“By some magic of genetics and environment, the keys rose to meet my fingers and music came,” writes Andrea Avery, who displayed much promise as a pianist growing up, in a harrowing essay which the Washington Post excerpted from her memoir. “And then, too soon, by some inverted miracle of genetics and environment, rheumatoid arthritis appeared. The keys still rose to meet my fingers, but my curling fingers recoiled.”
Trying to be both a pianist and arthritic at the same time proved elusive to Avery, an English teacher in Phoenix, who explains that RA feels like her body calls the shots. That sense of feeling subjugated to one’s body makes it hard for people with RA to remain active. A small study earlier this year found that RA patients who wore pedometers — even if they weren’t aiming to walk a certain number of daily steps — were more active, Reuters reported, and the lead author said, “We found that increasing activity just through walking decreased fatigue.”
A new study published in Annals of the Rheumatic Diseases finds that RA patients who receive text messages reminding them to be more active spend more than two hours less sitting every day than those who don’t receive the encouraging prompts. “An individually tailored, behavioural intervention reduced daily sitting time in patients with RA and improved patient-reported outcomes and cholesterol levels,” write the Danish researchers, who add that RA patients have a 50 to 60 percent greater risk of premature death from heart disease.
(Read about whether exercise is good for rheumatoid arthritis.)
The researchers randomly assigned 75 RA patients to an experimental group, and another 75 RA patients to a control group. Members of the intervention group met on an individual basis with professionals for “motivational counselling” on three occasions, and then received text messages “aimed at reduction of sedentary behaviour” over a 16-week period, the researchers write. The control group was encouraged to maintain its normal levels of activity.
Patients wore a monitor called ActivPAL, which measured their activity levels, and separated between patients’ sleep and inactive waking hours. Researchers also tracked secondary outcomes, including differences in levels of “pain, fatigue, physical function, general self-efficacy, quality of life, blood pressure, blood lipids, haemoglobin A1c, body weight, body mass index, waist circumference, and waist–hip ratio,” researchers write.
The found, on average, that the intervention group spent 1.61 fewer hours seated per day, while the control group sat .59 more hours per day, for a combined difference of 2.20 hours a day spent seated. “Most of the secondary outcomes were also in favour of the intervention,” researchers write. “The decrease in daily sitting time was replaced by increased standing and stepping time with between-group differences in change of 1.52 hours [per] day and 0.55 hours [per] day, respectively.”
(Read rheumatologist Lynn Ludmer’s interview with the Baltimore Sun about RA and exercise.)
The study has limitations. “We cannot rule out that the significant changes in cholesterol levels and self-reported clinical outcomes were reached by other pathways than through increases in low-intensity, non-exercise physical activity, for example, through healthy dietary habits,” the researchers write.
“The results may not be generalisable to all patients with RA, since those who declined participation were younger and the proportion of men was higher,” they add. “The intervention may have been more appealing to women, since 81 percent of the included patients were women; however, up to 75 percent of patients with RA are women.”