OP0203-HPR EVALUATION OF A 10-WEEK PROGRESSIVE RESISTANCE TRAINING PROGRAMME FOR PEOPLE WITH INFLAMMATORY ARTHRITIS

Abstract

Background: Inflammatory Arthritis [IA] adversely affects well-being, function, fatigue and strength1. Guidelines recommend people with IA should exercise to improve strength and cardiovascular fitness2. In 2015, our team introduced an evidence-based Progressive Resistance Training Programme [PRTP] for IA3. Objectives: To evaluate the effectiveness of a PRTP within a United Kingdom National Health Service setting. Methods: A pre-to post-treatment evaluation was conducted. People with IA attending Rheumatology Physiotherapy were offered a supervised PRTP (1 hour x 10 weeks): 7 exercises at 70-80% 1-repetition maximum (3 x 8-12 repetitions). Treatment outcomes included Health Assessment Questionnaire [HAQ], EQ5D-5L, 30s sit-to-stand [STS], Self-Efficacy (SARAH Trial) [SE], Grip Strength and FACIT-Fatigue [FACIT-F]. Changes in outcomes were analysed using Paired Samples t-tests and standardised mean difference (SMD). Results: 201 patients commenced the programme between May 2015 and April 2019, with 121 participants providing complete pre-post HAQ data. Diagnoses included Rheumatoid Arthritis (n=149), Psoriatic Arthritis (n=42), Juvenile Idiopathic Arthritis (n=5), Enteropathic IA (n=2), Oligoarthritis (n=1), Reactive Arthritis (n=1) and Undifferentiated IA (n=1). Age (mean ± SD) = 56.8 ± 14.8 years; number of sessions attended = 7.7 ± 3.4. There were no differences between those recorded as not completing the PTRP (n=54; 72% women; age 55.0 ± 14.6 years; HAQ 0.99 ± 0.70) versus the others (n=147; 78% women; age 57.5 ± 14.8; HAQ 0.86 ± 0.65). A pragmatic decision was made to analyse all available data for each outcome. Conclusion: All outcome measures demonstrated statistically significant improvements. Notably, minimal clinically important differences were achieved in STS and FACIT-F. STS correlates to lower limb power, balance and endurance, and is a predictor of falls4. Fatigue significantly impacts function in people with IA5, often limiting confidence and willingness to participate in exercise activities6. Effective evidence-based PRTPs for people with IAs can be delivered by Physiotherapists. Improvements in function, wellbeing, self-efficacy, strength and fatigue are achievable, however, exploration of the clinical relevance of these observed changes is recommended. Further research exploring patients' perspectives of the PRTP and adherence to long-term exercise is needed.