Current and Maintained Health-Enhancing Physical Activity in Rheumatoid Arthritis: A Cross-Sectional Study


Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100 Karolinska Institutet, SE-141 83 Huddinge, Sweden. E-mail:



To describe and identify the explanatory factors of variation in current and maintained health-enhancing physical activity (HEPA) in persons with rheumatoid arthritis (RA).


In this cross-sectional study, current HEPA was assessed with the International Physical Activity Questionnaire and maintained HEPA with the Exercise Stage Assessment Instrument, the latter explicitly focusing on both aerobic physical activity and muscle strength training. Sociodemographic, disease-related, and psychosocial data were retrieved from the Swedish Rheumatology Quality (SRQ) registers and a postal questionnaire. The explained variations in the respective HEPA behaviors were analyzed with logistic regression.


In all, 3,152 (58.5%) of 5,391 persons identified as eligible from the SRQ registers responded to the questionnaire. Current HEPA was reported by 69%, and maintained HEPA by 11% of the respondents. The most salient and consistent factors explaining variation in both current and maintained HEPA were self-efficacy, social support, and outcome expectations related to physical activity.


To our knowledge, this is the first study exploring maintained physical activity in a large well-defined sample of persons with RA. Our results indicate that a minority perform maintained HEPA, including both aerobic physical activity and muscle strength training, and that psychosocial factors are the most salient and consistent in the explanation of HEPA variation.