People with rheumatoid arthritis, or RA, are more likely to be physically active if they believe it will help manage their disease, according to new research.

“Knowledge and motivation are kind of related. A lot of people don’t understand that you can be physically active and not hurt your joints. I don’t think everybody believes that,” explains Rowland Chang, MD, a rheumatologist and professor at the Northwestern University Feinberg School of Medicine in Chicago.

In a study published online in Arthritis Care & Research, Dr. Chang and his colleagues found that, despite a multitude of studies showing the benefits of physical activity, many RA patients remain physically inactive due to a variety of factors including age, pain, functional limitations and lack of education about the benefits of exercise.

Patients may not believe in the benefits because they worry about pain and hurting already damaged joints, says Dr. Chang. And it wasn’t so long ago that RA patients were given different advice. “In the 1950s, if you had RA, it was not uncommon for you to be hospitalized [or prescribed bed rest.] It’s only been in the last 30 years that people realized that is not the right idea,” Dr. Chang explains.

Now we know that a lack of physical activity can make RA worse and increase the risk of cardiovascular disease. Dr. Chang and his colleagues wanted to better understand the knowledge gap about physical activity among people with RA in the hope that this information could lead to interventions to get more patients moving.

The researchers looked at three potential predictors of physical activity in 185 adult RA patients. They examined the extent to which subjects believed physical activity was helpful in managing RA, whether they felt confident that they could be physically active (what they called “motivation”), and whether they had worries – about their ability to do or not do the things they enjoy or their ability to work, for instance – that influenced their activity level. Participants were asked questions in these areas. Their activity levels were also measured over the course of a week by an accelerometer, which tracks when someone is moving and the intensity of that movement.

Using that data, researchers discovered that beliefs and motivation related to physical activity carried a lot of weight. “There was a significant increase in physical activity if you had high belief and high motivation,” Dr. Chang explains.

The challenge facing health professionals is getting more patients to learn and believe that exercise is a key tool in the prevention and management of RA as well as many other diseases.