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

Caroline Feldthusen; Elizabeth Dean; Helena Forsblad-d'Elia; Kaisa Mannerkorpi

doi:10.1016/j.apmr.2015.09.022

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.

Authors

Caroline Feldthusen¹, Elizabeth Dean², Helena Forsblad-d'Elia³, Kaisa Mannerkorpi⁴

Affiliations

¹ Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The University of Gothenburg Centre for Person-centred Care, Gothenburg, Sweden. Electronic address: caroline.feldthusen@vgregion.se.
² Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
³ Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden.
⁴ The University of Gothenburg Centre for Person-centred Care, Gothenburg, Sweden; Section of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

PMID: 26482574
DOI: 10.1016/j.apmr.2015.09.022

Abstract

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