Physical Activity and Correlates of Physical Activity Participation Over Three Years in Adults With Rheumatoid Arthritis

Objective: To characterize physical activity participation (moderate-to-vigorous physical activity [MVPA], 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity per week), to examine associations between disease activity and MVPA, and to identify MVPA correlates in adults with rheumatoid arthritis (RA) over 3 years. Methods: This study included 573 RA patients (94% white, 83% female, mean age 61 years, mean RA duration 19.5 years) with 1 annual registry visit and who completed the physical activity questionnaire. Baseline and annual measures included demographics/medical history, self-efficacy for disease management, quality of life, patient/physician global assessment, physical function, and self-reported physical activity. A logistic repeated-measures model using the generalized estimating equation examined the relationship between disease activity and MVPA. Results: Average disease activity (from the 3-variable Disease Activity Score in 28 joints using the C-reactive protein level) was meanSD 3.1 +/- 1.4, 36% were physically inactive, and 29% met MVPA recommendations. There was a negative borderline association with disease activity (odds ratio [OR] 0.89 [95% confidence interval (95% CI) 0.79-1.00]). Correlates of meeting MVPA recommendations, adjusting for disease activity, were being white (OR 2.95 [95% CI 1.29-6.75]), older age (ages >69 years OR 0.58 [95% CI 0.36-0.92]), poor mental health (OR 0.63 [95% CI 0.41-0.95]), poor physical function (OR 0.59 [95% CI 0.34-1.01]), overweight/obese (body mass index [BMI] >25-30 OR 0.69 [95% CI 0.50-0.95], BMI >30-39.9 OR 0.60 [95% CI 0.41-0.88], and BMI 40 OR 0.24 [95% CI 0.08-0.74]), and patient global assessment (10-20 OR 0.57 [95% CI 0.39-0.83]). Conclusion: A small proportion of patients met MVPA recommendations despite well-controlled disease. Disease activity was negatively associated with physical activity over time. Physical activity correlates were linked to lifestyle, mental health, and patient perceptions of disease, suggesting physical activity interventions that address patient perspectives may facilitate RA management.