Rigshospitalet, Glostrup, Denmark.
Bispebjerg and Frederiksberg Hospitals and University of Copenhagen, Copenhagen, Denmark.
Arthritis Care Res (Hoboken). 2020 Nov;72(11):1560-1570. doi: 10.1002/acr.24060.
To evaluate the 18-month postintervention efficacy following a 4-month individually tailored behavioral intervention on daily sitting time in patients with rheumatoid arthritis (RA).
In an observer-blinded randomized trial, 150 RA patients were included. During 4 months, the intervention group (n = 75) received 3 motivational counseling sessions and tailored text messages aimed at increasing light-intensity physical activity through reduction of sedentary behavior. The control group (n = 75) maintained their usual lifestyle. The primary outcome was change from baseline to 18 months postintervention in objectively measured daily sitting time (using ActivPAL). Secondary outcomes included changes in clinical patient-reported outcomes and cardiometabolic biomarkers. A mixed-effect repeated measures analysis of covariance model in the intent-to-treat population was applied.
At 22 months follow-up from baseline, 12 participants were lost to follow-up. Compared to baseline, sitting time in the intervention group decreased 1.10 hours/day, whereas it increased by 1.32 hours/day in the control group, a between-group difference of -2.43 hours/day (95% confidence interval [95% CI] -2.99, -1.86; P < 0.0001) favoring the intervention group. For most secondary outcomes, between-group differences favored the intervention: visual analog scale (VAS) pain -15.51 mm (95% CI -23.42, -7.60), VAS fatigue -12.30 mm (95% CI -20.71, -3.88), physical function -0.39 Health Assessment Questionnaire units (95% CI -0.53, -0.26), total cholesterol -0.86 mmoles/liter (95% CI -1.03, -0.68), triglycerides -0.26 mmoles/liter (95% CI -0.43, -0.09), and average glucose -1.15 mmoles/liter (95% CI -1.39, -0.91).
The 4-month postintervention results showed that patients in the intervention reduced their daily sitting time and improved patient-reported outcomes and total cholesterol levels compared to the control group. Eighteen months after intervention, patients in the intervention group were still significantly less sedentary than controls. Findings suggest that a behavioral approach is beneficial for promoting long-term physical activity and health in patients with RA.
评估为期 4 个月的个体化行为干预对类风湿关节炎（RA）患者日常久坐时间的 18 个月干预后效果。
在一项观察者盲随机试验中，纳入了 150 名 RA 患者。在 4 个月期间，干预组（n=75）接受了 3 次动机咨询会议和个性化短信，旨在通过减少久坐行为来增加低强度体力活动。对照组（n=75）保持其日常的生活方式。主要结局是从基线到 18 个月时，通过客观测量的日常久坐时间（使用 ActivPAL）的变化。次要结局包括临床患者报告结果和心血管代谢生物标志物的变化。采用意向治疗人群的混合效应重复测量方差分析模型进行分析。
从基线开始随访 22 个月时，有 12 名参与者失访。与基线相比，干预组的久坐时间减少了 1.10 小时/天，而对照组增加了 1.32 小时/天，组间差异为-2.43 小时/天（95%置信区间 [95%CI] -2.99，-1.86；P<0.0001），有利于干预组。对于大多数次要结局，组间差异有利于干预组：视觉模拟量表（VAS）疼痛-15.51 毫米（95%CI -23.42，-7.60），VAS 疲劳-12.30 毫米（95%CI -20.71，-3.88），身体功能-0.39 健康评估问卷单位（95%CI -0.53，-0.26），总胆固醇-0.86 毫摩尔/升（95%CI -1.03，-0.68），甘油三酯-0.26 毫摩尔/升（95%CI -0.43，-0.09），平均血糖-1.15 毫摩尔/升（95%CI -1.39，-0.91）。
4 个月的干预后结果表明，与对照组相比，干预组患者减少了日常久坐时间，并改善了患者报告的结果和总胆固醇水平。干预 18 个月后，干预组患者仍明显比对照组患者久坐时间少。研究结果表明，行为方法有利于促进 RA 患者的长期体力活动和健康。
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