Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial

Objective To assess the efficacy of a multifaceted counseling intervention at improving physical activity participation and patient outcomes. Methods We recruited people with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In weeks 1–8, the immediate group received education and counseling by a physical therapist, used a Fitbit and a web application to obtain feedback about their physical activity, and received 4 follow‐up calls from the physical therapist. The delay group received the same intervention in weeks 10–17. Participants were assessed at baseline and at weeks 9, 18, and 27. The primary outcome was time spent in moderate/vigorous physical activity (MVPA; in bouts of ≥10 minutes) measured with a SenseWear device. Secondary outcomes included step count, time in sedentary behavior, pain, fatigue, mood, self‐management capacity, and habitual behaviors. Results A total of 118 participants enrolled. The adjusted mean difference in MVPA was 9.4 minutes/day (95% confidence interval [95% CI] –0.5, 19.3, P = 0.06). A significant effect was found in pain (–2.45 [95% CI –4.78, –0.13], P = 0.04), and perceived walking habit (0.54 [95% CI 0.08, 0.99], P = 0.02). The remaining secondary outcomes improved, but were not statistically significant. Post hoc analysis revealed a significant effect in MVPA (14.3 minutes/day [95% CI 2.3, 26.3]) and pain (–4.05 [95% CI –6.73, –1.36]) in participants with RA, but not in those with SLE. Conclusion Counseling by a physical therapist has the potential to improve physical activity in people with inflammatory arthritis, but further study is needed to understand the intervention effect on different diseases. We found a significant improvement in pain, suggesting that the intervention might have a positive effect on symptom management.