medwireNews: Provision of pedometers could improve activity levels and reduce fatigue among patients with rheumatoid arthritis (RA), results of a randomized trial suggest.
Despite “published guidelines recommending physical activity for persons with RA,” a large proportion of patients “have very low levels” of activity, explain study author Patricia Katz (University of California, San Francisco, USA) and colleagues in Arthritis Care & Research.
“In contrast to more complex interventions, pedometers are a simple but effective means of increasing physical activity,” they add.
The researchers randomly assigned participants to receive an educational brochure (education only group), or an educational brochure together with a pedometer and step-monitoring diary with or without step targets (PED+ and PED groups, respectively). Activity levels were measured in all groups using the Jawbone Up® device, which monitors step counts without making participants aware of the results.
The average number of daily steps increased significantly from 4223 at baseline to 5655 at week 21 among 34 participants in the PED group, and from 5019 to 6675 among those with a pedometer plus step targets (n=34).
By contrast, the average number of daily steps decreased from 5572 to 4609 among 28 patients in the education only group.
Furthermore, the number of participants classified as sedentary – taking fewer than 5000 steps per day – decreased from 64% to 43% in the PED group and from 53% to 36% in the PED+ group, but increased from 50% to 70% in the education only group.
And the proportion of patients in the PED and PED+ groups achieving healthy activity levels, defined as 8000 steps per day or more, approximately doubled from baseline to week 21 (9 vs 17% and 15 vs 32%, respectively), whereas there was no change in the education only group, remaining at approximately 20% at both timepoints.
The team also observed significant reductions in fatigue from baseline to the 21-week follow-up among participants in the PED and PED+ groups, with corresponding mean changes in Patient-Reported Outcome Measurement Information System fatigue scores of –3.2 and –4.8 points. In the education only group, the mean change was –1.6 points.
Although changes in fatigue were not significantly different between the three groups, Katz and colleagues note that changes in the PED+ group met the minimally important change criterion of a 4-point decrease, indicating a “meaningful decrease in fatigue.”
They caution that it was not possible to determine exercise intensity, and the sample size was limited, but believe that the results were “encouraging” and “provide support for a larger trial.”
The authors conclude that the results “provide support for the hypothesis that increasing physical activity by walking has important effects on fatigue and other RA symptoms.”
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