Rheumatoid Arthritis and Daily Participation

RHEUMATOID arthritis may sharply reduce daily participation after onset, especially in leisure, household, and social roles.

Rheumatoid Arthritis and Occupational Repertoire

Rheumatoid arthritis (RA) may reshape everyday life well beyond joint symptoms, according to an observational study of Brazilian adults that found broad reductions in occupational repertoire after disease onset. The study examined how RA affected the range of activities and social roles adults retained, modified, or stopped performing after diagnosis.

Researchers assessed 32 adults with RA, including 28 women, recruited from outpatient rheumatology clinics at a tertiary public teaching hospital in Brazil. Participants completed the Disease Activity Score-28, Health Assessment Questionnaire Disability Index, and Activity Card Sort – Brazil, which captured participation before and after RA onset across instrumental activities, low-demand leisure, high-demand leisure, and social activities.

Leisure and Social Roles Declined

Participation fell across all Activity Card Sort domains after RA onset. The steepest reductions were seen in instrumental activities, high-demand leisure, and social activities. These findings suggest that rheumatoid arthritis may disrupt not only self-care or employment, but also activities that support identity, autonomy, and social connection.

Activities such as sports, household maintenance, work-related tasks, and social functions were commonly reduced after onset. Low-demand leisure activities also declined, indicating that symptom burden, fatigue, energy conservation, or unpredictability may affect even less physically intense forms of participation.

The study also found a shift toward health-management activities. Medication management and medical or allied health appointments became more prominent after RA onset, suggesting that disease management may occupy time and energy previously used for leisure and social participation.

Functional Status Mattered More Than Disease Activity

Functional disability, rather than disease activity, showed clearer associations with reduced occupational repertoire. Worse functional status correlated with lower participation in instrumental and social domains, while disease activity showed less consistent associations.

The findings support routine mapping of occupational repertoire in RA care, particularly by occupational therapists. Identifying early withdrawal from leisure and social roles may help clinicians set client-centered goals, track outcomes, and protect meaningful participation alongside medical self-management.

The authors noted that the cross-sectional design, convenience sample, moderate sample size, and reliance on retrospective self-report limit causal interpretation. Still, the study highlights participation as a meaningful clinical outcome and points to the need for longitudinal research across diverse sociocultural settings.

Reference
de Almeida PHTQ et al. Reshaping daily life: An observational study on the impact of rheumatoid arthritis on occupational repertoire. British Journal of Occupational Therapy. 2025;doi:10.1177/03080226251404421.

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