Autonomous motivation, cardiorespiratory fitness, and exercise in rheumatoid arthritis: randomised controlled trial

Jet J.c.s. Veldhuijzen Van Zanten, Sally A.m. Fenton, Peter C. Rouse, Nikos Ntoumanis, Ahmad Osailan, Chen-an Yu, George S. Metsios, George D. Kitas, Joan L. Duda

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4 Citations (SciVal)


Objective: Rheumatoid arthritis (RA) is an autoimmune disease, characterised by high-grade systemic inflammation, pain, and swollen joints. RA patients have an increased risk for cardiovascular disease (CVD). This study examined if a 3-month individualised RA-tailored exercise programme with one-on-one Self-Determination Theory (SDT)-based support for physical activity (PA) facilitated autonomous motivation, increased PA behaviour, and induced greater improvements in cardiovascular and RA-related disease characteristics, and wellbeing in RA, compared to a standard provision tailored exercise programme. Methods: 115 RA patients were randomised into either the SDT-based psychological intervention + exercise programme (experimental group) or an exercise programme only (control group). Cardiorespiratory fitness (primary outcome), self-reported PA, disease characteristics, CVD risk, wellbeing, and SDT constructs were assessed at baseline (pre-intervention), 3 months (post-intervention), 6 months, and 12 months follow-up. Mixed linear modeling was used to examine within- and between participant changes in these outcome measures. Results: In 88 patients with complete baseline data, cardiorespiratory fitness did not change from baseline to 3-, 6- or 12 months in either group. CVD risk, disease characteristics, wellbeing, and need satisfaction did not change, with the exception of diastolic blood pressure. Significant group by time interaction effects were found for functional ability (6- & 12-months), CVD risk (6-months) and PA (3-months). Autonomous motivation increased and controlled motivation decreased more in the experimental group compared to the control group at 3 months. Conclusions: Despite improving quality of motivation for exercise, no changes in cardiorespiratory fitness or other psychological and physiological health outcomes were found. This suggests more intensive support is needed when initiating an exercise programme to achieve health benefits in RA.

Original languageEnglish
Article number101904
JournalPsychology of Sport and Exercise
Early online date30 Jan 2021
Publication statusPublished - 31 Jul 2021

Bibliographical note

Funding Information:
This study was funded through the Medical Research Council , National Prevention Research Initiative Phase 3 ( G080212 ). All authors are independent from the funding body.


  • Cardiovascular disease risk
  • Exercise
  • Physical activity
  • Rheumatoid arthritis
  • Self-determination theory

ASJC Scopus subject areas

  • Applied Psychology


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