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Table 3 Outline of session content

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

Week number Session number Group discussion topics (45–55 min) followed by coffee break (10–15 min) Practical session (30–45 min) Support materials and homework tasks
1 1 • Introduction to the course – aims and expectations, Ground rules and housekeeping • Demonstration of exercises and gym equipment • Handouts – Arthritis Research UK fatigue booklet, Causes of fatigue, PA in RA, List of exercises included in the practical session
• Discussion topic: Share and discuss current feelings and experiences relating to fatigue and PA • Patient choice of exercises with supervision as time allows
• Task – Activity diary to complete for next session
• Discuss benefits of PA in RA
• Introduction to activity diaries
2 2 • Review and discuss activity diaries • Individual goal setting (PA goal) • Handouts – Pacing, Graded approach to exercise, Goal setting, Borg scale
• Activity analysis, pacing and energy management • Discuss potential barriers to PA and possible solutions
• Task – Goal setting activity and graded PA plan, establish a baseline for chosen PA, continue activity diary
• Introduce principles of graded approach to exercise and progression of PA • Introduce Borg scale for monitoring exertion
• Introduction to goal setting • Patient choice of exercises with supervision
3 3 • Review and discuss pacing and activity analysis • Review individual goals • Handouts – sleep, stress and relaxation, relaxation CD
• Patient choice of exercises with supervision
• Discuss impact of sleep and rest on PA and fatigue • Task – try out relaxation CD, continue with PA goal and activity diary
• Progression of exercises as appropriate
• Effects of stress and techniques for relaxation • End with relaxation
4 4 • Review general progress. Discuss barriers and potential solutions • Review individual goals • Handouts – self monitoring, pedometers, healthy diet
• Patient choice of exercises with supervision
• Discuss ideas for self-monitoring PA • Task – try out tools for self-monitoring and prompting PA, continue with PA goal and activity diary
• Progression of exercises as appropriate
• Discuss diet and weight management in relation to PA
6 5 • Review general progress • Review individual goals • Handouts –Managing external demands, managing setbacks
• How to manage setbacks • Patient choice of exercises with supervision
• Tasks – think about and formulate a setback plan, continue with PA goal and activity diary
• Discuss managing PA alongside occupation
• Progression of exercises as appropriate
8 6 • Review general progress • Review individual goals • Handouts – Template for planning long-term PA
• Review and discuss setback plan • Patient choice of exercises with supervision
• Discuss how to continue and maintain PA in the longer term • Task – continue with PA goal and activity diary, complete long-term PA plan
• Progression of exercises as appropriate
12 7 • Review general progress, setback plan, options for long-term maintenance and continued progression of PA • Review individual goals • Handouts – List of resources for long-term PA
• Patient choice of exercises with supervision
• Progression of exercises as appropriate
  1. PA = physical activity; RA = rheumatoid arthritis