Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled Trial

Arch Phys Med Rehabil. 2016 Jan;97(1):26-36. doi: 10.1016/j.apmr.2015.09.022. Epub 2015 Oct 16.


Objective: To examine effects of person-centered physical therapy on fatigue and related variables in persons with rheumatoid arthritis (RA).

Design: Randomized controlled trial.

Setting: Hospital outpatient rheumatology clinic.

Participants: Persons with RA aged 20 to 65 years (N=70): intervention group (n=36) and reference group (n=34).

Interventions: The 12-week intervention, with 6-month follow-up, focused on partnership between participant and physical therapist and tailored health-enhancing physical activity and balancing life activities. The reference group continued with regular activities; both groups received usual health care.

Main outcome measures: Primary outcome was general fatigue (visual analog scale). Secondary outcomes included multidimensional fatigue (Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire) and fatigue-related variables (ie, disease, health, function).

Results: At posttest, general fatigue improved more in the intervention group than the reference group (P=.042). Improvement in median general fatigue reached minimal clinically important differences between and within groups at posttest and follow-up. Improvement was also observed for anxiety (P=.0099), and trends toward improvements were observed for most multidimensional aspects of fatigue (P=.023-.048), leg strength/endurance (P=.024), and physical activity (P=.023). Compared with the reference group at follow-up, the intervention group improvement was observed for leg strength/endurance (P=.001), and the trends toward improvements persisted for physical (P=.041) and living-related (P=.031) aspects of fatigue, physical activity (P=.019), anxiety (P=.015), self-rated health (P=.010), and self-efficacy (P=.046).

Conclusions: Person-centered physical therapy focused on health-enhancing physical activity and balancing life activities showed significant benefits on fatigue in persons with RA.

Keywords: Arthritis; Fatigue; Randomized controlled trial at topic; Rehabilitation; Rheumatoid.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / complications*
  • Exercise Therapy
  • Fatigue / etiology*
  • Fatigue / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Person-Centered Psychotherapy / methods*
  • Single-Blind Method
  • Surveys and Questionnaires
  • Visual Analog Scale