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 20-65y (n=70); intervention-group (n=36) and reference-group (n=34).
INTERVENTION: 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 healthcare.
MAIN OUTCOME MEASURES: Primary outcome was general fatigue (Visual Analogue Scale, VAS). Secondary outcomes included multidimensional fatigue (Bristol Rheumatoid Arthritis Fatigue - Multi-Dimensional Questionnaire, BRAF-MDQ), and fatigue-related variables, i.e., disease, health and function.
RESULTS: At posttest, general fatigue improved more in the intervention-group than reference-group (p=0.042). Improvement in median general fatigue reached minimal clinically important difference between and within groups at posttest and follow-up. Improvement was also observed for anxiety (p=0.0099) and trends toward improvements was observed for most multidimensional aspects of fatigue (p=0.023-p=0.048), leg strength/endurance (p=0.024) and physical activity (p=0.023). Compared with the reference-group at follow-up, intervention-group improvement was observed for leg strength/endurance (p=0.001) and the trends toward improvements persisted for physical (p=0.041) and living-related (p=0.031) aspects of fatigue, physical activity (p=0.019) and anxiety (p=0.015) and self-rated health (p=0.010) and self-efficacy (p=0.046).
CONCLUSIONS: Person-centered physical therapy focused on health-enhancing physical activity and balancing life activities, showed significant benefits on fatigue in persons with RA.
2016. Vol. 97, no 1, 26-36 p.
Arthritis, Rheumatoid, Fatigue, Randomized controlled trial at topic, Rehabilitation