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Larkin L, McKenna S, Pyne T, Comerford P, Moses A, Folan A, Gallagher S, Glynn L, Fraser A, Esbensen BA, Kennedy N. Promoting physical activity in rheumatoid arthritis through a physiotherapist led behaviour change-based intervention (PIPPRA): a feasibility randomised trial. Rheumatol Int 2024; 44:779-793. [PMID: 38438576 PMCID: PMC10980645 DOI: 10.1007/s00296-024-05544-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/17/2024] [Indexed: 03/06/2024]
Abstract
Physical activity (PA) is recommended as a key component in the management of people with rheumatoid arthritis (RA). The objective of this study was to examine the feasibility of a physiotherapist led, behaviour change (BC) theory-informed, intervention to promote PA in people with RA who have low levels of current PA. A feasibility randomised trial (ClinicalTrials.gov NCT03644160) of people with RA over 18 years recruited from outpatient rheumatology clinics and classified as insufficiently physically active using the Godin-Shephard Leisure Time Physical Activity Questionnaire. Participants were randomised to intervention group (4 BC physiotherapy sessions in 8 weeks) delivered in person/virtually or control group (PA information leaflet only). Feasibility targets (eligibility, recruitment, and refusal), protocol adherence and acceptability were measured. Health care professionals (HCPs) involved in the study and patients in the intervention and control arms were interviewed to determine acceptability. Descriptive statistics were used to analyse the data with SPSS (v27) with interviews analysed using content analysis using NVivo (v14). Three hundred and twenty participants were identified as potentially eligible, with n = 183 (57%) eligible to participate, of which n = 58 (32%) consented to participate. The recruitment rate was 6.4 per month. Due to the impact of COVID-19 on the study, recruitment took place over two separate phases in 2020 and 2021. Of the 25 participants completing the full study, 23 were female (mean age 60 years (SD 11.5)), with n = 11 allocated to intervention group and n = 14 to control. Intervention group participants completed 100% of sessions 1 & 2, 88% of session 3 and 81% of session 4. The study design and intervention were acceptable overall to participants, with enhancements suggested. The PIPPRA study to improve promote physical activity in people with RA who have low PA levels was feasible, acceptable and safe. Despite the impact of COVID-19 on the recruitment and retention of patients, the study provides preliminary evidence that this physiotherapist led BC intervention is feasible and a full definitive intervention should be undertaken. Health care professionals involved in the study delivery and the patient participants described a number of positive aspects to the study with some suggestions to enhance the design. These findings hence inform the design of a future efficacy-focused clinical trial.
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Affiliation(s)
- Louise Larkin
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Seán McKenna
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Tadhg Pyne
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Paul Comerford
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Anusha Moses
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Ailish Folan
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Psychology, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Alexander Fraser
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Department of Rheumatology, University Limerick Hospitals Group, Limerick, Ireland
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Norelee Kennedy
- Faculty of Education and Health Sciences, School of Allied Health, Discipline of Physiotherapy, University of Limerick, Limerick, Ireland.
- Health Research Institute, University of Limerick, Limerick, Ireland.
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