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

Journal article
Authors Caroline Feldthusen
Elizabeth Dean
Helena Forsblad d'Elia
Kaisa Mannerkorpi
Published in Archives of physical medicine and rehabilitation
Volume 97
Issue 1
Pages 26–36
ISSN 1532-821X
Publication year 2016
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Institute of Medicine, Department of Rheumatology and Inflammation Research
Pages 26–36
Language en
Links dx.doi.org/10.1016/j.apmr.2015.09.0...
Keywords Arthritis, Rheumatoid, Fatigue, Randomized controlled trial at topic, Rehabilitation
Subject categories Physiotherapy, Health Sciences

Abstract

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.

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