Rheumatoid arthritis patients given pedometers reported a decrease in fatigue over a 21-week period, coupled with a small but significant increase in steps walked, according to a study from investigators at the University of California, San Francisco.

“Our results provide evidence that pedometers are effective at increasing physical activity among people with RA and provide support for the hypothesis that increasing physical activity by walking has important effects on fatigue and other RA symptoms,” wrote the researchers, led by Patricia Katz, PhD.

The researchers gave 68 rheumatoid arthritis patients pedometers and step-tracking diaries, 34 of whom also were given a step goal. The remaining 28 participants, acting as the control group, received a brochure on how to live a healthy lifestyle. All groups self-reported their activity levels at weeks 1, 10, and 21. Participants were mostly female (87.5%), white (63.5%), with an average age of 55 years and body mass index of 32 kg/m2 (Arthritis Care Res. 2017 Apr 5. doi: 10.1002/acr.23230 ).

Patients who were given only pedometers increased their walking from baseline to week 21 by an average of 1,441 steps, while those given pedometers plus a step goal walked a mean of 1,656 steps additionally. The control group had a mean decrease of 747 steps.

Scores on the Patient-Reported Outcome Measurement Information System fatigue short form at 21 weeks declined by –3.2 for those who received pedometers only (P = .02) and by –4.8 for those who received pedometers plus a step goal (P = .0002), compared with the control group, which reported a decrease of –1.6 (P = .26).

While both intervention groups saw increased activity when compared with controls, patients given a step goal saw constant improvement, averaging an increase of 22 steps per week, while those without a step goal reported a decrease of 37 steps per week, which the researchers suspected could be from a larger initial increase in activity that could have discouraged a continued increase over time.

Dr. Katz and her associates said that the positive change that a rise in physical activity had on all other aspects of patients’ self-reported assessment shows promising results for the efficacy of exercise in patients, which some physicians had questioned.

“In the past, there was concern that physical activity or exercise might exacerbate rheumatoid arthritis symptoms, [however], our findings are similar to previous reports that exercise did not lead to worsened rheumatoid arthritis,” they wrote.

This study was limited by the small number of participants in the study, as well as the self-reported method of data collection. Researchers were also unable to gather activity intensity, as well as the amount of time patients wore the pedometer, causing the measure of adherence to “only be considered an estimate.”

The researchers reported technical difficulties with the devices, creating missing data.

The study was supported by the Rheumatology Research Foundation. The researchers reported no relevant financial disclosures.

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