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Dynamic and static physical training in patients with rheumatoid arthritis: application of a self-appraisal and coping model
Andersson SI, Ekdahl C
Disability and Rehabilitation 1996;18(9):469-475
clinical trial
2/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

A self-appraisal and coping model was examined using a longitudinal data set involving 56 classical or definite rheumatic arthritis patients randomly assigned to either dynamic (n = 28) or static (n = 28) physiotherapeutic training. The model considers both adaptational consequences and antecedents of training (muscular endurance, pain, self-appraisal, and coping through avoidance or painful problem-solving). Measures were obtained prior to and after a 6-week training period (partly supervised and partly self-training) at a health-care centre, and after an additional 3 months of self-training only. Path analysis supported the mediating role of self-appraisal and of avoidance in influencing muscular endurance in dynamic training patients. Regression analyses likewise supported these conclusions, suggesting some patients in dynamic training to be caught in a vicious circle of avoidance and low self-appraisal. Theoretical issues are discussed, and suggestions made for developing more effective interventions in rheumatic patients.

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