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OBJECTIVE: Current Head and Neck cancer (HNC) follow-up models are considered sub-optimal at detecting recurrences. We describe the development of a patient-initiated follow up (PIFU) trial intervention support package, to support HNC patients to engage in PIFU self-care behaviors. METHODS: An intervention mapping approach, informed by evidence synthesis, theory and stakeholder consultation, guided intervention development. Data sources included a patient survey (n = 144), patient interviews (n = 30), 7 workshops with patients (n = 25) and caregivers (n = 3) and 5 workshops with health professionals (n = 21). RESULTS: The intervention ('ACT now & check-it-out') comprises an education and support session with a health professional and an app and/or a booklet for patients. The main targets for change in patient self-care behaviors were: assessing what is normal for them; regularly checking for symptom changes; prompt help-seeking for persistent/new symptoms; self-management of fear of recurrence; engaging with the intervention over time. CONCLUSIONS: We have developed an evidence, person and theory-based intervention to support PIFU self-care behaviors in HNC patients. PRACTICE IMPLICATIONS: A trial is underway to assess the effectiveness and cost-effectiveness of the intervention. If successful, this intervention could be adapted for patients with other cancers or diseases, which is important given the recent shift towards PIFU pathways.
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Neoplasias de Cabeça e Pescoço , Autogestão , Humanos , Seguimentos , Pessoal de Saúde , Cuidadores , Neoplasias de Cabeça e Pescoço/terapiaRESUMO
BACKGROUND: Individuals with rheumatoid arthritis (RA) are at a high risk of cardiovascular diseases (CVD). A reduced chronotropic response (CR), which produces exercise intolerance, is known to be a contributing factor to CVD and mortality. Studies have shown that patients with RA have a reduced CR. However, knowledge of CR-related factors in patients with RA is limited. This study aimed to explore CR-related factors, including CVD risk factors, inflammatory markers, and cardiorespiratory fitness (VO2PEAK). METHODS: A total of 106 RA patients underwent a treadmill test, heart rate monitoring, and various assessments, including serological CVD risk factors, inflammatory markers, and VO2PEAK. RESULTS: A total of 34% of participants demonstrated a reduced CR (≤80%). Body mass index, HOMA, hsCRP, and fibrinogen were inversely related to CR, while HDL, QUICKi, VO2PEAK, and RER exhibited a positive association. HDL and VO2PEAK emerged as independent CR-related factors in regression analysis. CONCLUSIONS: The current findings suggest that reduced CR in RA is associated with several CVD risk factors, inflammatory markers, and cardiorespiratory fitness. Future studies should investigate the effects of controlling these associated variables on CR in patients with RA.
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Introduction: Quantitative Sensory Testing (QST) modalities used to assess central pain mechanisms require different protocols in people with different musculoskeletal conditions. Objectives: We aimed to explore the possible effects of musculoskeletal diagnosis and test site on QST interrater and test-retest reliability. Methods: The study included participants with rheumatoid arthritis (RA, n = 18; QST conducted on lower leg) and low back pain (LBP, n = 25; QST conducted on forearm), plus 45 healthy control participants (n = 20 QST on lower leg and n = 25 QST on forearm). Test-retest reliability was assessed from QST conducted 1 to 3 weeks apart. Quantitative sensory testing modalities used were pressure pain detection threshold (PPT) at a site distant to tissue pathology, temporal summation (TS), and conditioned pain modulation (CPM). Temporal summation was calculated as difference or ratio of single and repeated punctate stimuli and unconditioned thresholds for CPM used single or mean of multiple PPTs. Intraclass correlation coefficients (ICCs) were compared between different subgroups. Results: High to very high reliability was found for all assessments of PPT and TS across anatomical sites (lower leg and forearm) and participants (healthy, RA, and LBP) (ICC ≥ 0.77 for PPT and ICC ≥ 0.76 for TS). Reliability was higher when TS was calculated as a difference rather than a ratio. Conditioned pain modulation showed no to moderate reliability (ICC = 0.01-0.64) that was similar between leg or forearm, and between healthy people and those with RA or LBP. Conclusion: PPT and TS are transferable tools to quantify pain sensitivity at different testing sites in different musculoskeletal diagnoses. Low apparent reliability of CPM protocols might indicate minute-to-minute dynamic pain modulation.
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BACKGROUND: Lifestyle physical activity (PA) is defined as any type of PA undertaken as part of daily life. It can include engagement in activities of daily living (i.e., household chores, gardening, walking to work), incidental PA, walking and/or reducing sedentary or sitting behaviours (SB). Regular PA is recommended for people with Rheumatoid Arthritis (RA) to reduce disease activity and systemic inflammation, as well as to improve patient- and clinician-important health outcomes. However, there is no summarised evidence of the effectiveness of interventions specifically targeting lifestyle PA and SB in this population. The aims of this systematic review with meta-analysis were to evaluate interventions targeting lifestyle PA and/or SB on 1) disease activity; 2) PA, SB and 3) patient- and clinician-important outcomes in people with RA. METHODS: Eight databases [Medline, Cochrane Library CENTRAL, Web of Science, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Scopus, Excerpta Medica database and Physiotherapy Evidence Database] were searched from inception-August 2022. Inclusion criteria required interventions to target lifestyle PA and/or SB, conducted in adults with RA, assessing patient- and/or clinician-important outcomes. RESULTS: Of 880 relevant articles, 16 interventions met the inclusion criteria. Meta-analyses showed statistically significant effects of interventions on disease activity (standardised mean difference = -0.12 (95% confidence interval = -0.23 to -0.01, I2 = 6%, z = 2.19, p = .03), moderate-to-vigorous PA, light/leisure PA, steps, functional ability, and fatigue. Whereas, no intervention effects were visualised for total PA, pain, anxiety or quality of life. CONCLUSIONS: Lifestyle PA interventions led to increased PA, reductions in SB and improvements in disease activity and other patient- and/or clinician-important health outcomes in people with RA. Future interventions should be less heterogenous in content, structure, focus and outcome measures used to aid understanding of the most effective intervention components for improving health. More SB interventions are needed to determine their effectiveness at producing clinical benefits.
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In the last decade, studies into sedentary behaviour in inflammatory arthritis have raised important questions regarding its role in this condition. Specifically, evidence is needed on whether sedentary behaviour might exacerbate adverse inflammatory arthritis outcomes, and whether reducing sedentary behaviour might offer an effective avenue for self-management in this population. Research exploring these important research questions is still very much in its infancy and lacks the direction and scientific rigour required to inform effective intervention design, delivery and evaluation. Behavioural epidemiology refers to research that aims explicitly to understand and influence health behaviour patterns to prevent disease and improve health. To this end, the Behavioural Epidemiology Framework specifies a focused approach to health behaviour research, which leads to the development of evidence-based interventions directed at specific populations. In this review, we introduce the Behavioural Epidemiology Framework in the context of research into sedentary behaviour in inflammatory arthritis and ask: where are we, and where do we need to go?
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Using the multi-states (MuSt) theory as a framework, the present study focused on the individual (personality) antecedents of psychobiosocial states. Psychobiosocial states comprise emotional subjective experiences and their correlates (cognitive, motivational, volitional, bodily, motor-behavioural, operational, and communicative), that can be functional for performance (helpful) or dysfunctional (harmful). Specifically, we examined the relationships between two perfectionism dimensions (perfectionistic strivings and concerns) and functional and dysfunctional psychobiosocial states. The hypothesized mediational role of competitive appraisals was also tested. Participants (N = 271, 138 female, 133 male, M age = 22.74 ± 7.01) completed questionnaires assessing the targeted variables. Structural equation modelling revealed that perfectionistic strivings were positive predictors of functional states directly and via challenge appraisals. On the other hand, perfectionistic concerns were positive predictors of dysfunctional states directly and via threat appraisals. Results provide support to MuSt theory and extend the literature on the antecedents of athletes' performance-related feeling states. Findings also provide support for the holistic conceptualization of psychobiosocial states encompassing the functionality dimension. The results highlight the importance of developing interventions aimed at helping athletes high in perfectionistic concerns evaluate situations as a challenge (and less of a threat) and increasing their perceived resources.Highlights Perfectionistic strivings positively related to functional psychobiosocial statesPerfectionistic concerns positively related to dysfunctional psychobiosocial statesCompetitive challenge appraisals mediated the relationship between perfectionistic strivings and functional psychobiosocial statesCompetitive threat appraisals mediated the relationship between perfectionistic concerns and dysfunctional psychobiosocial states.
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Desempenho Atlético , Perfeccionismo , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Motivação , Personalidade , Atletas/psicologia , Desempenho Atlético/psicologiaRESUMO
Living with knee and hip osteoarthritis (OA) means living with pain and difficulty in movement. Given the beneficial effects of physical activity (PA) and reduction of sedentary behaviour (SB), these behaviours need to be understood in the context of individuals' daily lives and sense of well-being. Twelve individuals (age: 43-79 years; 67% female) with knee and/or hip OA purposively selected (e.g., age, OA duration, OA severity) participated in semi-structured interviews. Data was analysed using inductive thematic analysis. PA and SB were narrated as multifaceted experiences with two overarching themes, PA negotiations (valuing mobility, the burden of osteoarthritis, keep going, the feel-good factor), SB negotiations (the joy of sitting, a lot is too bad, the osteoarthritis confines), and two overlapping themes (the life context, finding a balance). Physical and psychological aspects of PA and SB experiences were interwoven. Participants valued mobility and were proactively trying to preserve it by keeping active. A constant negotiation among the OA burden, the need to enjoy life and life circumstances was underlying PA behaviour. Prescription and encouragement of a physically active lifestyle in this population should be linked to mobility-related personal values and sense of well-being, while addressing concerns around OA-safety and normalizing PA trade-offs.
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BACKGROUND: This longitudinal study investigated whether changes in autonomous and controlled motivation to reduce sedentary behaviour were associated with variability in sedentary, standing and stepping time and, in turn, disease activity, systemic inflammation, pain and fatigue in rheumatoid arthritis (RA). METHODS: People with RA undertook assessments at baseline (T1, n = 104) and 6 months follow-up (T2, n = 54) to determine autonomous and controlled motivation to reduce sedentary behaviour (Behavioural Regulation in Exercise Questionnaire-2), free-living sedentary, standing and stepping time (7 days activPAL3µ wear), Disease Activity Score-28 (DAS-28), systemic inflammation (c-reactive protein [CRP]), pain (McGill Pain Questionnaire) and fatigue (Multidimensional Assessment of Fatigue Scale). N = 52 participants provided complete data at T1 and T2. STATISTICAL ANALYSES: In a series of models (A and B), path analyses examined sequential associations between autonomous and controlled motivation to reduce sedentary behaviour with activPAL3µ-assessed behaviours and, in turn, RA outcomes. RESULTS: Models demonstrated good fit to the data. Model A (sedentary and stepping time): autonomous motivation was significantly negatively associated with sedentary time and significantly positively related to stepping time. In turn, sedentary time was significantly positively associated with CRP and pain. Stepping time was not significantly associated with any health outcomes. Model B (standing time): autonomous motivation was significantly positively associated with standing time. In turn, standing time was significantly negatively related to CRP, pain and fatigue. CONCLUSIONS: Autonomous motivation to reduce sedentary behaviour is associated with sedentary and standing time in RA which may, in turn, hold implications for health outcomes.
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Based on the conceptual model of multidimensional and hierarchical motivational climate the objective of this study was to test two models. One model (M1) of total mediation, testing the mediating mechanisms that explain why the motivational climate affects intention of continuity or dropout. Specifically, we test the mediating role of satisfaction/frustration of basic psychological needs and self-determined motivation, in the relationship between the players' perception of the empowering and disempowering climate created by the coach, and the intention of young soccer players to continue/dropout the sport practice. The second model (M2) of partial mediation, contributes to knowing the mechanisms that link the antecedent variables included in the model (perceived empowering and disempowering motivational climate) and the outcomes (intention of continuity or dropout in sport). A total of 381 young male soccer players between 12 and 14 years of age (M = 12.41, SD = 0.89), completed a questionnaire package tapping into the variables of interest: players' perception of the motivational climate created by the coach (empowering and disempowering), satisfaction/thwarting of basic psychological needs, self-determined motivation and the intention to continue/dropout sports participation. The hypothesized model was tested using a structural equation model technique with latent variables. The results of the partial mediation model were satisfactory (χ2= 120.92; df = 68; RMSEA = 0.045; CFI = 0.968; TLI = 0.957) and showed that need satisfaction and self-determined motivation partially mediated the relationship between the perception of the empowering climate and the intention to continue. Moreover, need satisfaction showed a positive and significant relationship with the intention to continue sports participation. Additionally, need thwarting and self-determined motivation totally mediated the relationship between the perception of the disempowering climate and the intention to dropout. Furthermore, needs thwarting was positively and significantly related to the intention to dropout of sports participation. Findings point to the importance of fostering empowering climates and preventing the creation of disempowering climates in the grassroots football.
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Motivação , Futebol , Humanos , Masculino , Intenção , Autonomia Pessoal , Poder PsicológicoRESUMO
OBJECTIVE: This cross-sectional study explored how using age-specific and non-age-specific cut-points to assess moderate-to-vigorous physical activity (MVPA) measured by GT3X accelerometers affected bouted and total volume MVPA associations with health and well-being. METHODS: MVPA correlations with physical function, BMI, joint pain, quality of life, anxiety and depression were tested. Steiger's z compared the strength of these correlations for each pair of cut-points. RESULTS: A total of 109 adults with hip/knee osteoarthritis [M= 63.8 years (±10.58), 63.3% women] participated. Applying age-specific cut-points resulted in significantly more time classified as MVPA (76/9.5min total volume/bouted) compared to non-age-specific (38.8/7min total volume/bouted). Only total volume MVPA correlations differed significantly as a function of cut-points for self-reported function, quality of life, anxiety and depression (p ≤ .05). For age-specific cut-points, more time spent in MVPA was associated with a worse psychological profile. DISCUSSION: Applying age-specific cut-points for MVPA assessment in older adults with lower limb OA had implications for MVPA associations with health and well-being when total volume, but not bouted, MVPA was considered. Age-specific total volume MVPA needs further understanding regarding patterns and affective responses it comprises. Bouted MVPA is an important pattern for MVPA accrual, but probably not an applicable PA target for many patients.
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Osteoartrite do Quadril , Osteoartrite do Joelho , Acelerometria , Idoso , Estudos Transversais , Exercício Físico , Feminino , Humanos , Masculino , Qualidade de VidaRESUMO
The purpose of this study was to test the measurement invariance (across five languages, two time points, and two experimental conditions) of the empowering and disempowering motivational climate questionnaire-coach (EDMCQ-C; Appleton et al., 2016) when completed by 9256 young sport participants (M age = 11.53 years, SD = 1.39 years; 13.5% female). Exploratory Structural Equation Modeling was used to test the validity of a 2-factor (empowering and disempowering) model running a multiple group analysis without any equality constraint (configural invariance) followed by measurement invariance of factor loadings and thresholds (scalar invariance). Findings provided support for partial invariance across languages and scalar invariance across time and experimental groups. The factors were interpretable across the analyses, and items loaded as intended by theory except for item 15. This study provides further evidence regarding the psychometric properties of the EDMCQ-C and suggests this scale (minus item 15) can be used to provide meaningful latent mean comparisons (Marsh et al., 2013) of empowering and disempowering coach-created climates across athletes speaking the five targeted languages, across time, and across experimental groups.
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INTRODUCTION: Non-ambulant children and young people with physical disabilities are at high risk of experiencing negative health outcomes associated with sedentary time. A previous scoping review summarising evidence relating to sedentary behaviours of children with physical disabilities identified the need for validated methods of measuring physical activity of children who use wheelchairs and evaluation of interventions to reduce sedentary time. The scoping review did not assess the quality of evidence relating to this topic, therefore its validity remains unclear. No reviews focussing on non-ambulant children and young people up to the age of 25 years have been undertaken.The objectives of this systematic search and review are to:Identify all peer-reviewed articles relating to sedentary behaviour of non-ambulant children and young people.Categorise the articles according to study design and four subquestions relating to (i) measurement, (ii) patterns, (iii) associated risks and (iv) interventions to reduce sedentary time or behaviour.Critically appraise quality of the articles using established critical appraisal tools.Summarise the evidence for each subquestion. Describe its cumulative strength and identify knowledge gaps. METHODS AND ANALYSIS: This protocol was developed using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. The research questions, inclusion/exclusion criteria and search terms have been developed a priori using the 'Population, Concept and Context' framework. Online databases will be systematically searched to identify peer-reviewed articles published between 1996 and 2021. Two reviewers will screen, categorise and critically appraise the articles. Data extraction and analysis will be verified by the second reviewer.Results will be reported as a best evidence synthesis, with reference to the PRISMA checklist. ETHICS AND DISSEMINATION: Ethical approval is not required. The review will be submitted to an appropriate peer-reviewed journal. REGISTRATION: The review is registered on the Open Science Framework database. DOI: https://doi.org/10.17605/OSF.IO/SQXJB. Any protocol amendments will be recorded in the Open Science Framework database.
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Atenção à Saúde , Comportamento Sedentário , Adolescente , Adulto , Criança , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como AssuntoRESUMO
In the original article [...].
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The coach-created motivational climate influences variations in athletes' motivation and emotional experiences. The present study aimed to examine social environmental antecedents of athletes' emotions. Participants (N = 262, 52% female, M age = 22.75 ± 6.92) completed questionnaires assessing perceptions of coach-created motivational climates, goal orientations, motivation regulations, and emotions. The mediation effects of goal orientations (i.e., task/ego) and motivation regulations (i.e., autonomous/controlled) on the relationship between motivational climate (i.e., empowering/disempowering) and emotions (i.e., happiness, excitement, anxiety, dejection, and anger) were examined. Structural equation modeling revealed positive direct effects of perceptions of an empowering motivational climate on happiness. Indirect effects of empowering climate to happiness and excitement via task orientation and autonomous motivation emerged. Perceptions of a disempowering climate positively predicted anxiety, dejection, and anger via ego orientation and controlled motivation. Overall, the findings have implications for coach education as they highlight the importance of creating more empowering environments and avoiding or reducing social comparisons.
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Atletas , Motivação , Adolescente , Adulto , Ira , Ansiedade , Emoções , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVES: The aims of this study were to examine the longitudinal and bi-directional associations of pain and fatigue with sedentary, standing and stepping time in RA. METHODS: People living with RA undertook identical assessments at baseline (T1, n = 104) and 6-month follow-up (T2, n = 54). Participants completed physical measures (e.g. height, weight, BMI) and routine clinical assessments to characterize RA disease activity (DAS-28). Participants also completed questionnaires to assess physical function (HAQ), pain (McGill Pain Questionnaire) and fatigue (Multidimensional Assessment of Fatigue Scale). Participants' free-living sedentary, standing and stepping time (min/day) were assessed over 7 days using the activPAL3µ™. For the statistical analysis, hierarchical regression analysis was employed to inform the construction of path models, which were subsequently used to examine bi-directional associations of pain and fatigue with sedentary, standing and stepping time. Specifically, where significant associations were observed in longitudinal regression analysis, the bi-directionality of these associations was further investigated via path analysis. For regression analysis, bootstrapping was applied to regression models to account for non-normally distributed data, with significance confirmed using 95% CIs. Where variables were normally distributed, parametric, non-bootstrapped statistics were also examined (significance confirmed via ß coefficients, with P < 0.05) to ensure all plausible bi-directional associations were examined in path analysis. RESULTS: Longitudinal bootstrapped regression analysis indicated that from T1 to T2, change in pain, but not fatigue, was positively associated with change in sedentary time. In addition, change in pain and fatigue were negatively related to change in standing time. Longitudinal non-bootstrapped regression analysis demonstrated a significant positive association between change in fatigue with change in sedentary time. Path analysis supported the hypothesized bi-directionality of associations between change in pain and fatigue with change in sedentary time (pain, ß = 0.38; fatigue, ß = 0.44) and standing time (pain, ß = -0.39; fatigue, ß = -0.50). CONCLUSION: Findings suggest pain and fatigue are longitudinally and bi-directionally associated with sedentary and standing time in RA.
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Artrite Reumatoide/fisiopatologia , Fadiga/etiologia , Dor/etiologia , Comportamento Sedentário , Posição Ortostática , Idoso , Artrite Reumatoide/complicações , Exercício Físico , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Medição da Dor , Análise de Regressão , Índice de Gravidade de Doença , Fatores de Tempo , CaminhadaRESUMO
Findings in different contexts suggest that task orientation and ego orientation are related to adaptive and maladaptive motivational patterns, respectively. In sport, these personal dispositions could influence other important variables such as the goals that athletes pursue (and why they pursue them) during the season and their well- and ill-being. The main purpose of this research was to examine the relationship between athletes' dispositional goal orientations, their goal motives, and their reported well-being (subjective vitality) and ill-being (physical and emotional exhaustion). The study involved 414 Spanish university athletes (206 female and 208 male) with an age range of 17 to 33 years (M = 20.61; SD = 2.58) that completed a package of questionnaires at the beginning of the season. Results of path analysis revealed that athletes' task orientation was negatively associated to physical and emotional exhaustion indirectly through autonomous and controlled goal motives. In contrast, ego orientation was positively related to physical and emotional exhaustion via its link to controlled goal motives. Athletes' task orientation directly and positively predicted subjective vitality, even though goal motives were not significant mediators. These findings support previous evidence about the protective role of athletes' task orientation, in contrast to ego orientation, confirming its positive relationship with well-being and its negative one with ill-being. Additionally, it extends the knowledge regarding interdependencies between goal orientations and goal motives and how both contribute to athletes' optimal or compromised functioning.
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Objetivos , Esportes , Adolescente , Adulto , Atletas , Feminino , Humanos , Masculino , Motivação , Inquéritos e Questionários , Adulto JovemRESUMO
Physical inactivity is prevalent in rheumatoid arthritis (RA) patients, increasing the risk of poor physical health and compromised well-being. Interventions are therefore required to support physical activity (PA) behavior change in this population. This study examined whether a self-determination theory (SDT) based exercise intervention for people with RA, increased autonomous motivation for PA and in turn, moderate-to-vigorous PA (MVPA) and subjective vitality RA patients (n = 115) were randomized to a 3-month SDT-based psychological intervention + RA-tailored exercise program (experimental group, n = 59) or a RA-tailored exercise program only (control group, n = 56). During the program, the SDT-based intervention group received one-on-one consultations with a PA advisor trained in delivering strategies to promote autonomous motivation for PA. Well-established questionnaires assessed autonomous and controlled motivation for PA, MVPA (min/week), and subjective vitality at baseline (T1) and 3 months (T2). Path analysis examined the hypothesized theoretical process model. The model demonstrated an excellent fit to the data (n = 70, χ2 (26) = 28.69, p = .33, comparative fit index = 0.99, root square mean error of approximation = 0.04). The intervention corresponded to higher autonomous motivation and lower controlled motivation for PA at T2, after controlling for T1 autonomous and controlled motivation. In turn, changes in autonomous motivation from T1 to T2 significantly positively predicted changes in MVPA and subjective vitality. Results suggest an SDT based psychological intervention comprising autonomy-supportive strategies for PA predicted greater reported autonomous reasons for PA in RA patients participating in a tailored 3-month exercise program. Increased autonomous motivation linked to increased engagement in MVPA and feelings of vitality in these patients.
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Artrite Reumatoide , Autonomia Pessoal , Artrite Reumatoide/terapia , Exercício Físico , Humanos , Motivação , Atividade MotoraRESUMO
Nationwide lockdowns during SARS-CoV-2 (COVID-19) can compromise mental health and psychological wellbeing and limit opportunities for physical activity (PA), particularly in clinical populations, such as people with rheumatoid arthritis (RA), who are considered at risk for COVID-19 complications. This study aimed to investigate associations between PA and sedentary time (ST) with indicators of mental health and wellbeing in RA during COVID-19 lockdown, and examine the moderation effects of self-isolating. 345 RA patients completed an online questionnaire measuring PA (NIH-AARP Diet and Health Study Questionnaire), ST (International Physical Activity Questionnaire-Short Form), pain (McGill Pain Questionnaire and Visual Analogue Scale), fatigue (Multidimensional Fatigue Inventory), depressive and anxious symptoms (Hospital Anxiety and Depression Scale), and vitality (Subjective Vitality Scale) during the United Kingdom COVID-19 lockdown. Associations between PA and ST with mental health and wellbeing were examined using hierarchical multiple linear regressions. Light PA (LPA) was significantly negatively associated with mental fatigue (ß = - .11), depressive symptoms (ß = - .14), and positively with vitality (ß = .13). Walking was negatively related to physical fatigue (ß = - .11) and depressive symptoms (ß = - .12) and positively with vitality (ß = .15). Exercise was negatively associated with physical (ß = - .19) and general (ß = - .12) fatigue and depressive symptoms (ß = - .09). ST was positively associated with physical fatigue (ß = .19). Moderation analyses showed that LPA was related to lower mental fatigue and better vitality in people not self-isolating, and walking with lower physical fatigue in people self-isolating. These findings show the importance of encouraging PA for people with RA during a lockdown period for mental health and wellbeing.
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Artrite Reumatoide/psicologia , COVID-19 , Exercício Físico , Idoso , Ansiedade/psicologia , Controle de Doenças Transmissíveis , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Distanciamento Físico , SARS-CoV-2 , Comportamento Sedentário , Inquéritos e QuestionáriosRESUMO
In response to the COVID-19 pandemic, many countries have adopted community containment to manage COVID-19. These measures to reduce human contact, such as social distancing, are deemed necessary to contain the spread of the virus and protect those at increased risk of developing complications following infection with COVID-19. People with rheumatoid arthritis (RA) are advised to adhere to even more stringent restrictions compared to the general population, and avoid any social contact with people outside their household. This social isolation combined with the anxiety and stress associated with the pandemic, is likely to particularly have an impact on mental health and psychological wellbeing in people with RA. Increasing physical activity and reducing sedentary behaviour can improve mental health and psychological wellbeing in RA. However, COVID-19 restrictions make it more difficult for people with RA to be physically active and facilitate a more sedentary lifestyle. Therefore, guidance is necessary for people with RA to adopt a healthy lifestyle within the constraints of COVID-19 restrictions to support their mental health and psychological wellbeing during and after the COVID-19 pandemic.
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OBJECTIVES: Research demonstrates that sedentary behaviour may contribute towards cardiovascular disease (CVD) risk in rheumatoid arthritis (RA). This study explored diurnal patterns of sedentary time and physical activity (PA) in RA and examined associations with long-term CVD risk. METHODS: 97 RA patients wore an accelerometer for 7 days to assess sedentary time, light-intensity and moderate-to-vigorous-intensity PA. Estimated 10-year CVD risk was determined via QRISK score. Hourly estimates of sedentary time and PA (min/hour) were computed for valid-wear hours (ie, valid-wear = 60 min/hour of activity data, ≥3 days). Hourly data were averaged across time periods to represent morning (08:00-11:59), afternoon (12:00-17:59) and evening (18:00-22:59) behaviour. Participants providing data for ≥2 complete time periods/day (eg, morning/evening, or morning/afternoon) were used in the main analysis (n = 41). Mixed linear modelling explored the associations between 10-year CVD risk and within-person (time: morning, afternoon, evening) changes in sedentary time and PA. RESULTS: Sedentary time was higher, and light-intensity and moderate-to-vigorous-intensity PA lower in the evening, compared to morning and afternoon. Significant interactions revealed individuals with higher CVD risk were more sedentary and did less light-intensity PA during the afternoon and evening. Findings remained significant after adjustment for disease duration, functional ability and erythrocyte sedimentation rate. CONCLUSION: Results suggest that the evening time period may offer a significant window of opportunity for interventions to reduce sedentary behaviour in RA and contribute to associated improvements in CVD risk. Due to inverse patterns of engagement, replacing sedentary time with light-intensity PA may offer an effective approach for intervention.