Skip to main content

Research Repository

Advanced Search

Developing a group intervention to manage fatigue in rheumatoid arthritis through modifying physical activity

Salmon, Victoria E.; Hewlett, Sarah; Walsh, Nicola E.; Kirwan, John R.; Morris, Maria; Urban, Marie; Cramp, Fiona


Victoria E. Salmon

Profile Image

Nicola Walsh
Professor in Knowledge Mobilisation & Muscul

John R. Kirwan

Maria Morris

Marie Urban

Fiona Cramp
Professor in Long Term Conditions


© 2019 The Author(s). Background: Fatigue is a major symptom of rheumatoid arthritis (RA). There is some evidence that physical activity (PA) may be effective in reducing RA fatigue. However, few PA interventions have been designed to manage fatigue and there is limited evidence of end-user input into intervention development. The aim of this research was to co-design an intervention to support self-management of RA fatigue through modifying PA. Methods: A series of studies used mixed methodological approaches to co-design a fatigue management intervention focused on modifying PA based on UK Medical Research Council guidance, and informed by the Behaviour Change Wheel theoretical framework. Development was based on existing evidence, preferences of RA patients and rheumatology healthcare professionals, and practical issues regarding intervention format, content and implementation. Results: The resulting group-based intervention consists of seven sessions delivered by a physiotherapist over 12 weeks. Each session includes an education and discussion session followed by supervised PA chosen by the participant. The intervention is designed to support modification and maintenance of PA as a means of managing fatigue. This is underpinned by evidence-based behaviour change techniques that might support changes in PA behaviour. Intervention delivery is interactive and aims to enhance capability, opportunity and motivation for PA. Conclusion: This study outlines stages in the systematic development of a theory-based intervention designed through consultation with RA patients and healthcare professionals to reduce the impact of RA fatigue. The feasibility of future evaluation of the intervention should now be determined.


Salmon, V. E., Hewlett, S., Walsh, N. E., Kirwan, J. R., Morris, M., Urban, M., & Cramp, F. (2019). Developing a group intervention to manage fatigue in rheumatoid arthritis through modifying physical activity. BMC Musculoskeletal Disorders, 20(1), 1-13.

Journal Article Type Article
Acceptance Date Apr 9, 2019
Publication Date May 4, 2019
Journal BMC Musculoskeletal Disorders
Electronic ISSN 1471-2474
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 20
Issue 1
Pages 1-13
Public URL
Publisher URL


You might also like

Downloadable Citations