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Abstract
Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.
Details
1 School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland; Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands
2 School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
3 Rheumazentrum Ruhrgebiet, Herne, Germany; Ruhr University, Bochum, Germany
4 Faculty of Health Sciences and Arthritis Research UK Centre of Excellence for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK
5 Department of Orthopaedics, Danderyd University Hospital Corp., Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
6 National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
7 PMR Department, Rheumatology Division, Marmara University, School of Medicine, Istanbul, Turkey
8 Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet., Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
9 University Center of Orthopaedics and Traumatology, University Medicine at Technische Universität Dresden, Dresden, Germany
10 Department Social Affaire and Health, ECORYS Nederland BV, Rotterdam, Netherlands
11 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Departmentof Occupational and Physical Therapy, University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen, Denmark
12 School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute, University of Limerick, Limerick, Ireland
13 Department of Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
14 Department of Rheumatology, Amsterdam Rheumatology and immunology Center, VU University Medical Center, Amsterdam, The Netherlands
15 Centre for Biomedical Research, University of Algarve, Faro, Portugal
16 EULAR PARE Patient Research Partner, ReumaNet, Leuven, Belgium
17 Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
18 EULAR Patient Research Partner, Cyprus League Against Rheumatism, Nicosia, Cyprus
19 Primary Health Care Sciences, Keele University, Keele, UK
20 PRP (Patient Research Partner EULAR), Bulgarian Ankylosing Spondylitis Patient Society, Sofia, Bulgaria and ASIF (Ankylosing Spondylitis International Federation), London, UK
21 Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands