[Promotion of physical activity for older patients with rheumatism : Characteristics of inflammatory rheumatic diseases against the background of physical activity recommendations]. / Bewegungsförderung für ältere Rheumapatienten : Besonderheiten bei entzündlich rheumatischen Erkrankungen vor dem Hintergrund aktueller Bewegungsempfehlungen.

Due to the wide range of positive effects and the clear evidence of effectiveness, physical activity is one of the most important treatments for inflammatory rheumatic diseases. Because of the frequent overlap of disease and age-related aspects in older patients, the implementation of the German national physical activity recommendations has to be checked and accompanied by physicians. To get the older patients in motion, a patient-centered approach is required that takes the individual health problem(s) and the current context of life into account. This article provides an overview of the activity-related characteristics of older patients with inflammatory rheumatic diseases. Against this background a simple strategy is provided for promoting physical activity during medical consultation, which takes the characteristics of older patients with rheumatism into consideration. In this way, physicians can integrate a targeted, resource and time-saving economic strategy into consultations that is in concordance with the national physical activity recommendations.

Disease-related everyday communication of persons with rheumatic and musculoskeletal diseases-Results of a participatory research project.

OBJECTIVE: The aim of the present study is to describe and analyse significant factors of disease-related everyday communication of persons with RMDs in a nationwide project in Germany funded by the Deutsche Rheumaliga Bundesverband e.V. (German League against Rheumatism). METHODS: In this participatory research project four persons with RMDs are involved. An online questionnaire addressing context, difficulties, and burden of disease-related everyday communication was answered by 1.015 persons with RMDs. Social and communication skills were recorded by questionnaires to capture social insecurity and patient communication competence. RESULTS: More than half of the participants reported difficulties in disease-related conversations across various situations. The majority of these persons suffer from this experience particularly in conversations at the work environment or with staff members of authorities. They feel unconfident especially in situations which require saying "no". Furthermore, compared to the general population persons with RMDs have more anxiety about contact with others. CONCLUSION: Strengthening the social skills of persons with RMDs in conversations related to everyday situations can promote a self-determined life and contribute to the maintenance of social participation. PRATICE IMPLICATIONS: Based on the results, a communication skills training for persons with RMDs will be developed.

Short- and long-term effects of intensive training and motivational programme for continued physical activity in patients with inflammatory rheumatic diseases.

BACKGROUND: Despite the positive health effects of (intensive) exercise in patients with inflammatory rheumatic diseases, they are very often inactive. Motivational exercise interventions in other patient samples have shown good effects in promoting exercise behaviours. AIM: To evaluate the short- and long-term effects of an intensive exercise training programme in rheumatic patients with additional motivation for continued physical activity. DESIGN: Controlled prospective intervention study with repeated measures over 12 months. SETTING: Rheumatologic inpatient rehabilitation in two centres in Germany. POPULATION: Three-hundred-and-seven patients with chronic polyarthritis or spondyloarthritis. METHOD: The patients were assigned to a control group (CG, standard therapy, N.=156) or an intervention group (IG, motivation and intensive training, N.=151). Socio-demographic (age, gender, social background, employment) and health parameters (SF-36, HFAQ, HADS, pain, disease activity), exercise motivation, physical activity and costs of illness were assessed by questionnaires at baseline (t1), discharge (t2), and 12-months-follow-up (t5). Participants evaluated the rehabilitation programme at t2. RESULTS: At t2, IG-patients rated their rehabilitation better than CG-patients and reported higher exercise motivation. All patients had a better health status at t2 compared to t1. At t5, IG-patients reported more physical activity in everyday life. An unexpected lower physical component score (SF-36) of the IG compared to the CG lacked clinical relevance. No other variable showed significant group differences. Both CG- and IG-patients showed improvements in their health-related quality of life, pain, psychological well-being, sports activities, and exercise self-efficacy. CONCLUSION: The rehabilitation programme that included intensive training was perceived to be better than the conventional programme and the patients benefited more from the motivation intervention. Long-term improvements in all participants may be indicators of the positive effects of conventional rheumatic rehabilitation in Germany. Intensive training with motivation also improves physical activity and may have positive socio-economic effects. Future research needs to identify the most effective factors of the intervention and the patient groups that benefit most. CLINICAL REHABILITATION IMPACT: Intensive training with motivation is appropriate for patients with inflammatory rheumatic diseases aged up to at least 60 years and without severe health impairments. It enhances patients' exercise motivation and increases physical activity over at least 1 year.

[Social participation and activities of daily living of patients with inflammatory rheumatic diseases : support by self-help, exercise therapy and new media]. / Soziale Teilhabe und Alltagsaktivitäten von Patienten mit entzündlich-rheumatischen Erkrankungen : Unterstützung durch Selbsthilfe, Bewegungstherapie und neue Medien.

Rheumatic patients are at risk of social isolation and physical inactivity which can have a significant impact on physical and mental health. Only every seventh patient is organized in a self-help group (SHG), most of them in the German League Against Rheumatism (GLAR). Members of a SHG are socially and physically more active and take part in exercise therapy (ET) more often. Depending on the study, the utilization of ET ranges from 25 % to 71 %. The functional training as the most attended offer of the GLAR showed positive effects at the physical and psychological levels. To motivate difficult to reach patients to engage in self-help and regular exercise, further development of exercise programs with individually tailored intensive strength and endurance elements as well as the increased use of new media seems promising. The Internet provides various opportunities for networking and social participation especially for severely impaired and temporally less flexible patients.