title: Physical Activity to Reduce Fatigue in Rheumatoid Arthritis: A Randomized Controlled Trial.
abstract: Effective treatments for rheumatoid arthritis (RA) fatigue are limited. We tested the effect of a pedometer-based intervention on increasing physical activity and decreasing fatigue among individuals with RA.
  
  
  
  Participants completed baseline questionnaires; had 1 week of activity monitoring; were randomized to control (education [EDUC]), pedometer and step-monitoring diary (PED), or pedometer and diary plus step targets (PED+) groups, and were followed for 21 weeks. At week 10, questionnaires were administered by phone to all participants. During the final week, all participants again had 1 week of activity monitoring. Primary outcomes were changes in average weekly steps and fatigue (Patient-Reported Outcomes Measurement Information System 7-item questionnaire) from baseline to week 21. Secondary outcomes were self-reported disease activity, physical function, pain interference, and depressive symptoms. Changes in steps were tested using a linear mixed model. Changes in fatigue were tested with repeated-measures models, including baseline, week-10, and week-21 scores.
  
  
  
  A total of 96 individuals participated. Eight did not complete the 21-week assessments. Both intervention groups significantly increased steps (+1,441 [P = 0.004] for PED and +1,656 [P = 0.001] for PED+), and the EDUC group decreased steps (-747 [P = 0.14]) (group-by-time interaction P = 0.0025). Between-group changes in fatigue were not significantly different (interaction P = 0.21). Mean changes in fatigue scores from baseline to week 21 were -1.6 (with-group P = 0.26), -3.2 (P = 0.02), and -4.8 (P = 0.0002) for EDUC, PED, and PED+ groups, respectively. Function and self-reported disease activity also improved in the PED and PED+ groups.
  
  
  
  Provision of pedometers, with and without providing step targets, was successful in increasing activity levels and decreasing fatigue in this sample of individuals with RA.
authors.affiliation: University of California, San Francisco.
authors.forename: Patricia
authors.initials: P
authors.lastname: Katz
authors.affiliation: University of California, San Francisco.
authors.forename: Mary
authors.initials: M
authors.lastname: Margaretten
authors.affiliation: University of California, San Francisco.
authors.forename: Steven
authors.initials: S
authors.lastname: Gregorich
authors.affiliation: University of California, San Francisco.
authors.forename: Laura
authors.initials: L
authors.lastname: Trupin
mesh_terms: D056044:Actigraphy / Q000295:instrumentation; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D017079:Exercise Tolerance; D005221:Fatigue / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D000072936:Fitness Trackers; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods; D012495:San Francisco; D013997:Time Factors; D016896:Treatment Outcome