Exercise and CBT relieve chronic fatigue from arthritis and other inflammatory diseases, study shows
- Inflammatory rheumatic diseases including arthritis affect up to 14 million people globally, and many live with chronic fatigue. Drugs are often of no help
- A study shows patients who had exercise or therapy sessions suffered less fatigue for up to six months, and had better sleep, mental health and quality of life
Millions of people with conditions such as arthritis could combat symptoms of fatigue with exercise and talking therapy, a new study suggests.
People with inflammatory rheumatic diseases – which include rheumatoid arthritis, lupus and axial spondylitis – could benefit from the treatments and they should be used as part of routine care, experts said.
In the UK, about 800,000 people suffer from these conditions and four in five of these (80 per cent) live with fatigue every day, affecting their ability to concentrate, work, and live independently.
Research has previously pointed to around 460 out of every 100,000 people around the world being diagnosed with rheumatoid arthritis. Up to 14 million people around the world have rheumatoid arthritis, according to the WHO.
Participants were either given telephone-delivered physical activity programmes, cognitive behavioural therapy (CBT), or received their usual care.
Those in the exercise group had five one-on-one 45-minute sessions over 30 weeks, while those who had talk therapy received an average of eight sessions over the same period and the usual care group were given an education booklet on fatigue.
The researchers found that those who had talk therapies or exercise therapy had significantly reduced fatigue levels compared to those receiving usual care.
Wendy Booth, 57, from Pitmedden in Aberdeenshire, Scotland, had to give up her job as a psychiatric nurse at Royal Cornhill Hospital in Aberdeen as a result of the effects of lupus and Sjogren’s syndrome – an immune system disorder whose common symptoms are dry eyes and a dry mouth.
“The fatigue really affects what you can do. If I do some work in the garden one day, I know I’ll pay for it the next,” she says.
Booth, who received physical activity sessions as part of the study, adds: “The physio called me about once a fortnight and it really encouraged me. I feel like it (the study) helped give me purpose.”
“I joined a gym and I have a good instructor who understands my abilities and gives me modified exercises so I can carry on in the same class along with everyone else.
“Mentally I feel stronger and physically – my motto is ‘I want to keep what I’ve got’ rather than deteriorate.”
Lead investigator Professor Neil Basu, who carried out the majority of the research at the University of Aberdeen, and is now at the University of Glasgow, says: “Our study provides new evidence that some non-pharmacological interventions can be successfully and effectively delivered by non-specialist members of the clinical service.”
It has been encouraging to see that the interventions have led to improvements for participants even six months after the end of the treatment, Basu adds.
She stresses the urgent and unmet need for more evidence-based interventions including better access to non-drug treatments – like cognitive behavioural therapies and supported physical activity – so more people with inflammatory rheumatic diseases can retain their independence, stay in work, and enjoy better mental health, which these conditions can cruelly take away.
“The study’s implementation across the health service would give people with inflammatory arthritis and related conditions access to the support they need to manage fatigue while producing long-lasting improvements to their mental health.”