BackgroundRheumatoid arthritis (RA) is a systemic chronic autoimmune inflammatory disease characterized by synovial joint inflammation that results in functional limitations accompanied by social and psychological outcomes.ObjectivesThe aim of this study was to investigate the association between fear of movement and age, upper and lower extremity functions and functional disability in patients with Rheumatoid Arthritis (RA).MethodsA total of 88 patients with RA participated to the study. Disease activity was assessed using the Disease Activity Score in 28 joints (DAS28). Functional disability was assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI). The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) was used to assess the upper extremity function. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess the lower extremity function. The Tampa Scale for Kinesiophobia (TSK) was used to assess pain-related fear of movement. The multiple stepwise linear regression model with R-square (R2) was used to compare across the models and explain the total variance.ResultsEight independent variables namely, age (r=0.215; p=0.044), QuickDASH (r=0.504; p<0.001), HAQ-DI (r=0.315; p=0.003), WOMAC Pain (r=0.512; p<0.001), WOMAC Stiffness (r=0.419; p<0.001), WOMAC Function (r=0.398; p<0.001), WOMAC Total (r=0.429; p<0.001), WOMAC range (r=0.419; p<0.001), demonstrated significant correlations with TSK. There were correlations between two independent variables (QuickDASH, p=0.013; WOMAC Pain, p=0.034) and TSK (R2=0.293).ConclusionsHealth professionals should keep in mind that fear of movement were likely to cause poorer upper extremity functional disability and lower extremity pain levels in spite of varied drug therapies in patients with RA.References Wan, S. W., He, H.-G., Mak, A., Lahiri, M., Luo, N., Cheung, P. P., & Wang, W. (2016). Health-related quality of life and its predictors among patients with rheumatoid arthritis. Applied Nursing Research, 30, 176–183.Doury-Panchout, F., Metivier, J., & Fouquet, B. (2015). Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty. European journal of physical and rehabilitation medicine, 51(2), 155–161. Disclosure of InterestNone declared

BackgroundRheumatoid arthritis (RA) and ankylosing spondylitis (AS) are among the most common rheumatic (joint) conditions. RA and AS are different types of arthritis. Living with RA or AS can significantly affect your quality of life, mental health, and emotional well-being.ObjectivesWe report the preliminary results of an ongoing prospective observational study that compare the body awareness, physical activity, kinesiophobia, pain catastrophizing and psychosocial status in individuals with RA and AS.MethodsA total of 78 individuals (RA=48; AS=30; women/men=48/30) recruited from two university hospitals in Turkey. All individuals were assessed regarding physical characteristics (age, BMI, duration of disease, BASDAI, DAS-28); body awareness by Body Awareness Questionnaire, physical activity level by International Physical Activity Questionnaire Short Form, fear of movement by Tampa Scale of Kinesiophobia, pain catastrophizing by Pain Catastrophizing Scale and psychosocial status by Beck Depression Inventory.ResultsIndividuals’ characteristics and outcome measures are presented in Table 1. As expected, there were statistical differences between age and gender in study groups (p<0.001). However, disease duration and disease activity, mild depression level were similar between groups. Individuals with AS were significantly more physically active compared to individuals with RA (p<0.005). Body awareness, kinesiophobia, pain catastrophizing and psychosocial status were similar between groups (p>0.05). In addition, disease activity was moderately correlated with body awareness, pain catastrophizing and kinesiophobia individuals with AS (r=-0.529; r=0.613; r=0.427, p<0.05).ConclusionTreatment of RA and AS is similar, but there are key differences. According to our results, individuals with AS is more physically active than individuals with RA regardless of disease duration and disease activity. Health professionals can also focus on correlation between disease activity and higher body awareness, pain catastrophizing and kinesiophobia in individuals with AS.References[1]Oskay D, Tuna Z, Düzgün İ, Elbasan B, Yakut Y, Tufan A. Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis. Turk J Med Sci. 2017 Nov 13;47(5):1340-1347. doi: 10.3906/sag-1702-93. PMID: 29151302.[2]Baday-Keskin D, Ekinci B. The relationship between kinesiophobia and health-related quality of life in patients with rheumatoid arthritis: A controlled cross-sectional study. Joint Bone Spine. 2022 Mar;89(2):105275. doi: 10.1016/j.jbspin.2021.105275. Epub 2021 Sep 15. PMID: 34536623.Table 1.Characteristics of patients and outcome measuresPatients’ characteristicsRA n=48AS n=30p*Age (year): mean ± SD51.34 ± 11.040.27 ± 10.380.000*BMI (kg/m2): mean ± SD28.21 ± 4.4726.66 ± 5.780.101Gender (n, %)Female41 (85.4%)7 (23.3%)0.000*Male7 (14.6%)23 (76.7%)Duration of disease (year): mean ± SD7.20 ± 9.395.91 ± 7.280.488ESR (mm/h)13 (2-58)9 (3-54)0.115CRP (mg/dl)3.65 (0.18-37.70)5.2 (0.60-49.06)0.300BASDAI (0-10)n (%)Active disease18 (60)Inactive disease12 (40)DAS-28n (%)Remission24 (50)Low activity12 (25)Moderate activity12 (25)Outcome measuresBDI (0-29)14.5 (0-45)14 (0-42)0.991IPAQ-SF594 (0-4380)1188 (66-5805)0.005*PCS (0-52)29 (4-51)27 (7-50)0.610TSK (0-68)39 (23-56)42.5 (25-57)0.102BAQ (18-126)94 (50-126)91.5 (49-1200)0.463RA= Rheumatoid arthritis; AS= Ankylosing spondylitis; SD= Standard deviation; BMI= Body mass index; ESR= Erythrocyte sedimentation rate; CRP= C reactive protein; Bath Ankylosing Spondylitis Disease Activity Index, BDI= Beck Depression Inventory. IPAQ-SF= International Physical Activity Questionnaire-Short Form; PCS= Pain Catastrophizing Scale; TSK= Tampa Scale for Kinesiophobia; BAQ: Body Awareness Questionnaire.*Mann-Whitney U test.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

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Methods: Baseline data of 573 patients with knee OA of the Amsterdam-Osteoarthritis cohort were used. Upper leg muscle strength (Nm/ kg) was measured isokinetically. Activity limitations were measured with the timed Get Up and Go (GUG) test and timed Stair Climb Test (SCT), subdivided in stair-ascending and stair-descending. In order to determine whether the relationships between muscle strength and activity limitations are nonlinear, it was tested whether nonlinear (exponential) models fitted the data significantly better than linear models. Finally, linear plus constant models were used to detect thresholds. Results: Nonlinear models improved model fit compared to linear models. The improvement was 5.9, 8.2 and 5.2 percentage points for respectively the GUG, stair-ascend and stair-descend time. Muscle strength thresholds were 0.93 Nm/kg (95%CI 0.80e1.05), 0.89 Nm/kg (95%CI 0.77e1.00) and 0.97 Nm/kg (95%CI 0.86e1.09) for relationships with respectively GUG, stair-ascend and stair-descend time.Conclusions: In a large population of patients with knee OA, relationships between muscle strength and activity limitations are nonlinear (i.e., exponential), allowing detection of muscle strength thresholds. Patients with muscle strength below these thresholds might benefit more from muscle strength training to reduce limitations in daily activities than patients with muscle strength above the thresholds. Future research is needed to assess the clinical value of the thresholds determined.

BackgroundSpinal stiffness and loss of spinal mobility, explained byspinal inflammation and structural damage due to extensive osteoproliferation, are characteristics of Ankylosing Spondylitis (AS). AS usually disables a person with severe back pain and, in later stages, remarkable spinal kyphotic deformity.The deformity eventually may necessitate a major corrective procedure. Therefore, controlling the symptoms and progression of AS in early stages by effective medication is the main step in the management of AS.ObjectivesThe aim of this study was to investigate the effectiveness of DMARD therapies on NSAID intake and kinesiophobia in patients with AS.MethodsA total of 74 patients, diagnosed according to the modified New York criteria for AS, were enrolled. Patients were assessed to measure disease activity using the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]. Fear of movement was assessed with the Tampa Scale for Kinesiophobia [TSK]. To calculate NSAID intake and the type of NSAID, dose, percentage of days with intake were recorded, along with DMARD therapy, age, body mass index (BMI), and disease duration. The NSAID equivalent scoring was calculated according to recommendations from longitudinal clinical studies. The drug therapy groups were compared using the Kruskal-Wallis test and the Chi-square test. Correlation analysis was evaluated by Spearman's correlation coefficient.ResultsSeventy-four patients (36 women, 38 men; mean age: 43.81±10.18 years; mean disease duration: 9.89±8.50 years; BMI: 28.20±5.07) treated with four types of DMARDs (adalimumab+golimumab =17; infliximab =19; etanercept =13; sulfasalazine =25) were included. There were no drug group differences in terms of age (p=0.179), sex (p=0.886), or BMI (p=0.821). BASDAI scores (mean: 3.9±2.4) and NSAID intake (mean: 68.1±76.1; p=0.003) were significantly higher in the sulfasalazine therapy (ST) group compared to other drug groups. BASDAI scores were not correlated with age (p=0.103), disease duration (p=0.131), BMI (p=0.641) or the TSK scores (p=0.376). Different NSAID intake groups (p=0.089) had similar TSK scores.ConclusionsPatients with AS had fear of movement independent of age, BMI or disease duration, even when they experienced positive results from drug therapies and concomitant therapy with a single oral dose of NSAID or oral corticosteroids in stable dosages.References Braun J, Baraliakos X, Heldmann F, et al. Tumor necrosis factor alpha antagonists in the treatment of axial spondyloarthritis. Expert Opin Investig Drugs. 2014;23:647–659.Rohekar S, Chan J, Tse SM, et al. 2014 update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada treatment recommendations for the management of spondy- loarthritis. Part I: principles of the management of spondyloarthritis in Canada. J Rheumatol. 2015;42:654–664.Rohekar S, Chan J, Tse SM, et al. 2014 update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada treatment recommendations for the management of spondy- l...