Article

No interventions to promote physical activity can succeed for all
participants. Insights into the specific characteristics of those who do succeed
are needed. One aim was to investigate whether a selection of correlates of
general health perception creates cluster typologies in individuals with
rheumatoid arthritis (RA). Another was to evaluate whether magnitude of change in
health status differs between clusters after a 1-year coaching intervention
targeting health-enhancing physical activity. METHOD: Two hundred and
twenty-eight patients (74% women, mean age 56 years, disease duration 1 year)
with RA, from 10 rheumatology clinics in Sweden, participated. The patients were
assigned at random to intervention or control. The intervention group underwent 1
year of coaching to adopt health-enhancing physical activity (moderately
intensive, 30 min/day, > 4 days/week). The cluster analysis included five
correlates of general health perception: disease activity; pain; timed standing;
activity limitation; and self-reported physical activity. The primary outcome of
the coaching intervention was self-reported health status. RESULTS: One-hundred
and forty-six patients were eligible for inclusion in the cluster analysis. The
eight clusters identified both at baseline and post interventions were
operationalized according to the number of cluster variables affected: less (LE)
affected or more (MO) affected, respectively. Clusters with LE affected variables
had significantly better general health perception at baseline than those with MO
affected variables. Further, coached individuals in MO affected clusters
significantly improved self-reported health status compared both to those coached
in LE affected clusters and to those in MO affected clusters in the control
group. CONCLUSION: This person-based approach contributed more than did the
results in a previous randomized controlled trial to the understanding of which
patients benefit most from the present physical-activity coaching intervention.
The intervention may thus be most beneficial for individuals more severely
affected by their disease at baseline.

Langue : ANGLAIS