Rheumat Int 39(9)_1585-1594 - DKucharski et al 010919.pdf (471.57 kB)

Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis

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posted on 2023-05-03, 18:31 authored by Daniel Kucharski, Elvira Lange, Alastair RossAlastair Ross, Sara Svenlund, Caroline Feldthusen, Karen Onnheim, Kaisa Mannerkorpi, Inger Gjertsson
Fatigue is described as a dominant and disturbing symptom of rheumatoid arthritis (RA) regardless of the advances in pharmacological treatment. Fatigue is also found to correlate with depression. The objective was to evaluate the impact of moderate-to-high intensity, aerobic and resistance exercise with person-centered guidance on fatigue, anxiety and depression, in older adults with RA. Comparisons were made between older adults (> 65 years) with RA taking part in a 20-week moderate-to-high intensity exercise at a gym (n = 36) or in home-based exercise of light intensity (n = 38). Assessments were performed at baseline, at 20 weeks, and at 52 weeks. Outcomes were differences in Multidimensional Fatigue Inventory (MFI-20), Visual Analog Scale Fatigue (VAS fatigue), and Hospital Anxiety and Depression Scale (HADS). Analysis of metabolomics was also performed. The subscales “physical fatigue” and “mental fatigue” in MFI-20 and symptoms of depression using HADS depression scale improved significantly at week 20 in the exercise group compared with the control group. Exercise did not influence global fatigue rated by VAS or subscales “reduced motivation”, “reduced activity” and “general fatigue” in MFI-20. No significant change was found on the anxiety index of HADS. The improvements in physical fatigue were associated with changes in the metabolism of lipids, bile acids, the urea cycle and several sugars. Moderate-to-high intensity exercise with person-centered guidance decreased fatigue and improved symptoms of depression and were accompanied by metabolic changes in older adults with RA.


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© The Author(s) 2019. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.


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Journal title

Rheumatology International




Kucharski, D., Lange, E., Ross, A. B., Svenlund, S., Feldthusen, C., Onnheim, K., … Gjertsson, I. (2019). Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis. Rheumatology International, 38(9), 1585–1594. doi:10.1007/s00296-019-04384-8

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