Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Attaining Public Health Physical Activity Guidelines for Persons with Rheumatoid Arthritis (RA): Does It Improve Their Health Utility?
Dunlop, D. D., Chang, R. W., Song, Jing, Manheim, L. M., Lee, Jae Chul
Health utility (HU) is a standard economic measure of effectiveness in clinical trials. Although physical activity can improve the health of persons with RA, it is an open question whether or not attaining public physical activity guidelines improves their HU. This study examines if persons with RA who meet U.S. Surgeon General (USSG) guidelines have improved HU over one year.
Participants with RA were recruited from the Increasing Motivation for Physical Activity in Arthritis Clinical Trial (IMPAACT), an ongoing randomized clinical trial that evaluates a behavioral intervention to increase physical activity in persons with arthritis. We focused on IMPACCT participants with RA whose data were available at a baseline, a 6-month visit, and a 12-month visit. USSG guidelines attainment was objectively assessed every 6 month using accelerometer monitoring. If persons had >=150 minutes of moderate or vigorous (MV) physical activity) per week, they were identified as meeting the guidelines. The IMPACCT data included n=77 who have RA and valid physical activity data (aged 2378) during baseline with a 6 month HU followup; n=42 also had valid physical activity data (aged 2478) at 6 months with a 12 month HU followup. Regression analysis examined the baseline relationship of guideline attainment with HU. Longitudinal analyses using GEE examined the relationship between USSG attainment and subsequent HU.
Only 18% (n=14) of this RA cohort met USSG guidelines at baseline. Attaining USSG guidelines was not related to HU at baseline or longitudinally. Further analyses examined the relationship between MV physical activity quartiles and HU. This RA cohort had very low activity levels (Q1: 0; Q2: 115; Q3:1690; Q4:>90 min MVPA a week); persons below the median had almost no MV physical activity (<15 min/week). Baseline HU is almost identical for persons with RA below the median (Q1:HU=0.67, Q2: HU=0.69). Those with RA above the median had higher baseline HU (Q3: HU=0.74, Q4: HU=0.74), which suggests attaining even low amount of MV activity is beneficial for those with RA. At baseline having MV activity above the median was associated with significantly higher utility compared to persons below the median (0.72 vs 0.67, p=0.004). Longitudinally, persons with MV activity above the median had better subsequent utility than those below the median (0.72 vs 0.68, p=.012).
Few persons with RA attained USSG guidelines. USSG attainment was not associated with HU at baseline or longitudinally. In contrast, persons who attained even low levels of MV physical activity had significantly better utility at baseline and better subsequent utility compared to persons attaining little or no MV activity. These findings suggest that moving persons with RA from none to some MV physical activity may be a more effective strategy than working to attain USSG guidelines. Separate public health physical activity guidelines should be investigated for persons with RA.
To cite this abstract, please use the following information:
Dunlop, D. D., Chang, R. W., Song, Jing, Manheim, L. M., Lee, Jae Chul; Attaining Public Health Physical Activity Guidelines for Persons with Rheumatoid Arthritis (RA): Does It Improve Their Health Utility? [abstract]. Arthritis Rheum 2009;60 Suppl 10 :985