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Predictors of Exercise Behavior in Patients With Rheumatoid Arthritis 6 Months Following a Visit With Their Rheumatologist

Maura D Iversen, Anne H Fossel, Kelly Ayers, Allison Palmsten, Hai Wei Wang and Lawren H Daltroy^,

MD Iversen, PT, SD, is Associate Professor and Director, Human Performance Laboratory, Department of Physical Therapy, School for Health Studies, Simmons College; Senior Clinical Researcher, RBB Arthritis and Musculoskeletal Diseases Clinical Research Center, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; and Instructor in Medicine, Harvard Medical School, Boston, Mass
AH Fossel is Project Manager RBB Arthritis and Musculoskeletal Diseases Clinical Research Center, Department of Medicine, Division of Rheumatology, Immunology & Allergy, Brigham and Women's Hospital
K Ayers, PT, DPT, A Palmsten, PT, DPT, and HW Wang, PT, DPT, were students in the Doctoral Program in Physical Therapy, School for Health Studies, Simmons College, when this study was conducted
LH Daltroy, DrPH, was an Associate Professor, Harvard School of Public Health and Harvard Medical School, and Associate Director, RBB Arthritis and Musculoskeletal Diseases Clinical Research Center, Department of Medicine, Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital

Address all correspondence to Dr Iversen at RBB Arthritis and Musculoskeletal Diseases Clinical Research Center, Department of Medicine, Division of Rheumatology, Immunology & Allergy, Brigham and Women's Hospital PBB-B3, 75 Francis St, Boston, MA 02115 (USA) (miversen{at}partners.org)

Background and Purpose. When factors that influence exercise behavior are known, health care professionals can more likely design and modify patient education materials targeted to promote exercise behavior. This study aimed to identify predictors of exercise behavior in patients with rheumatoid arthritis 6 months after a visit with their rheumatologist. Subjects and Methods. Twenty-five rheumatologists and 132 patients with rheumatoid arthritis participated. One hundred thirteen patients (85.6%) completed the 6-month follow-up. Rheumatologists and patients completed baseline questionnaires and were audiotaped during a subsequent visit. Physical function and exercise behavior were ascertained via questionnaire 6 months following the visit. Multivariate logistic regression identified predictors of exercise behavior at 6 months. Eighty-nine patients (79%) were female. The average age was 54.8 years (SD=14.4, range=20–94). The mean duration of illness was 9.8 years (SD=8.7, range=<1–35). Patients were moderately impaired (mean Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] function score=49.3, SD=27.5). Thirty-four patients (27%) were exercising 6 months after visiting their rheumatologist. More than 50% of the rheumatologists had 5 or more years of clinical experience, 18 (72%) were male, and 10 (42%) reported they exercised regularly. Results. Predictors of exercise behavior at 6 months were patients' past history of exercise (odds ratio=6.8, 95% confidence interval=3.1–15) and rheumatologists' current exercise behavior (odds ratio=0.26, 95% confidence interval= 0.09–0.77). Discussion and Conclusion. Patients were nearly 7 times more likely to exercise 6 months after visiting their rheumatologist if they participated in exercise in the past. If a patient's rheumatologist was currently performing aerobic exercise, the patient was 26% more likely to be engaged in exercise at follow-up. These data may be useful in understanding patient motivation to participate in exercise.

Key Words: Exercise behavior • Rheumatoid arthritis

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