Acute and chronic effects of reducing sedentary time in rheumatoid arthritis: the Take a stand for health study

Abstract

Rheumatoid arthritis patients spend most of their daily hours in sedentary behavior (~10.3 hours), which refers to any waking behaviour performed while in a sitting or lying posture. Sedentary behavior is a strong and independent factor predisposing to poor health-related outcomes and all-cause mortality in several populations. In this context, new interventions focused on reducing sedentary time could be of great therapeutic relevance. To date, however, studies assessing this topic remain scarce. This project aims to comprehensively investigate the clinical, physiological, metabolic, and molecular effects of reducing sedentary behavior in rheumatoid arthritis. To that end, we will perform an acute laboratory study and a randomized controlled trial. The acute laboratory study primarily aims to better understand the potential mechanisms underlying the effects of successive active breaks in prolonged sitting (i.e., 3-minute bouts of light-intensity walking every 30 minutes for 8 hours) versus 30-minutes of exercise followed by prolonged sitting or prolonged sitting only (control condition), in a well-controlled laboratory condition. The 4-month parallel-group randomized controlled trial aims to investigate the feasibility and efficacy of a newly developed personalized intervention focused on reducing sedentary time in this population. Measures will include: (1) Sedentary behavior and physical activity levels; (2) Clinical parameters; (3) Anthropometric parameters and body composition; (4) Aerobic fitness; (5) Muscle function; (6) Blood pressure; (7) Blood samples; (8) Insulin sensitivity surrogates; (9) Muscle biopsy; (10) Fatigue and health-related quality of life; and, (11) Food intake. Additionally, lipidomic analyses will be performed at Baker Institute. Findings emerging from this project will be of paramount clinical relevance since they could provide the foundation for new prescriptions focused on reducing sedentary behavior, which is an important, modifiable and so far, overlooked risk factor in rheumatoid arthritis patients. From a scientific standpoint, this project will generate a unique body of cutting-edge data, which could be highly influential in broad scientific fields, including Medical Sciences, Exercise Science, Public Health, and Basic Sciences. (AU)