DYNAMIC AND STATIC PHYSICAL-TRAINING IN PATIENTS WITH RHEUMATOID-ARTHRITIS - APPLICATION OF A SELF-APPRAISAL AND COPING MODEL

A self-appraisal and coping model was examined using a longitudinal da ta set involving 56 classical or definite rheumatic arthritis patients randomly assigned to either dynamic (n = 28) or static (n = 28) physi otherapeutic training. The model considers both adaptational consequen ces and antecedents of training (muscular endurance, pain, self-apprai sal, and coping through avoidance or planful problem-solving). Measure s were obtained prior to and after a 6-week training period (partly su pervised 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 m uscular endurance in dynamic training patients. Regression analyses li kewise supported these conclusions, suggesting some patients in dynami c 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.