Introduction: Gait impairments are one of the earliest signs reported by patients with Parkinson's disease (PD) and cause an increased number of falls and decreased quality of life among these patients. Objective: To compare the effectiveness of three physical therapy interventions using Rhythmic Cues (RC), Swiss Ball (SB) and Dual Task (DT), with an emphasis on gait treatment (step and stride length, duration and velocity), in individuals with PD. Methods: Quasi-randomized clinical trial addressing a sample composed of 45 individuals assigned to three groups. The individuals were assessed before and after the intervention protocol using the following: Modified Hoehn and Yahr Scale (HY), Unified Parkinson's Disease Rating Scale (UPDRS), Footprint analysis, Video Gait analysis, and Timed Up and Go Test (TUG). The groups were homogeneous concerning age, HY and UPDRS. Statistical analysis was performed using SPSS, version 20.0. Results: Statistically significant differences were found in all the variables analyzed in the RC and SB groups when compared in the pre-and post-intervention. With the exception of the TUG variable, the DT group presented statistically significant differences in all the remaining variables. Conclusion: The three interventions were effective for the outcomes under study, but the SB group presented the greatest magnitude of

Introduction: HIV/AIDS is considered one of the great cases of public health, but it is seen that patients who use antiretroviral therapy (ART) and practice strength training promote a promotion of their health. Objectives: Assess the impact of strength and resistance training on cytokines and body composition in people living with HIV/AIDS. Methods: Randomized clinical trial, the sample consisted of 12 patients, 7 from the Strength Group (GF) and 5 from Group 2, Muscular Resistance (MGR). We compared the levels of IL-2, IL-4, IL-6, IL-10 and TNF-α cytokines and body composition in the first and last sessions. The patients completed 36 strength and resistance training sessions over 12 weeks. Results: After 36 sessions of GRM resistance training, there was a significant increase from 4,734 pg/mL to 5,050 pg/mL of IL-10 (p=0.002). Regarding the GFR, no significant results were found. For body composition, there were significant differences in GFR due to the increase in lean mass of the arms from 6,441g to 7,014g (p=0.04), legs from 16,379g to 17,281g (p=0.02) and whole body of 45,640g to 47,343g (p=0.01). In G2 there was a significant decrease in the percentage of fat in the arms from 23,160% to 20,750% (p = 0.04). To assess quality of life, the WHOQOL-HIV-Bref questionnaire was used, where significant improvement was found in all domains, except for the level of independence domain. Conclusion: We conclude that muscular resistance training is effective in increasing IL-10 and decreasing the percentage of fat in the arms, whereas strength training increases lean mass in arms, legs, and the whole body. Level of Evidence I; Randomized Clinical Trial.

BackgroundSeveral studies describe an association between anxiety, depression and disease activity in Spondyloarthritis (SpA).ObjectivesTo assess disease activity and quality of life in anxious and depressed SpA patients.MethodsObservational, retrospective, cross-sectional study of SpA patients on bDMARDs, registered at Reuma.pt, Portuguese Rheumatology registry, with ≥1 clinical evaluation from November 2015 to July 2016. Demographic and clinical outcomes including: BASDAI, BASMI, BASFI, ASDAS, DAS 28–3V ESR in peripheral psoriatic arthritis, tender and swollen 44 joints count (TJC, SJC), patients' pain and global assessments, physician's global assessment, CRP, ESR, ASQoL, EQ-5D, FACIT-F for fatigue and HADS scale with 2 domains, HADS-A for anxiety and HADS-D for depression (a cutoff of 8 defining these symptoms), were collected. Statistics: Mann-Whitney test, p<0.05. SPSS® v.17.Results160 patients were included, 41.9% were male, with mean: current age 50.7±11.9, age at diagnosis 36.9±11.96, at 1st bDMARD 46.2±11.8, time from diagnosis 18.5±10.3, years. The mean DAS 28–3V ESR was 3.2±1.4, BASDAI 2.98±2.2, ASDAS 2.4±1.2, BASFI 2.68±2.26, BASMI 3.36±1.7, patient's global assessment 28.8±24.1, physician's global assessment 14.5±15.2, ESR 18.8±18.1 mm/h, CRP 6.7±16.01 mg/L, ASQoL 6.2±5.6, FACIT-F 37.2±10.1 and EQ-5D 0.417±0.19. The mean HADS-A was 5.96±4.01 and HADS-D was 5.05±4.1 (HADS-A≥8 in 39.5% and HADS-D≥8 in 28.3% patients). Comparison of anxious vs non-anxious and depressive vs non-depressive groups appears on table 1.Table 1.Comparison of anxious vs non-anxious and depressive vs non-depressive patientsHADS-A<8HADS-A ≥8 p-valueHADS-D<8HADS-D≥8 p-value Current age, mean±SD (years)48.9±11.952.6±10.80.04549.2±11.453.2±11.50.072Age at diagnosis, mean±SD (years)34.3±11.940.2±11.50.00434.9±11.540.9±12.50.015Age at 1st bDMARD, mean±SD (years)44.0±11.948.7±10.640.01344.7±11.548.7±11.60.059HADS-A, mean±SD3.2±2.110.2±2.1–4.5±3.49.7±3.1<0.001HADS-D, mean±SD2.9±3.38.3±2.7<0.0012.98±2.510.3±2.3–ASQoL, mean±SD3.12±3.810.6±4.5<0.0014.6±4.79.63±5.8<0.001BASMI, mean±SD3.1±1.83.9±1.60.0033.2±1.73.9±1.60.016BASFI, mean±SD1.7±1.64.1±2.3<0.0012.0±1.74.3±2.6<0.001BASDAI, mean±SD1.98±1.64.5±2.1<0.0012.4±1.94.5±2.3<0.001ASDAS, mean±SD2.3±1.32.6±1.10.0022.3±1.22.7±1.20.006Patient's pain assessment (VAS), mean±SD23.96±21.841.2±22.10.02029.1±23.338.2±23.00.226Patient's global assessment (VAS), mean±SD19.1±19.942.8±23.1<0.00122.9±21.642.6±24.5<0.001physician's global assessment (VAS), mean±SD10.6±12.920.1±16.8<0.00110.8±12.423.95±17.8<0.001TJC, mean±SD1.4±4.24.3±9.990.0021.79±5.34.45±10.30.002FACIT-F, mean±SD42.4±7.829.5±8.2<0.00140.4±8.629.3±9.5<0.001EQ5D, mean±SD0.51±0.110.29±0.19<0.0010.48±0.130.28±0.23<0.001ConclusionsThese results suggest that anxious and depressed patients may have higher disease activity, more functional limitations and worse quality of life. These symptoms should not be underestimated, but instead, they should be controlled to achieve clinical improvement.Disclosure of InterestNone declared

Parkinson's disease is a progressive, degenerative neurological disorder associated to profound changes in the quality of life of its survivors. This study was designed to investigate the effectiveness of a 16-week program of exercise-based interventions aiming to [1] improve motor symptoms and [2] provide social integration of PD patients. To achieve this goal, we analyzed the scores recorded by the Parkinson's disease Quality of Life questionnaire (PDQL) before and after the intervention. Results revealed significant improvement in overall quality of life of our group of patients (p=0.002). The results also revealed significant improvements in scores recorded from two specific domains of the PDQL assessment tool; Parkinson Symptoms (p=0.002) and Social Functions (p=0.045). These findings are consistent with the hypothesis that the 16-week exercise-based protocol proposed was effective to promote improvement in measurements of mobility and social integration of PD patients.

BackgroundA BASDAI ≥4 has been often required to start TNFi therapy in patients with axSpA. However, this cut-off of high disease activity (HDA) is largely arbitrary. Unlike BASDAI, ASDAS incorporates objective measures (e.g. CRP) and has a validated definition of HDA (≥2.1). It has thus been suggested that ASDAS could also be used to guide treatment decisions, but evidence to support this is still scarce.ObjectivesTo compare the impact of applying the ASDAS and BASDAI definitions of HDA in selecting patients for TNFi-treatment in daily clinical practiceMethodsPatients from Reuma.pt (Rheumatic Diseases Portuguese Register), with diagnosis of axSpA according to their rheumatologists (both treated and not treated with their first TNFi), with complete baseline BASDAI and ASDAS data, and complete 6 month of follow-up (i.e. baseline, 3 and 6 months visits available) were included. Four subgroups [cross-tabulation between ASDAS (≥2.1) and BASDAI (≥4) definitions of HDA], were compared according to baseline demographic and clinical characteristics in the ‘eligible population’ (i.e. irrespective of TNFi-treatment). In addition, for patients starting TNFi and with complete follow-up BASDAI/ASDAS data (‘efficacy population’), the subgroups were also compared according to different response criteria (see table 1), at 3 and 6 months.ResultsIn total, 466 patients were included (59% males and 66% HLA-B27 positive). The large majority (n=382; 82%) fulfilled the definition of HDA according to both BASDAI and ASDAS at baseline (i.e. BASDAI≥4 and ASDAS≥2.1). The frequency of ASDAS≥2.1, if BASDAI<4, was much higher than the opposite condition (i.e. ASDAS<2.1, if BASDAI≥4) (70% vs 0.5%). Compared to patients fulfilling both definitions, those who were ASDAS≥2.1 only, were more likely to be male (82.5% vs 54%), HLA-B27 positive (79% vs 54%), to show higher levels of CRP (2.6±2.5 vs 2.2±2.8 mg/dL) and lower BASFI (3.1±2.6 vs 5.6±2.3). In the ‘efficacy population’ (n=296), better responses were observed among patients with ASDAS≥2.1 only, especially for the most ’stringent’ outcomes [e.g. ASDAS inactive disease (ASDAS ID): 59% and 50%, at 3 and 6 months respectively], compared to patients fulfilling both definitions (ASDAS ID: 26% and 25% at 3 and 6 months respectively) (table 1).Abstract SAT0260 – Table 1TNFi response criteria across subgroups according to BASDAI/ASDAS category (‘efficacy population’)ConclusionsOur results show that the ASDAS-HDA definition (ASDAS≥2.1) is more inclusive than the BASDAI-HDA definition (≥4) in selecting axSpA patients for TNFi treatment. Importantly, the additionally ‘captured’ patients respond better and have higher likelihood of predictors thereof. These results support the use of ASDAS≥2.1 as a selection criterion for treatment decisions.AcknowledgementsSupported in part by a research Grant from Investigator-Initiated Studies program of MSD Disclosure of InterestJ. Marona Grant/research support from: MSD, A. Sepriano Grant/research support from: MSD, S. Rodrigues-Manica Grant/research support from: MS...