Physical inactivity in rheumatoid arthritis: socioeconomic, clinical, and psychological insights
Abstract
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.
Related
- Effects of cognitive behavioral therapy on psychological and physical outcomes in adults with rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials
- Cross-sectional analysis of socioeconomic determinants of functional disability in rheumatoid arthritis patients: a single-region experience from Saudi Arabia
- Psychological Experiences of Adults with Rheumatoid Arthritis: A Systematic Review and Qualitative Evidence Synthesis
- Associations of Physical Activity, Sedentary Behavior, and Handgrip Strength with Clinical Characteristics in Women with Rheumatoid Arthritis from Western Mexico.
- Nationwide trends in physical disability among rheumatoid arthritis patients in Korea (2010–2022): A retrospective cohort study based on national registry data
BibTeX
@article{theofanidis2026physical,
title = {{Physical inactivity in rheumatoid arthritis: socioeconomic, clinical, and psychological insights}},
author = {A Husivargova Theofanidis and V Timkova and P Mikula and Z Macejova and I Nagyova},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1036},
url = {https://doi.org/10.1093/eurpub/ckag169.1036},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Physical inactivity in rheumatoid arthritis: socioeconomic, clinical, and psychological insights
AU - A Husivargova Theofanidis
AU - V Timkova
AU - P Mikula
AU - Z Macejova
AU - I Nagyova
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1036
UR - https://doi.org/10.1093/eurpub/ckag169.1036
AB - 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.
SN - 1101-1262
SN - 1464-360X
ER -