RA. Methods: A randomised controlled trial was performed to study the effects of exercise on disability, and health and fitness-related outcomes. Seventy-four older adults (>65 years) with RA were randomised to moderate- to high intensity exercise with person-centred guidance or light home-exercise for 20 weeks. After the randomised study a qualitative interview study was performed to explore how older adults with RA experience exercise, and aspects that affect the transition to independent exercise. Finally, a long-time follow-up study was performed to evaluate physical activity and physical fitness after four years. Results: The result of the thesis show that exercise with person-centred guidance did not affect disability as assessed with the Health Assessment Questionnaire - Disability Index, but positive effects were found on physical fitness, fatigue, and symptoms of depression when compared to controls. The exercise was experienced as manageable and several aspects affecting the transition to independent exercise were described, including development of a personal way to exercise. After four years, there was no significant difference between groups, when change in physical activity level was compared. In conclusion moderate- to high intensity exercise is beneficial for older adults with RA and is experienced as manageable and prepares the transition to independent exercise. This thesis supports the recommendation of physical activity as part of routine management of RA in adults above 65 years of age. However, maintaining exercise over several years is challenging.
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