Physical inactivity in rheumatoid arthritis: socioeconomic, clinical, and psychological insights

Background

Although physical activity (PA) is one of the most common behavioural management tools recommended for people with rheumatoid arthritis (RA), it is often underutilized due to various clinical, sociodemographic, and psychosocial factors. Therefore, we aimed to identify biopsychosocial factors associated with physical inactivity in people with RA.

Methods

Sample included 157 RA patients (84.7% female; mean age 56.4±13.9 years; mean disease duration 19.5±9.5 years). All participants completed the 36-item Short Form Health Survey, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Physical Activity Scale. Correlations and multiple linear regressions were used to analyse the data.

Results

We observed that 75% of RA patients in our sample engaged in less PA than the WHO minimum recommendation. Results showed significant correlations between higher age, disease activity, fatigue, pain, and lower income, as well as poorer social and physical functioning and PA. No associations were found between sex, depression, or anxiety and PA. Multiple regression analyses revealed that income (β=.24; p ≤ 0.01), social (β=.28; p ≤ 0.05) and physical functioning (β=.37; p ≤ 0.05) were significantly associated with PA in the final model, with total explained variance of 16%.

Conclusions

Despite recommendations, most RA patients remain physically inactive, underscoring a major public health issue. Lower PA was primarily associated with reduced social and physical functioning, as well as socioeconomic disadvantage, rather than psychological distress. Public health strategies should therefore extend beyond clinical and pharmacological management to address behavioral and psychological factors and the role of economic inequities. Promoting accessible nonpharmacological interventions may improve PA adherence and quality of life while reducing healthcare costs by preventing comorbidities and all-cause mortality in RA. (Grants: APVV-24-0522)

Key messages

• Most RA patients remain physically inactive despite recommendations; thus, accessible nonpharmacological interventions are needed, taking into account socioeconomic barriers.

• Boosting PA in RA requires nonpharmacological strategies that address psycho-behavioral factors to reduce the burden of disease and healthcare costs.