WP8 - Understanding and treating fatigue and pain; Special emphasis on the effects of exercise

WP-coordinator: Christina Opava

A majority of patients with RA accumulate too little physical activity in order to maintain health. Physical activity is an important predictor of health perception in RA and a coaching intervention has proved to increase muscle strength and health perception in patients with RA. It has also been found that high-intensity strength training seems to reduce inflammation and pain in patients with rheumatic disease, but the mechanisms behind this reduction remain unclear. So far three studies are included in WP 8.

Study I
The impact of high-intensity (80% of max.) will be investigated in a randomised controlled study including subjects with RA. Factors studied will be outcome regarding muscle strength, pain, fatigue and health perception as well as mechanisms related to local and general inflammation, expression of estrogene receptor and the pathophysiology of pain.

Study II
The long-term effects of physical activity, including strength training, will be studied in a multicenter center trial including patients with RA, fibromyalgia and healthy controls. Factors studied will be similar to those in study one and long-term follow-up on co morbidity among patients with RA will be performed through collaboration with the Swedish Rheumatology Registers.

Study III
This study will be performed in order to identify barriers and facilitators among health care staff and in the health care system to implementation of physical activity among patients with RA. A model for implementation will be launched and its outcome evaluated in terms of improved health perception.