Table 1.

Descriptions and examples of interventions included in the integrative management of rheumatoid arthritis guideline.

Intervention	Description and/or examples
Exercise
Physical activity	Movement of the body requiring energy expenditure.
Exercise	Performance of physical activity in regular and structured manner to improve fitness and health.
Aerobic exercise	Exercise intended to improve cardiorespiratory fitness and muscular endurance. Examples include walking, biking or cycling, running, hiking, aerobics, rowing, swimming, using an elliptical.
Aquatic exercise	Exercise performed in water, containing elements of both aerobic and resistance exercise. Examples include swimming, water aerobics, water walking or jogging.
Resistance exercise	Exercise intended to increase muscular strength. Examples include free weights, weight machines, resistance bands, Pilates.
Mind-body exercise	Exercise that combines movement, mental focus, and controlled breathing. Examples include yoga, Tai Chi, Qigong.
Rehabilitation
Comprehensive occupational therapy	Evaluation and treatment by Occupational Therapist with the goal of increasing physical function and participation. Receives patient-centered individualized treatment. Components of OT services vary and may include arthritis education, ADL evaluation and training, joint protection, activity pacing, work simplification and fatigue management, exercise (particularly for the hand and arm), splinting/orthotics, provision of assistive/adaptive devices, environmental adaptations, work and leisure counselling/rehabilitation, work-site assessment, sexual advice, relaxation, and pain and stress management training.
Comprehensive physical therapy	Evaluation and treatment by a physical therapist. Components of PT services will vary and should include exercise. May also include functional training and physical activity, energy conservation, workplace accommodations, mobility and gait training, manual therapy, self-management education, electrotherapy, application of orthoses, instruction in assistive devices, pain-management including thermal therapy.
Hand therapy exercises	Exercises of the hand to improve mobility and strength.
Bracing and orthoses	Devices to correct and support musculoskeletal function, improve joint alignment, or protect the joint. Examples include wrist and finger splints, foot or knee orthoses, compression gloves, taping.
Joint protection techniques	Self-management approach that aims to maintain function by providing people with ways to alter work methods and movement patterns of affected joints to reduce pain, inflammation, and joint stress. Examples include changing the way of performing activities to avoid pain, resting, using alternative muscle groups.
Activity pacing	Balancing activity and rest to accomplish activities. Includes activity pacing, energy conservation, activity modification, fatigue management techniques.
Assistive devices	Devices to assist with mobility. Examples include crutches, canes, walkers, wheelchairs, tricycles, scooters.
Adaptive equipment	Devices to assist with activities of daily living. Examples include built up and/or long handled equipment, sock aide, button hook, reachers, pill cutters, cell phone holders.
Environmental adaptations	Adapting environment to improve safety. Examples include adaptations for toileting (raised toilet seat, commode, toilet safety rail), showering (tub seat, handheld shower, walk in bath), grab bars, ramps, stair lifts, home modification.
Vocational rehabilitation	Training programs to overcome barriers preventing successful employment.
Work site evaluation and modifications	Evaluating and adjusting work-site conditions and duties for safety and well-being.
Dietary
Formally defined diet	Specific formally defined diets evaluated in this guideline were: anti-inflammatory, Mediterranean-style, ketogenic, paleo, gluten-free, vegetarian, vegan, intermittent fasting, elemental, elimination, raw foods, whole food plant-based.
Mediterranean-style diet	Diet pattern that emphasizes intake of vegetables, fruits, whole grains, nuts, seeds, and olive oil; moderate amounts of low-fat dairy and fish; and limits added sugars, sodium, highly processed foods, refined carbohydrates, and saturated fats.
Dietary supplement	Substances used to add nutrients, botanicals, herbs, or microbials (probiotics) to the diet. Specific supplements evaluated in this guideline were vitamin D, probiotics, fish oil and omega fatty acids, antioxidants (selenium, zinc, vitamin A, vitamin C, vitamin E), turmeric, glucosamine, γ-linolenic acid, borage seed oil, evening primrose oil, black currant seed oil, selenium, Boswellia, ginger.
Weight loss	Intentional loss of body weight. Examples include lifestyle modification through diet and/or exercise, support groups, health coaching, medically-supervised weight loss programs, branded dietary weight loss programs, weight loss surgery.
Additional adjunctive therapies
Self-management program	Standardized program to guide self-management. Examples include Arthritis Self-Management Program, Chronic Disease Self-Management Program, Better Choices Better Health, Tomando Control de su Salud, RA Self-Management Intervention, OPERAS (an On-demand Program to EmpoweR Active Self-management).
Cognitive behavioral therapy	Psychological therapy to identify and change thought and behavior patterns.
Mind-body approaches	Practices engaging both mind and body functions. Examples include biofeedback, goal setting, meditation, mindfulness, breathing exercises, progressive muscle relaxation, guided imagery.
Acupuncture	Stimulation of specific body points through insertion of thin needles.
Massage therapy	Rubbing and kneading of muscles and joints with the hands. Examples include Swedish, Deep Tissue, Trigger Point.
Thermal modalities	Use of heat and cold for medical treatment. Examples include cryotherapy, heat, therapeutic ultrasound, infrared sauna, paraffin therapy, and laser therapy.
Electrotherapy	Use of electrical energy for medical treatment. Examples include transcutaneous electrical nerve stimulation (TENS), neuro-muscular electrical nerve stimulation (NMES).
Vagal nerve stimulation	Implantation of a device to stimulate the vagus nerve with electrical impulses.
Chiropractic	Diagnosis and manipulation of malaligned joints, particularly the spine.
Tobacco cessation	Counseling on tobacco cessation, tobacco cessation programs (phone, mobile applications), nicotine replacement therapies, tobacco cessation medications without nicotine.

Abbreviations: ADL, activities of daily living; OT, occupational therapy; PT, physical therapy