Randomized Controlled Study The Effect of Exercise on Sleep and Fatigue in Rheumatoid Arthritis: A

ABSTRACT. Objective. Sleep disturbance and chronic fatigue are common in rheumatoid arthritis (RA) andcontribute to disability, symptomatology, and healthcare use. It has long been recognized in otherpopulations that exercise can improve sleep and diminish fatigue. The effect of exercise on sleepquality and fatigue in RA has not been evaluated. Methods. Ours is a randomized controlled study in RA to determine the effect of an exerciseprogram on sleep quality and fatigue. These were measured using the Pittsburgh Sleep Quality Indexand the Fatigue Severity Scale. Patients were randomized to either a 12-week, home-based exerciseintervention or usual care. The exercise program consisted of specific exercises to target individualdeficiencies identified using the Health Assessment Questionnaire (HAQ) with cardiovascular workas per the guidelines. The intervention group was evaluated on a 3-week basis. Full evaluation wascarried out at baseline and at 12 weeks. Results. Forty patients were randomized to the intervention with 38 controls. In the exercise inter-vention group, there was a statistically significant improvement in HAQ (p = 0.00), pain (p = 0.05),stiffness (p = 0.05), sleep quality (p = 0.04), and fatigue (p = 0.04). In our control group, there wasa statistically significant improvement demonstrated in their overall perceptions of the benefits ofexercise, but none of the other variables.