Behavioral Strategies to Increase Physical Activity in Patients With Rheumatoid Arthritis: A Narrative Review

Research objectives: The aim of this narrative review is to systematize knowledge about the theoretical basis and effectiveness of behavioral interventions aimed at increasing and maintaining long-term physical activity in patients with rheumatoid arthritis (RA). Methods: A narrative review of the available literature was conducted, analyzing key models of behavior change, including the COM-B model, Self-Determination Theory, and Social-Cognitive Theory, and identifying the main barriers and facilitators to physical activity in this group of patients. Key findings: The analysis revealed that traditional medical education is insufficient to induce lasting behavioral change. Low physical activity results from physical barriers:pain, chronic fatigue; psychological barriers: kinesiophobia, lack of motivation, depression; and logistical and systemic barriers. The most effective interventions are multi-component and focus on building self- efficacy and resilience. Positive results are achieved through the implementation of hybrid models, mHealth, motivational interviewing, and close interdisciplinary collaboration between physicians, nurses, and physiotherapists. Conclusions: Individualized behavioral strategies are an essential component of comprehensive RA treatment. A holistic approach, incorporating social and psychological support, allows for the safe integration of exercise into the patient's daily life, preventing progressive disability and sarcopenia.