Fatigue is described as a dominant and disturbing symptom of rheumatoid arthritis (RA) regardless of the advances in pharmacological treatment. Fatigue is also found to correlate with depression. The objective was to evaluate the impact of moderate-to-high intensity, aerobic and resistance exercise with person-centered guidance on fatigue, anxiety and depression, in older adults with RA. Comparisons were made between older adults (> 65 years) with RA taking part in a 20-week moderate-to-high intensity exercise at a gym (n = 36) or in home-based exercise of light intensity (n = 38). Assessments were performed at baseline, at 20 weeks, and at 52 weeks. Outcomes were differences in Multidimensional Fatigue Inventory (MFI-20), Visual Analog Scale Fatigue (VAS fatigue), and Hospital Anxiety and Depression Scale (HADS). Analysis of metabolomics was also performed. The subscales "physical fatigue" and "mental fatigue" in MFI-20 and symptoms of depression using HADS depression scale improved significantly at week 20 in the exercise group compared with the control group. Exercise did not influence global fatigue rated by VAS or subscales "reduced motivation", "reduced activity" and "general fatigue" in MFI-20. No significant change was found on the anxiety index of HADS. The improvements in physical fatigue were associated with changes in the metabolism of lipids, bile acids, the urea cycle and several sugars. Moderate-to-high intensity exercise with person-centered guidance decreased fatigue and improved symptoms of depression and were accompanied by metabolic changes in older adults with RA.
Keywords: Anxiety; Arthritis; Depression; Exercise; Fatigue; Metabolomics; Patient-centered; Rheumatoid.
Effects of Aerobic and Resistance Exercise in Older Adults With Rheumatoid Arthritis: A Randomized Controlled TrialE Lange et al. Arthritis Care Res (Hoboken) 71 (1), 61-70. PMID 29696812. - Randomized Controlled TrialAerobic and resistance exercise with person-centered guidance improved physical fitness in terms of aerobic capacity, endurance, and strength in older adults with RA.
Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled TrialC Feldthusen et al. Arch Phys Med Rehabil 97 (1), 26-36. PMID 26482574. - Randomized Controlled TrialPerson-centered physical therapy focused on health-enhancing physical activity and balancing life activities showed significant benefits on fatigue in persons with RA. …
Low Aerobic Capacity and Physical Activity Not Associated With Fatigue in Patients With Rheumatoid Arthritis: A Cross-Sectional StudyT Munsterman et al. J Rehabil Med 45 (2), 164-9. PMID 23096407.Depression, but not aerobic capacity or physical activity, contributed to fatigue. However, no relationship was found between aerobic capacity and fatigue.
Exercise Therapy for Chronic Fatigue SyndromeL Larun et al. Cochrane Database Syst Rev 12 (12), CD003200. PMID 27995604. - ReviewPatients with CFS may generally benefit and feel less fatigued following exercise therapy, and no evidence suggests that exercise therapy may worsen outcomes. A positive …
Exercise Therapy for Chronic Fatigue SyndromeL Larun et al. Cochrane Database Syst Rev (6), CD003200. PMID 27339435. - ReviewPatients with CFS may generally benefit and feel less fatigued following exercise therapy, and no evidence suggests that exercise therapy may worsen outcomes. A positive …