Objective: To study the association between self-reported physical activity level and overall attitudes and barriers to and facilitators of physical activity in people with axial spondyloarthritis (axSpA), and to compare health status and quality of life (QoL) in people with different levels of physical activity. Methods: Four hundred forty-five members of the Danish Patient Association for Axial Spondyloarthritis completed an online survey including questions on physical activity, overall attitudes, barriers, and facilitators to physical activity, health, and QoL. Nonparametric tests and logistic regression analyses were performed. Results: The response rate was 46%, median age 56 years (range 22-85), and 54% were men. In all, 23% reported low physical activity (physical activity ≥30 min on a moderate intensity level ≤1 day/week), 36% were moderately physically active (2-3 days/week), and 41% reported high physical activity (≥4 days/week). In a multivariate model, high physical activity was associated with a positive overall attitude ("physical activity is ok," OR 5.44, 95%CI [1.24, 23.87], and "I like physical activity," OR 14.22, 95%CI [3.34, 60.61]), and higher disagreement with barriers to physical activity, OR 1.12, 95%CI [1.07, 1.17]). People with moderate or high physical activity levels reported better self-perceived health and QoL, compared with those with low physical activity level (p ≤ 0.003). Conclusion: To support changes in physical activity level in people with axSpA, health professionals need to discuss attitudes and barriers to physical activity with their clients. Barriers seem to be of greater significance than facilitators of any kind.

Background:Barriers such as high disease activity, fatigue, pain, stiffness, physical exertion and lack of time all have a negative impact on physical activity level in people with axial Spondyloarthritis (axSpA), while more time is a facilitator (1, 2). In addition, an intrinsic drive to exercise is an important motivator, guided by personal interest and enjoyment in exercise (1). There is a need for a better understanding of the impact of barriers, facilitators and attitudes on level of physical activity.Objectives:To study the association between self-reported level of physical activity and self-perceived health, attitudes, barriers and facilitators to physical activity in people with axSpA.Methods:In 2018, members with axSpA from the Danish Patient Association for Spondyloarthritis were invited to participate in an on-line survey. The questionnaire included diagnosis, socio-demographics, self-perceived health (poor, fair or good), level of physical activity (≤ 1 day/week, 2-3 days/week or 4-7 days/week) overall attitude (I do not care and I do not know, it’s ok or I like physical activity), barriers and facilitators toward physical activity (range 8-56, low to high disagreement). A logistic regression analysis was applied to study associations between level of physical activity (dependent variable) and attitudes, barriers, facilitators and self-perceived health (independent variables).Results:445/972 members (46%) completed the questionnaire. Median age was 56 years (range 22-85), 241 (54%) were men. 23% were physically active for at least 30 minutes on a moderate intensity level ≤ 1 day/week, 36% 2-3 days/week and 41% 4-7 days/week. Responders who were physically active ≥ 2 days/week had more positive attitudes to physical activity (p< 0.001), disagreed more often to suggested barriers (p<0.001), and had better self-perceived health (p<0.003) compared with those who reported a low physical activity level (≤ 1 day/week). In the regression analysis, positive attitudes (OR 14.21, 95%CI 3.34 - 60.53) and a higher disagreement with barriers for physical activity (OR 1.12, 95%CI 1.07 - 1.17) were associated with high level of physical activity.Conclusion:The overall attitude and experienced barriers towards physical activity have a strong impact on the level of physical activity in people with axSpA. To support lifestyle changes, health professionals need to discuss the impact of barriers and attitudes to physical activity with their clients.References:[1]Brophy S et al (2013). The effect of physical activity and motivation on function in ankylosing spondylitis: A cohort study. Semin Arthritis Rheum 42: 619–626.[2]Fongen C et al. (2015). Barriers and Facilitators for Being Physically Active in Patients with Ankylosing Spondylitis: A Cross-sectional Comparative Study. Musc. Care 13: 76–83.Figure 1.Percentage agreement with barriers and facilitators for physical activity. PA: Physical activity, PT: PhysiotherapistDisclosure of Interests:Jens Ole Rasmussen: None declared, Willy Fick: None declared, Jette Primdahl Speakers bureau: BMS and Pfizer, Ann Bremander: None declared

People with inflammatory arthritis (IA) treated with immunosuppressive disease-modifying anti-rheumatic drugs (DMARDs) were initially considered to have an increased risk of severe illness from the SARS-CoV-2 virus compared to the general population. The aim of this study was to explore how people with IA experienced restrictions during the pandemic and the possible impact of vaccination on their protection against COVID-19 and their everyday lives. Nineteen people with IA were interviewed in May–August 2021; shortly thereafter they were enrolled in the Danish national COVID-19 vaccination programme. Concurrently, society gradually reopened after a national complete lockdown. The analysis was inspired by inductive qualitative content analysis. Participants expressed a lack of targeted information on the specific risk associated with IA if they contracted COVID-19. They had to define their own level of daily-life restrictions to protect themselves and their families. They were impacted by inconsistent announcements by the authorities, and some expressed concerns regarding the potential influence of DMARDs on vaccine effectiveness. A societal spirit of being “in this together” emerged through the lockdown, and some were concerned that the reduced level of restrictions in the reopened society would put them at higher risk of a COVID-19 infection and force them to continue self-isolating.