Increased Prolonged Sitting in Patients with Rheumatoid Arthritis during the COVID-19 Pandemic: A Within-Subjects, Accelerometer-Based Study

• Published in: International journal of environmental research and public health Vol. 20; no. 5; p. 3944
• Main Authors: Pinto, Ana Jessica, Rezende, Diego, Sieczkowska, Sofia Mendes, Meireles, Kamila, Bonfiglioli, Karina, Ribeiro, Ana Cristina de Medeiros, Bonfá, Eloisa, Owen, Neville, Dunstan, David W., Roschel, Hamilton, Gualano, Bruno
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 23.02.2023; MDPI
• Subjects: Accelerometers; Accelerometry; Arthritis; Arthritis, Rheumatoid - complications; Brazil; Care and treatment; Chronic illnesses; Coronaviruses; COVID-19; COVID-19 - complications; Diabetes; Drugs; Exercise; Fatigue; Fatigue - complications; Female; Humans; Hypertension; Mental health; Middle Aged; Mortality; Pain; Pain - complications; Pandemics; Participation; Quality of Life; Questionnaires; Rheumatic diseases; Rheumatoid arthritis; Rheumatoid factor; Rheumatology; Sedentary behavior; Severe acute respiratory syndrome coronavirus 2; Social distancing; Statistical analysis; Type 2 diabetes; Within-subjects design; Brazil; Australia; United Kingdom > UK; fatigue; pain; health-related quality of life; sedentary behavior; physical activity level; inflammatory arthritis
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph20053944

Background: Social distancing measures designed to contain the COVID-19 pandemic can restrict physical activity, a particular concern for high-risk patient groups. We assessed rheumatoid arthritis patients’ physical activity and sedentary behavior level, pain, fatigue, and health-related quality of life prior to and during the social distancing measures implemented in Sao Paulo, Brazil. Methods: Post-menopausal females diagnosed with rheumatoid arthritis were assessed before (from March 2018 to March 2020) and during (from 24 May to 7 July 2020) social distancing measures to contain COVID-19 pandemic, using a within-subjects, repeated-measure design. Physical activity and sedentary behavior were assessed using accelerometry (ActivPAL micro). Pain, fatigue, and health-related quality of life were assessed by questionnaires. Results: Mean age was 60.9 years and BMI was 29.5 Kg/m2. Disease activity ranged from remission to moderate activity. During social distancing, there were reductions in light-intensity activity (13.0% [−0.2 h/day, 95% CI: −0.4 to −0.04; p = 0.016]) and moderate-to-vigorous physical activity (38.8% [−4.5 min/day, 95% CI: −8.1 to −0.9; p = 0.015]), but not in standing time and sedentary time. However, time spent in prolonged bouts of sitting ≥30 min increased by 34% (1.0 h/day, 95% CI: 0.3 to 1.7; p = 0.006) and ≥60 min increased by 85% (1.0 h/day, 95% CI: 0.5 to 1.6). There were no changes in pain, fatigue, and health-related quality of life (all p > 0.050). Conclusions: Imposed social distancing measures to contain the COVID-19 outbreak were associated with decreased physical activity and increased prolonged sedentary behavior, but did not change clinical symptoms sitting among patients with rheumatoid arthritis.