PARE0013 ‘FIND A NUDGE’ AND OTHER TIPS TO MAINTAIN YOUR LEVEL OF PHYSICAL ACTIVITY FOR A LONGER TIME
Authors: R. Geenen
Journal: Annals of the Rheumatic Diseases (2020)

Background: Pain, fatigue, physical disability, reduced well-being and sleep problems are common consequences of Rheumatic and Musculoskeletal Diseases (RMDs). Paradoxically, these consequences may all lead to a reduction of physical activity, while physical activity actually is an antidote against these consequences. This is acknowledged by experts that included physical activity and exercise into recommendations for management of RMDs [1-3]. Indeed, after programs aimed at a gradual build-up of exercise, many people with a RMD showed an increase of physical activity. However, it is hard to maintain a higher level of physical activity for years as part of daily routine [4-5]. Objectives: To identify and present tips, applications and illustrations that support people with an RMD to maintain their level of physical activity for a longer time. Methods: Theoretical considerations and empirical findings guided the identification of tips. Care was taken that the tips and illustrations were translated into layman language and fitted in daily life of common people. Results: Ten tips were found: 1) break the habit, 2) make sure you can do the exercise activity, 3) use aids if needed, 4) believe in a good outcome, 5) choose a physical activity that fulfils personal goals, 6) find a physical activity that you enjoy, 7) stop moving while it’s still fun, 8) find a buddy, 9) make an action plan, and 10) find a nudge. A “nudge” is a little push in the right direction that makes a person unconsciously perform physical activities. Examples are an outdoor photography hobby, a dog that comes to you with a dog leash in his mouth, or grandchildren that persuade you to go with them to the playground nearby. If a person with a RMD manages to find a nudge that stimulates instinctive moving without feeling the effort, then physical activity may be maintained. People differ a lot and must discover for themselves which tips help them to maintain physical activity. They must be aware that it may take up to two months for changed habits to stick. Conclusion: The presented tips will help to maintain your level of physical activity. Nevertheless, be aware that effort and perseverance are needed to keep on moving. A challenge for the future is to get more knowledge of natural and pleasurable physical activities. Peers with successful experiences and behavior change experts can help. For the time being, a main advice to maintain a higher level of physical activity with less effort is to find your own nudges. References: [1]Geenen R, Overman CL, Christensen R, et al. EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018;77(6):797–807. [2]Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2017;76(2):318–328. [3]Rausch Osthoff AK, Niedermann K, Braun J, et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018;77(9):1251–1260. [4]Knittle K, Nurmi J, Crutzen R, Hankonen N, Beattie M, Dombrowski SU. How can interventions increase motivation for physical activity? A systematic review and meta-analysis. Health Psychol Rev 2018;12(3):211–230. [5]Demmelmaier I, Bergman P, Nordgren B, Jensen I, Opava CH. Current and maintained health-enhancing physical activity in rheumatoid arthritis: a cross-sectional study. Arthritis Care Res (Hoboken). 2013;65(7):1166–1176. Disclosure of Interests: Rinie Geenen Speakers bureau: Sanofi Genzyme paid for a lecture on depression in RA.