Exercise and therapy fight fatigue in people with arthritis, study finds

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People with inflammatory rheumatic diseases – which include conditions such as rheumatoid arthritis, lupus and axial spondylitis – could benefit from the treatments and they should be used as part of routine care, experts said. Some 800,000 people suffer from these conditions across the UK and four in five of them (80%) live with fatigue on a daily basis, which affects their ability to concentrate, get to work and live well. independently.

The new study, published in Lancet Rheumatology, looked at how to improve fatigue in these patients.

Researchers from the Universities of Aberdeen and Glasgow, and funded by the charity Versus Arthritis, compared three different types of care as provided to 368 people with various inflammatory rheumatic diseases.

Participants received physical activity programs over the phone, cognitive behavioral therapy, or received usual care.

Those in the exercise group had five individual 45-minute sessions over 30 weeks, while those who received talk therapy received an average of eight sessions over the same period and the usual care group received a fatigue education booklet.

The researchers found that those who received talk therapies or exercise therapy significantly improved their level of fatigue compared to those who received usual care.

The benefits continued for six months after the treatment cycles were completed.

And people who were offered these interventions also reported improved sleep, mental health and quality of life, compared to those who received usual care.

Wendy Booth, 57, from Pitmedden in Aberdeenshire, had to give up her job as a psychiatric nurse at Cornhill Hospital in Aberdeen due to the effects of lupus and Sjogren’s syndrome.

She said: “The fatigue really affects what you can do. if I do work in the garden one day, I know that I will pay for it the next day.

Ms Booth, who received physical activity sessions as part of the study, added: “The physio called me about once a fortnight and that really encouraged me. I feel like this (the study) helped me to give purpose.

“I joined a gym and I have a good instructor who understands my abilities and gives me modified exercises so I can continue in the same class with everyone else.

“Mentally I feel stronger and physically – my motto is ‘I want to keep what I have’ rather than deteriorate.”

Principal investigator Professor Neil Basu, who carried out the majority of the research at the University of Aberdeen but now at the University of Glasgow, said: “Our study provides new evidence that certain non-pharmacological interventions can be carried out successfully and efficiently by specialist members of the clinical service.

“It was encouraging to see that the interventions resulted in improvements for the participants even six months after treatment ended.

“It’s also great to see that these steps have had an impact, even when delivered over the phone.

“Since the start of the pandemic, healthcare services have been redesigned to incorporate more remote care, but the evidence base to support this change has generally been limited.”

Dr Neha Issar-Brown, director of research and health intelligence at the charity Versus Arthritis, said: “Fatigue and chronic pain go hand in hand as twin challenges for people with rheumatic diseases. inflammatory diseases such as rheumatoid arthritis and lupus.

“But fatigue tends not to respond to medications for these conditions, and often goes unnoticed by clinicians.

“There is an urgent and unmet need for more evidence-based interventions, including better access to non-drug treatments such as cognitive behavioral therapies and sustained physical activity, so that more people with rheumatic diseases patients can retain their independence, stay at work, and enjoy better mental health, which we know these conditions can sorely take away.

“Implementing the LIFT study across health services would give people with inflammatory arthritis and related conditions access to the support they need to manage fatigue while producing lasting improvements. of their mental health.”

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