Engagement and satisfaction with an Internet-based physical activity intervention in patients with rheumatoid arthritis.

OBJECTIVE: To assess the engagement in and satisfaction with an Internet-mediated physical activity intervention with individual supervision in patients with rheumatoid arthritis (RA). METHODS: The intervention studied was one of the two strategies aimed at enhancing physical activity in RA patients that were being compared in a randomized controlled trial. A total of 82 patients, all experienced in using Internet and e-mail and registered at three different rheumatology out-patient clinics, were randomly allocated to the Internet-mediated individualized intervention (52 weeks). They had access to personal physical activity schedules and received individual supervision by a physical therapist by means of weekly e-mail feedback. In addition, telephone contacts, an online discussion forum, six face-to-face group meetings and electronic newsletters were offered. Besides registration of returned physical activity schedules, engagement and satisfaction were measured through questionnaires. RESULTS: The median physical activity schedule return rate of the 82 participants was 55%. The mean number of patients logging into the website at least once a week was 53 (70%) over 12 months. Of all patients, 69 returned the questionnaires (response 84%). Telephone contacts were used by 38/67 patients (57%), the mean (SD) number of attended group meetings was 3.1 (1.5) and the discussion forum comprised 15 posted messages. Overall, the proportions of patients being (very) satisfied with the amount of e-mail contacts, telephone contacts, usefulness of website information, physical activity schedules, group meetings and website layout were >/=85%. A smaller proportion of patients were satisfied with the links to other websites (68%), the newsletters (55%) and the online discussion forum (32%). CONCLUSION: Physical activity schedules with weekly feedback by e-mail, telephone contacts and a limited number of group meetings were frequently used website tools and modes of communication of an Internet-based physical activity intervention, with high-satisfaction rates from RA patients. Discussion forum and newsletters were less used and appreciated. Caution should be taken when extrapolating the results found to groups of patients who are not experienced Internet and e-mail users or patients with more severe physical disabilities.

Assessment of shoulder function in rheumatoid arthritis.

OBJECTIVE: (1) To develop a simple outcome measure of shoulder function in rheumatoid arthritis (RA), the Shoulder Function Assessment (SFA) Scale; (2) to compare the properties of this scale with those of 2 existing measures of shoulder function, the Constant Scale and the Hospital for Special Surgery (HSS) Scale. METHODS: Fifty consecutive patients with RA participated in an inpatient multidisciplinary treatment program. The SFA Scale was constructed by selecting items considered simple to assess and relevant to shoulder function by a team consisting of a rheumatologist, an orthopedic surgeon, a physical therapist, and an occupational therapist. To examine the intra and interobserver reliability in 25 patients the SFA Scale, the Constant, and the HSS Scale were assessed twice by examiner CHME, in the other 25 patients once by examiner CHME, and once by examiner EMV. The validity of all 3 scales was determined by calculating the correlation with (1) the observed shoulder function, (2) the patient's opinion of shoulder function, and (3) shoulder joint deformity. A receiver operating characteristic curve was constructed to determine the accuracy of all scales to discriminate between differences in the shoulder function of the "best" and "worst" shoulder as reported by the patient. RESULTS: The validity and the reliability of the SFA Scale were equivalent to or better than the validity and reliability of the Constant and the HSS scale. The discriminative ability of the SFA Scale was superior to both other scales. CONCLUSION: The SFA Scale is a reliable, valid, and accurate measure of shoulder function in patients with RA that can be completed within 3 minutes.