Effects of a Group-Based Exercise and Educational Program on Physical Performance and Disease Self-Management in Rheumatoid Arthritis: A Randomized Controlled Study Targeting motivation and self-regulation to increase physical activity among patients with rheumatoid arthritis: a randomised controlled trial Physical activity coaching of patients with rheumatoid arthritis in everyday practice: a long-term follow-up. Association of physical inactivity with increased cardiovascular risk in patients with rheumatoid arthritis Engagement and satisfaction with an Internet-based physical activity intervention in patients with rheumatoid arthritis. Patient education program to teach energy conservation behaviors to patients with rheumatoid arthritis: a pilot study. Using internet technology to deliver a home-based physical activity intervention for patients with rheumatoid arthritis: A randomized controlled trial. Motivational counselling and SMS-reminders for reduction of daily sitting time in patients with rheumatoid arthritis: a descriptive randomised controlled feasibility study EFFECTS OF A MODIFIED DANCE-BASED EXERCISE ON CARDIORESPIRATORY FITNESS, PSYCHOLOGICAL STATE AND HEALTH STATUS OF PERSONS WITH RHEUMATOID ARTHRITIS A tailored-guided internet-based cognitive-behavioral intervention for patients with rheumatoid arthritis as an adjunct to standard rheumatological care: results of a randomized controlled trial Maintenance of physical activity after Internet-based physical activity interventions in patients with rheumatoid arthritis. Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis. Long-term efficacy of a cognitive behavioural treatment from a randomized controlled trial for patients recently diagnosed with rheumatoid arthritis. Decreases in health care resource utilization in patients with rheumatoid arthritis following a cognitive behavioral intervention Physical fitness and work capacity in women with rheumatoid arthritis. Effects of a modular behavioural arthritis education programme: a pragmatic parallel-group randomized controlled trial. A blind, randomized, controlled trial of cognitive-behavioural intervention for patients with recent onset rheumatoid arthritis: preventing psychological and physical morbidity
Background Evidence supports the use of educational and physical training programs for people with rheumatoid arthritis ( RA ) . Objective The purpose of this study was to evaluate the effects of a group-based exercise and educational program on the physical performance and disease self-management of people with RA . Design This was a r and omized controlled trial . Setting The study was conducted at a rehabilitation center in the Netherl and s. Participants Thirty-four people diagnosed with RA participated in the study . Participants were r and omly assigned to either an intervention group ( n=19 ) or a waiting list control group ( n=15 ) . Intervention The intervention in this study was an 8-week , multidisciplinary , group therapy program for people with RA , consisting of physical exercise design ed to increase aerobic capacity and muscle strength ( force-generating capacity ) together with an educational program to improve health status and self-efficacy for disease-self-management . Measurements The main outcome measures were maximum oxygen uptake ( V̇o2max ) , muscle strength of the elbow and knee flexors and extensors , health status , and perceived self-efficacy . All data were recorded before intervention in week 1 , after intervention in week 9 , and at follow-up in week 22 . Results The intervention group showed significant improvement ( 12.1 % ) in V̇o2max at week 9 compared with the control group ( −1.7 % ) . Although significant within-group changes were found over time for muscle strength of the upper and lower extremities and health status that favored the intervention group , no between-group changes were found regarding these outcomes . Limitations An important limitation was the small number of participants included in our study , which may have result ed in a lack of power . Conclusions The present group-based exercise and educational program for people with RA had a beneficial effect on aerobic capacity but not on muscle strength , health status , or self-efficacy The purpose of this study is to evaluate the effects of targeting both the motivation and action phases of behaviour change in a 5-week intervention to increase physical activity ( PA )  among patients with rheumatoid arthritis ( RA ) not meeting current PA recommendations . In a r and omised controlled trial , a control group — which received a group-based patient education session led by a physical therapist — was compared to a treatment group which received the education session plus a motivational interview from a physical therapist and two self-regulation coaching sessions from a rheumatology nurse . Outcomes included  leisure-time PA , days per week with at least 30 min of moderate-intensity PA , self-efficacy and autonomous motivation ( cognitions which predict PA initiation and maintenance ) , disease activity , functional status , depressive symptoms and fatigue . Effects were assessed using mixed models repeated measures . Of the 78 patients r and omised , 76 and 67 completed the post-treatment and follow-up assessment s , respectively . Significant treatment effects were found for leisure-time PA  ( p = 0.022 ) , active days/week ( p = 0.016 ) , self-efficacy ( p = 0.008 ) and autonomous motivation ( p = 0.001 ) . At post-treatment and 6-months follow-up , significantly more treated patients than controls met current PA recommendations . No significant effects were found for disease activity , functional status , depressive symptoms or fatigue . Combining motivation- and action-focused intervention approaches improved PA-related cognitions and led to improved uptake and maintenance of leisure-time PA . However , further research is necessary to identify ways of helping patients with RA transition to— and maintain — more intensive forms of PA which are more likely to improve disease activity and functional status OBJECTIVES To investigate the long-term effects on perceived general health , disease activity , pain , activity limitation and cognitive behavioural factors of a one-year coaching programme performed in ordinary physical therapy practice to promote the adoption of health-enhancing physical activity in patients with early rheumatoid arthritis ( RA ) . METHODS A total of 228 patients with early RA , from 10 rheumatology clinics in Sweden , were r and omly assigned to an intervention group ( IG ; n = 94 ) or a control group ( CG ; n = 134 ) . The IG was coached by physical therapists during the first year to adopt health-enhancing levels of physical activity ( 30 minutes/day , moderately intensive , ≥ 4 days/week ) . No coaching was given during the subsequent year between post-intervention and follow-up . Follow-up assessment consisted of a postal question naire on physical activity and of visual analogue scales for ratings of general health perception and pain . The Health Assessment Question naire Disability Index ( HAQ ) and the Disease Activity Score in 28 joints ( DAS 28 ) were collected at regular medical check-ups . RESULTS Sixty-five ( 69 % ) participants in the IG and 92 ( 69 % ) in the CG completed the entire study period by filling in the follow-up question naire on physical activity two years after baseline . The intervention seemed to lack any significant influence on long-term outcome . However , different patterns of change in physical activity behaviour were observed in the two groups . CONCLUSIONS No long-term improvement in perceived general health or other outcomes were found in the follow-up . This may partly be because the intervention lacked several important behavioural elements for physical activity maintenance Objective Patients with rheumatoid arthritis ( RA ) are characterized by reduced physical activity and increased morbidity and mortality from cardiovascular disease ( CVD ) . The aim of this study was to investigate associations between levels of  physical activity and CVD risk profile in RA patients . Methods Levels of physical activity were assessed in 65 RA patients ( 43 females ) . Using the International Physical Activity Question naire , patients were allocated into three groups : active , moderately active and inactive .  Anthropometric characteristics , RA activity/severity , multiple classical and novel CVD risk factors and 10-year CVD event probability were assessed and compared among the three groups . Results Significant differences were detected among groups in systolic blood pressure ( P = 0.006 ) , cholesterol ( P < 0.001 ) , low-density lipoprotein ( P = 0.01 ) , homeostasis model assessment ( P = 0.001 ) , type-1 plasminogen activator inhibitor antigen ( P < 0.001 ) , tissue-type plasminogen activator antigen ( P = 0.019 ) , homocysteine ( P = 0.027 ) , fibrinogen ( P = 0.001 ) , apolipoprotein B ( P = 0.002 ) and von Willebr and Factor ( P = 0.001 ) , with a consistent deterioration from the physically active to the physically inactive group . Multivariate analysis of variance revealed that levels of physical activity  were significantly associated with the differences in all of the above variables ( P < 0.05 ) after adjustment for age , weight , sex , smoking status , as well as RA disease activity and severity . Conclusion This cross-sectional study suggests that physically inactive RA patients have significantly worse CVD risk profile compared with physically active patients . The possible beneficial impact of increased physical activity , including structured exercise , to the CVD risk of RA patients needs to be accurately assessed in prospect i ve studies . Eur J Cardiovasc Prev Rehabil 16:188 - 194 © 2009 The European Society of OBJECTIVE To assess the engagement in and satisfaction with an Internet-mediated physical activity intervention with individual supervision in patients with rheumatoid arthritis ( RA ) . METHODS The intervention studied was one of the two strategies aim ed at enhancing physical activity in RA patients that were being compared in a r and omized controlled trial . A total of 82 patients , all experienced in using Internet and e-mail and registered at three different rheumatology out-patient clinics , were r and omly allocated to the Internet-mediated individualized intervention ( 52 weeks ) . They had access to personal physical activity schedules and received individual supervision by a physical therapist by means of weekly e-mail feedback . In addition , telephone contacts , an online discussion forum , six face-to-face group meetings and electronic newsletters were offered . Besides registration of returned physical activity schedules , engagement and satisfaction were measured through question naires . RESULTS The median physical activity schedule return rate of the 82 participants was 55 % . The mean number of patients logging into the website at least once a week was 53 ( 70 % ) over 12 months . Of all patients , 69 returned the question naires ( response 84 % ) . Telephone contacts were used by 38/67 patients ( 57 % ) , the mean ( SD ) number of attended group meetings was 3.1 ( 1.5 ) and the discussion forum comprised 15 posted messages . Overall , the proportions of patients being ( very ) satisfied with the amount of e-mail contacts , telephone contacts , usefulness of website information , physical activity schedules , group meetings and website layout were > /=85 % . A smaller proportion of patients were satisfied with the links to other websites ( 68 % ) , the newsletters ( 55 % ) and the online discussion forum ( 32 % ) . CONCLUSION Physical activity schedules with weekly feedback by e-mail , telephone contacts and a limited number of group meetings were frequently used website tools and modes of communication of an Internet-based physical activity intervention , with high-satisfaction rates from RA patients . Discussion forum and newsletters were less used and appreciated . Caution should be taken when extrapolating the results found to groups of patients who are not experienced Internet and e-mail users or patients with more severe physical disabilities We report a prospect i ve , r and omized pilot study comparing a new workbook-based program , design ed to teach patients with rheumatoid arthritis ( RA ) energy conservation behaviors , with st and ard occupational therapy ( OT ) .  Sixteen patients took part in the new program and nine received the st and ard therapy .  Data on the number of tender or swollen joints , grip strength , walk time , activities of daily living , psychologic adjustment to illness , and daily activity log , were measured before and three months after intervention . Eleven percent of those who received st and ard therapy and 50 % of those who received the workbook increased their amount of physically active time ( p = .10 ) . Twenty-two percent of the control group and 50 % of those in the workbook group achieved a better balance of rest and physical activity ( p = .07 ) . We conclude that the adoption of energy conservation behaviors is different in the two groups . This initial study suggests that interrupting physical activity with rest periods may result in increased physical activity in patients with RA OBJECTIVE To compare the effectiveness of 2 Internet-based physical activity interventions for patients with rheumatoid arthritis ( RA ) . METHODS A total of 160 physically inactive patients with RA who had a computer with Internet access were r and omly assigned to an Internet-based physical activity program with individual guidance , a bicycle ergometer , and group contacts ( individualized training [ IT ] group ; n = 82 ) or to an Internet-based program providing only general information on exercises and physical activity ( general training [ GT ] group ; n = 78 ) . Outcome measures included quantity of physical activity ( question naire and activity monitor ) , functional ability , quality of life , and disease activity ( baseline , 3 , 6 , 9 , and 12 months ) . RESULTS The proportion of physically active patients was significantly greater in the IT than in the GT group at 6 ( 38 % versus 22 % ) and 9 months ( 35 % versus 11 % ; both P < 0.05 ) regarding a moderate intensity level for 30 minutes in succession on at least 5 days a week , and at 6 ( 35 % versus 13 % ) , 9 ( 40 % versus 14 % ) , and 12 months ( 34 % versus 10 % ; all P < 0.005 ) regarding a vigorous intensity level for 20 minutes in succession on at least 3 days a week . In general , there were no statistically significant differences regarding changes in physical activity as measured with an activity monitor , functional ability , quality of life , or disease activity . CONCLUSION An Internet-based physical activity intervention with individually tailored supervision , exercise equipment , and group contacts is more effective with respect to the proportion of patients who report meeting physical activity recommendations than an Internet-based program without these additional elements in patients with RA . No differences were found regarding the total amount of physical activity measured with an activity monitor Background Patients with rheumatoid arthritis ( RA ) spend a high proportion of their waking time in sedentary behaviour ( SB ) and have an increased risk of cardiovascular disease . Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems . Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary population s. To evaluate descriptively the feasibility of recruitment , r and omisation , outcome assessment s , retention and the acceptability of an individually tailored , theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA . Methods A r and omised , controlled trial with two parallel groups . RA patients > 18 years of age and Health Assessment Question naire ( HAQ ) score < 2.5 were consecutively invited and screened for daily leisure time sitting > 4 h. The 16-week intervention included 1 ) three individual motivational counselling sessions and 2 ) individual text message reminders aim ed at reducing daily sitting time . The control group was encouraged to maintain their usual lifestyles . Outcomes were assessed at baseline and after the 16 week intervention . Daily sitting time was measured using  an ActivPAL3TM activity monitor .  The study was not powered to show superiority ; rather the objective was to focus on acceptability among patients and clinical health professionals . Results In total , 107 patients were invited and screened before 20 met eligibility criteria and consented ; reasons for declining study participation were mostly flares , lack of time and co-morbidities . One patient from the control group dropped out before end of intervention ( due to a RA flare ) . Intervention participants completed all counselling sessions . All procedures regarding implementation of the trial protocol were feasible . The daily sitting time was reduced on average by 0.30 h in the intervention group unlike the control group that tended to increase it by 0.15 h after 16 weeks . Conclusions This study shows that an individually tailored behavioural intervention targeting reduction of SB was feasible and acceptable to patients with RA.Trial registration The Danish Data Protection Agency ( ref.nb . 711 - 1 - 08 - 20 March 2011 ) , the Ethics Committee of the Capital Region of Denmark ( ref.nb . H-2 - 2012 - 112- 17 October 2012 ) , clinical trials.gov ( NCT01969604 - October 17 2013 , retrospectively registered ) ABSTRACT Cardiorespiratory function and exercise tolerance appear very limited in persons with rheumatoid arthritis ( RA ) . Many studies have demonstrated that aerobic exercise training is beneficial to prevent physical deconditioning without inducing adverse effects on an individual 's joints and general health . The present study was conducted to demonstrate that a dance-based exercise program is a safe and efficient activity to improve physical fitness and psychological state in persons with RA . A group of 19 persons ( mean age , 49.3 ± 13 yr ) participated in a  12-wk exercise program  ( twice weekly ) , whereas 10 persons ( mean age , 49.4 ± 12 yr ) served as controls . Health status , use of medication , joint pain and swelling , physical fitness , activity of daily living and psychological state were assessed at baseline , after the 12-wk training program and 6 mo after the end of the program . Exercise training induced a mean improvement of 13 % in aerobic power , with the highest values reaching 40 % . No significant changes were observed in joint status , even though the count of painful joints tended to decrease in the exercise group . Positive changes in depression , anxiety , fatigue and tension were observed after the 12-wk exercise program . These findings provide some evidence s in favor of aerobic exercise in individuals with RA . Furthermore , it is of primary interest to note that a weight-bearing activity with limited ground impacts do not provoke short-term adverse effects on joint status . Further studies , however , are required to determine the long-term effect of weight-bearing exercise on the health status of individuals with RA Abstract For patients with chronic pain conditions such as rheumatoid arthritis ( RA ) , who experience elevated levels of distress , tailored-guided internet-based cognitive-behavioral treatment may be effective in improving psychological and physical functioning , and reducing the impact of RA on daily life . A multicenter , r and omized controlled trial was conducted for RA patients with elevated levels of distress as assessed by a disease-specific measure . The control group ( n = 71 ) received st and ard care and the intervention group ( n = 62 ) additionally received an internet-based tailored cognitive-behavioral intervention . Main analyses were performed using a linear mixed model estimating differences between the intervention and control groups in scores of psychological functioning , physical functioning , and impact of RA on daily life at preassesment and post assessment , and at 3 , 6 , 9 , and 12 months . Patients who received the internet-based intervention reported a larger improvement in psychological functioning compared with the control group , indicating less depressed mood ( P < 0.001 , d = 0.54 ) , negative mood ( P = 0.01 , d = 0.38 ) , and anxiety ( P < 0.001 , d = 0.48 ) during the course of the 1-year follow-up period . Regarding physical functioning , a trend was found for the intervention group reporting less fatigue than the control group ( P = 0.06 , d = 0.24 ) , whereas no effect was found on pain . No effects were found for the impact of RA on daily life , except for the intervention group experiencing fewer role limitations due to emotional problems ( P < 0.001 , d = 0.53 ) . Offering guided internet-based cognitive-behavioral therapy is a promising development to aid patients with psychological distress particularly in improving psychological functioning . Further research on adherence and specific intervention ingredients is warranted OBJECTIVES To investigate the maintenance of physical activity 12 months after two 1-year Internet-based physical activity interventions in patients with RA . METHODS This follow-up study was a r and omized comparison of an Internet-based individualized training ( IT ) and a general training ( GT ) programme in sedentary RA patients . Outcome measures included physical activity ( meeting public health recommendations for moderate physical activity , i.e. 30 min for at least 5 days/week ; or vigorous physical activity , i.e. 20 min for at least 3 days/week ) , functional ability and quality of life ( QoL ) . RESULTS Of the 152 RA patients who completed the initial study , 110 ( 72 % ) were available at follow-up . At 24 months , the proportions of patients meeting public health recommendations for moderate intensity physical activity were significantly higher compared with baseline in both the IT and GT groups ( 19 and 24 % , respectively , P < 0.05 ) , whereas the proportions of patients meeting the recommendation for vigorous activity was only significantly higher compared with baseline in the IT group ( P < 0.05 ) but not in the GT group . There were no differences between the IT and GT groups concerning proportions of patients meeting moderate or vigorous physical activity recommendations at 24 months . Apart from a significantly higher RAQoL score in the IT group at 24 months compared with baseline , there were no significant differences within or between the programmes regarding functional ability or QoL. CONCLUSION In RA patients , the effectiveness of both an individualized and a general 1-year Internet-based physical activity programme is sustained with respect to moderate intensity physical activity up to 12 months after the interventions OBJECTIVE To determine the effects of participation in a low-impact aerobic exercise program on fatigue , pain , and depression ; to examine whether intervention groups compared with a control group differed on functional ( grip strength and walk time ) and disease activity ( total joint count , erythrocyte sedimentation rate , and C-reactive protein ) measures and aerobic fitness at the end of the intervention ; and to test which factors predicted exercise participation . METHODS A convenience sample of 220 adults with rheumatoid arthritis ( RA ) , ages 40 - 70 , was r and omized to 1 of 3 groups : class exercise , home exercise using a videotape , and control group . Measures were obtained at baseline ( T1 ) , after 6 weeks of exercise ( T2 ) , and after 12 weeks of exercise ( T3 ) . RESULTS Using structural equation modeling , overall symptoms ( latent variable for pain , fatigue , and depression ) decreased significantly at T3 ( P < 0.04 ) for the class exercise group compared with the control group . There were significant interaction effects of time and group for the functional measures of walk time and grip strength : the treatment groups improved more than the control group ( P < or= 0.005 ) . There were no significant increases in measures of disease activity . Fatigue and perceptions of benefits and barriers to exercise affected participants ' amount of exercise , supporting previous research . CONCLUSION This study supported the positive effects of exercise on walk time and grip strength , and demonstrated that fatigue and perceived benefits /barriers to exercise influenced exercise participation . Furthermore , overall symptoms of fatigue , pain , and depression were positively influenced in this selective group of patients with RA ages 40 - 70 years OBJECTIVES This study examined the long-term efficacy of a cognitive behavioural intervention for patients with recent-onset , seropositive rheumatoid arthritis ( RA ) . METHODS Fifty-three consecutive patients with less than a 2-yr history of classic or definite RA were recruited into the trial . All participants received routine medical management during the study , and half were r and omly allocated to receive an 8-week adjunctive psychological intervention . All assessment s were conducted blind to the allocation . This paper reports intention-to-treat analyses of the 18-month follow-up . RESULTS Consistent with short-term results , significant differences were found between the groups in depressive symptoms . The intervention group maintained improvements in joint function , although those in routine care made similar improvements over the ensuing 18 months . At follow-up , group differences emerged for disability and anxiety . CONCLUSIONS These results indicate that cognitive behavioural intervention offered as an adjunct to st and ard clinical management early in the course of RA is efficacious in producing improvements in both psychological and physical indices . Furthermore , improvements appear to increase 18 months after a brief , time-limited psychological treatment We previously reported the efficacy of a multicomponent cognitive-behavioral intervention including biofeedback to decrease pain , affective distress , and objective measures of disease activity in patients with rheumatoid arthritis ( RA ) . In the present article we report evidence that this intervention is associated with reductions in RA-related clinic visits and days hospitalized as well as reductions in the costs of these medical services . Data were independently and objective ly collected over an 18-month interval as part of a controlled group outcome study . The importance of documenting economic as well as clinical benefits of our treatments in specific patient population s is noted OBJECTIVE To investigate physical fitness and work capacity in women with rheumatoid arthritis ( RA ) . METHODS The 42 subjects were a subset of a prospect i ve trial of conditioning exercise in rheumatic disease . Assignment to an exercise or nonexercise group was determined by proximity to the intervention , a 3-month supervised group exercise program . Physical fitness and work capacity were assessed at baseline , 3 months , and 12 months . RESULTS At baseline , subjects were deconditioned and limited in h and function , lifting ability , and lower extremity mobility . Only the exercise group improved their aerobic capacity and exercise tolerance . There were no significant changes in measured work capacity in either group . Moderate to strong correlations were found between aerobic capacity , mobility , h and function , and work capacity . Grip strength was a strong and consistent correlate of work capacity . CONCLUSION Our findings suggest that physical capacity , particularly h and function , may be important in the complex phenomenon of work disability in RA OBJECTIVES Rheumatology guidelines recommend people with RA receive behavioural self-management education . This study developed a modular behavioural group programme and evaluated its longer term effects on pain , physical and psychological status . METHODS People with RA or PsA were r and omized to a modular behavioural or st and ard information-focused education programme , both delivered by experienced rheumatology health professionals at one large district general hospital . Outcome measures were pain , self-efficacy , fatigue , functional ability , psychological status and use of health behaviours ( exercise , joint protection , fatigue and cognitive symptom management ) . Using an intent-to-treat analysis outcomes were compared at 6 and 12 months with analysis of covariance . RESULTS Out of 498 referred patients , 218 agreed to participate , met entry criteria and were r and omized ; 51 withdrew before education . Of the remaining patients , 86 attended the behavioural and 81 the st and ard programmes .  Participants were aged 55.4 yrs ( s.d . 12.42 ) with disease duration of 7.39 ( s.d . 6.88 ) yrs ( 53 % < 5 yrs ) . At 6 months , the behavioural group had better pain ( P = 0.01 ) , fatigue ( P = 0.01 ) , functional ability ( P = 0.05 ) and self-efficacy ( P = 0.01 ) scores and greater use of health behaviours . At 12 months , they continued to have better pain ( P = 0.03 ) , self-efficacy ( P = 0.001 ) and psychological status ( P = 0.0001 ) scores and greater use of some health behaviours . CONCLUSION Attending a modular behavioural education programme is effective for at least 1 yr in enabling people with RA and PsA to reduce pain , improve psychological status and self-manage their condition & NA ; This study examined the efficacy of a cognitive and behavioural intervention ( CBT ) for patients with recent onset , seropositive rheumatoid arthritis . Fifty‐three participants with a diagnosis of classical or definite rheumatoid arthritis , who were seropositive and had less than 2 years of disease history were recruited into the trial . All participants received routine medical management during the study , although half were r and omly allocated to receive an adjunctive psychological intervention . All pre‐ and post‐treatment assessment s were conducted blind to the allocation . Analyses were conducted of treatment completers and also by intention‐to‐treat . Significant differences were found between the groups at both post‐treatment and 6‐month follow‐up in depressive symptoms . While the CBT group showed a reduction in depressive symptoms , the same symptoms increased in the St and ard group . At outcome but not follow‐up , the CBT group also showed reduction in C‐reactive protein levels . However , the CBT group did show significant improvement in joint involvement at 6‐month follow‐up compared with the St and ard group , indicating physical improvements above those achieved with st and ard care . These results indicate that cognitive‐behavioural intervention offered as an adjunct to st and ard clinical management early in the course of RA is efficacious in producing reductions in both psychological and physical
There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA .
Research has shown that people who have rheumatoid arthritis ( RA ) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels , including quality of life , aerobic fitness and disease-related characteristics .
Behaviour change theory underpins the promotion of physical activity .
The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA , focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy .