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This research program aims to comprehensively investigate the clinical, physiological, metabolic, and molecular effects of reducing sedentary behavior in rheumatoid arthritis. To this aim, we will conduct a 4-month parallel-group randomized controlled trial aiming to investigate the feasibility and efficacy of a newly developed personalized intervention focused on replacing sedentary time with light-(or very light-) intensity physical activity in rheumatoid arthritis. Additionally, a sub-sample of patients will complete a randomised cross-over study aiming to unravel potential mechanisms underlying the metabolic, physiological and molecular effects of breaking up sedentary time with light-intensity physical activity versus carrying out the minimum amount of daily exercise at once and then remaining sedentary versus simply remaining sedentary throughout all sessions, in a well-controlled laboratorial condition.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Take a STAND for health | Experimental | A newly developed personalized intervention focused on replacing sedentary time with light-(or very light-) intensity physical activity |
|
| Control | No Intervention | The control group will receive all regular medical care and advice on healthy lifestyle, including the promotion of recommended physical activity levels and health nutrition. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Take a STAND for health | Behavioral | The Take a STAND for health is a newly developed 4-month goal-setting intervention aimed at reducing sedentary behavior |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sedentary behaviour as assessed by ActivPALâ„¢ | 4 months |
| Measure | Description | Time Frame |
|---|---|---|
| Physical activity levels as assessed by ActiGraph GT3X® | 4 months | |
| Disease activity as assessed by DAS28 | 4 months | |
| Drug doses |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Sao Paulo | Recruiting | São Paulo | 05508-30 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39283176 | Derived | Pinto AJ, Meireles K, Pecanha T, Mazzolani BC, Smaira FI, Rezende D, Benatti FB, DE Medeiros Ribeiro AC, DE Sa Pinto AL, Lima FR, Roschel H, Gualano B. Clinical and Cardiometabolic Effects of Reducing Sedentary Behavior in Postmenopausal Women with Rheumatoid Arthritis. Med Sci Sports Exerc. 2025 Jan 1;57(1):23-32. doi: 10.1249/MSS.0000000000003546. Epub 2024 Sep 16. | |
| 32051025 |
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| D006262 | Health |
| ID | Term |
|---|---|
| D011154 | Population Characteristics |
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We will perform a 4-month parallel-group randomised controlled trial, in which rheumatoid arthritis patients will be assessed at baseline (PRE) and after 4 months (POST). Moreover, a sub-sample (n=18) of patients will perform a randomised crossover trial at baseline (PRE). Patients will complete three experimental sessions in a random manner, as follows: Prolonged sitting (SIT), in which participants engaged in prolonged sitting throughout an 8-h period and were instructed to minimize excessive movement; Exercise followed by prolonged sitting (EX), in which participants performed a 30-min moderate-to-vigorous exercise bout on a treadmill, subsequently, participants engaged in prolonged sitting as described for SIT; Light-intensity breaks (BR), in which participants completed a 3-min bout of light-intensity walking every 30 min of sitting throughout the experimental period.
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Current and cumulative dose of prednisone, and current use of biological agents and non-biological disease-modifying anti-rheumatic drugs |
| 4 months |
| Fatigue as assessed by the Fatigue Severity Scale | 4 months |
| Pain as assessed by the Visual Analogic Scale | 4 months (RCT) and 8 hours (crossover) |
| Body composition as assessed by densitometry (DEXA) | lean mass, fat mass and bone mass | 4 months |
| Aerobic conditioning as assessed by a cardiopulmonary test | 4 months |
| Physical functioning as assessed by a Health Assessment Questionnaire | 4 months |
| Muscle function as assessed by a battery of tests | Timed Stands Test and Timed Up-and-Go Test | 4 months |
| Blood pressure | 4 months (RCT) and 8 hours (crossover) |
| Insulin sensitivity as assessed by surrogates of insulin sensitivity | Glucose, insulin, c-peptide, and HbA1c | 4 months (RCT) and 8 hours (crossover) |
| Inflammatory cytokines | 4 months (RCT) and 8 hours (crossover) |
| Lipid profile | Total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides | 4 months (RCT) and 8 hours (crossover) |
| Heart rate responses to exercise as assessed by a cardiopulmonary test | Chronotropic response and heart rate recovery | 4 months |
| Muscle sympathetic nerve activity as assessed by microneurography | 4 months |
| Quality of life as assessed by the SF-36 questionnaire | 4 months |
| Western blotting | 4 months (RCT) and 8 hours (crossover) |
| RT-PCR | 4 months (RCT) and 8 hours (crossover) |
| RNA sequencing | 4 months (RCT) and 8 hours (crossover) |
| Lipidomics | 4 months (RCT) and 8 hours (crossover) |
| Vascular function and structure as assessed using a high-resolution ultrasound machine | Flow-mediated dilation and carotid intima-media thickness | 4 months |
| Pinto AJ, Pecanha T, Meireles K, Benatti FB, Bonfiglioli K, de Sa Pinto AL, Lima FR, Pereira RMR, Irigoyen MCC, Turner JE, Kirwan JP, Owen N, Dunstan DW, Roschel H, Gualano B. A randomized controlled trial to reduce sedentary time in rheumatoid arthritis: protocol and rationale of the Take a STAND for Health study. Trials. 2020 Feb 12;21(1):171. doi: 10.1186/s13063-020-4104-y. |
| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |