Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled Trial.
OBJECTIVE
To examine effects of person-centered physical therapy on fatigue and related variables in persons with rheumatoid arthritis (RA).


METHODS
Randomized controlled trial.


METHODS
Hospital outpatient rheumatology clinic.


METHODS
Persons with RA aged 20 to 65 years (N=70): intervention group (n=36) and reference group (n=34).


METHODS
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.


METHODS
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.
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.
Caroline
C
Feldthusen
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.
Elizabeth
E
Dean
Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden.
Helena
H
Forsblad-d'Elia
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.
Kaisa
K
Mannerkorpi
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D005081:Exercise Therapy; D005221:Fatigue / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009629:Person-Centered Psychotherapy / Q000379:methods*; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale
Arthritis; Fatigue; Randomized controlled trial at topic; Rehabilitation; Rheumatoid