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04-08-2020 | Rheumatology | News | Article

Evening ‘window of opportunity’ for RA patients to improve physical activity

Claire Barnard

medwireNews: People with rheumatoid arthritis (RA) are less likely to be physically active in the evening than at other times of the day, research suggests.

Therefore, “the evening time period may offer a significant window of opportunity for interventions to reduce sedentary behaviour in RA,” say Sally Fenton (University of Birmingham, UK) and colleagues.

The study included 41 patients, aged an average of 58 years, with a mean DAS28 score of 3.18 points who wore an accelerometer for 1 week to measure the amount of time spent physically active at different times of the day. Participants had an average 10-year cardiovascular disease (CVD) risk of 15.8% as measured by the QRISK score, which the team says is “indicative of the need for further intervention to lower CVD risk.”

Fenton and co-authors found that participants spent significantly more time being sedentary – defined as any waking behavior requiring no more than 1.5 metabolic equivalents and undertaken in a sitting, reclining, or lying posture – in the evening (18:00–22:59) compared with the morning (08:00–11:59) and afternoon (12:00–17:59), at an average of 47.80 versus 38.04 and 39.74 min/hour, respectively.

Similarly, they spent less time on average doing light-intensity (11.97 vs 20.13 and 19.21 min/hour) or moderate-to-vigorous intensity (0.25 vs 1.86 and 1.07 min/hour) physical activity in the evening compared with the morning or afternoon.

The researchers also conducted mixed linear modelling to evaluate interactions between participants’ 10-year CVD risk and diurnal patterns of sedentary time, finding that those with higher CVD risk spent more time sedentary in the afternoon and evening compared with those at lower CVD risk. No significant interaction between CVD risk and time spent sedentary in the morning was found, however.

These findings suggest that “interventions targeting evening sedentary time […] may be particularly valuable in regards to reducing CVD risk,” write the study authors in RMD Open.

They say it will be “critical” to consider “the factors underlying engagement in sedentary behaviours” when developing such interventions, and add that “[t]o date, few studies have sought to identify determinants of sedentary behaviour in RA, which—due to the pathophysiology of this disease—are likely to be complex and multifactorial.”

And the team concludes: “Identifying RA-related and non-RA-related factors (eg, symptoms, motivation) that may influence engagement in sedentary behaviour is an important avenue for future research.”

medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group

RMD Open 2020; 6: e001216

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