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Sleep and Exercise in Rheumatoid Arthritis

Not Applicable
Completed
Conditions
Rheumatoid Arthritis
Inflammatory Arthritis
Interventions
Behavioral: Walking Programme
Registration Number
NCT03140995
Lead Sponsor
University Hospital of Limerick
Brief Summary

Regular physical activity is important for people with rheumatoid arthritis (RA). Sleep requirements for adults should be on a 'sleep needs spectrum' of between 7 to 9 hours per day. Poor sleep is a common complaint among people with RA, which may have an effect on their activity levels and well-being. There is evidence that physical activity and exercise can improve sleep quality and disturbances in other chronic disease populations therefore, examining how same affects sleep in RA is important.

Detailed Description

Sleep is an important aspect in maintaining the body's circadian rhythm. In general getting fewer than 5 hours sleep per day has been associated with cardiovascular problems, diabetes and obesity and can also be linked to depression and anxiety. Poor sleep is a common complaint among people with rheumatoid arthritis (RA) with disturbed sleep and fatigue known to affect up to 70% in this population. Poor sleep quality may contribute to the feelings of pain, fatigue and poor psychological well-being which in turn may further deteriorate functional ability and reduced activity.

It is known that exercise improves a person's psychological state which can also be an additional factor in improving or indeed disrupting quality of sleep. Exercise has been identified as an important part of the nonpharmacological management of poor sleep and in improving sleep quality however, people with RA were previously cautioned about undertaking exercise. Therefore, changes in sleep quality during exercise intervention should be evaluated so that society can understand more the potential for long-term changes in overall health status, in people who have RA. Indeed the intensity level of the activity in people with RA may be of additional importance.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Participants will be eligible to participate if they are aged 18-70; have a diagnosis of RA (defined by the American College of Rheumatology 1987 criteria); have poor sleep (Pittsburgh Sleep Quality Index global score >5); have a low disease score on 28 joints (DAS28) <3.2; Health Assessment Questionnaire result of <2.4 and are able to provided informed consent, understand and speak English. All the above will be determined should the person be interested in participating and before any fitness testing will be place.
Exclusion Criteria
  • Participants will be excluded from the study if they have severe physical disability (HAQ score > 2.5); are pregnant; participate in regular physical activity in their leisure time (self-reported aerobic exercise > 5 times per week); have cardiac symptoms corresponding to New York Heart Association (NYHA) functional classification > 2;

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Exercise InterventionWalking ProgrammeThe walking programme will consist of a total of 21 aerobic walking sessions, with 1 per week being supervised by a trained physiotherapist, spread over a maximum of eight weeks (2-3 times/week). During the first 4 weeks the intention is to increase frequency and the final 4 weeks the intensity, using the Borg Rate of Perceived exertion 6-20 or distance from 2km to 6km. The participants will attend the University of Limerick for a final assessment at week 9.
Primary Outcome Measures
NameTimeMethod
Pittsburgh Sleep Quality Index8 Weeks

Sleep

Secondary Outcome Measures
NameTimeMethod
State Trait Anxiety Inventoryup to 8 weeks

Anxiety

Profile of Moods Stateup to 8 weeks

Mood

Quick Inventory of Depressive Symptomatologyup to 8 weeks

Depression

Disease Activity Score with 28 jointsup to 8 weeks

Disease activity

Exercise Benefits and Barriers Scaleup to 8 weeks

Exercise barriers

RA related Pain - visual analog scale (VAS) consisting of a 10cm horizontal line anchored from 0 (no pain) to 10 (worst pain possible).up to 8 weeks follow up

Pain

Health Assessment disability Indexup to 8 weeks

Functional limitation

Rheumatoid Arthritis-Specific Quality of Life Instrumentup to 8 weeks

Quality of Life

Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaireup to 8 weeks

Fatigue

Trial Locations

Locations (1)

University Hospitals Limerick

🇮🇪

Limerick, Cork, Ireland

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