TY - JOUR
T1 - Autonomous motivation, cardiorespiratory fitness, and exercise in rheumatoid arthritis
T2 - randomised controlled trial
AU - Veldhuijzen Van Zanten, Jet J.C.S.
AU - Fenton, Sally A.M.
AU - Rouse, Peter C.
AU - Ntoumanis, Nikos
AU - Osailan, Ahmad
AU - Yu, Chen-an
AU - Metsios, George S.
AU - Kitas, George D.
AU - Duda, Joan L.
PY - 2021/7/31
Y1 - 2021/7/31
N2 - 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.
AB - 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.
KW - Cardiovascular disease risk
KW - Exercise
KW - Physical activity
KW - Rheumatoid arthritis
KW - Self-determination theory
UR - http://www.scopus.com/inward/record.url?scp=85105780155&partnerID=8YFLogxK
U2 - 10.1016/j.psychsport.2021.101904
DO - 10.1016/j.psychsport.2021.101904
M3 - Article
SN - 1469-0292
VL - 55
JO - Psychology of Sport and Exercise
JF - Psychology of Sport and Exercise
M1 - 101904
ER -
