High disease activity is related to low levels of physical activity in patients with ankylosing spondylitis

Abstract

This study aims to compare physical activity (PA) level and exercise habits in patients with ankylosing spondylitis (AS) who have high disease activity with those who have low disease activity and, further, to compare both groups with population controls. Cross-sectional study design was used. The participants include 149 patients (mean age 49.3 (SD 11.1), 61% men, 54% high disease activity) and 133 controls (mean age 52.7 (SD11.3), 58% men). PA was reported with the International PA Questionnaire-Long and results were presented as weekly energy expenditure (metabolic equivalent, MET) in different intensities, domains, and proportion reaching health enhancing physical activity (HEPA). Types of PA were registered in a structured interview. The AS Disease Activity Score was used to assess patients' disease activity. Patients with high disease activity reported significantly lower total weekly energy expenditure (MET) than patients with low disease activity and controls (p = 0.02, p = 0.01, respectively) and lower amounts of walking (p < 0.01, p = 0.02, respectively) and vigorous activity (p = 0.06, p = 0.06, respectively). Only 41% of the patients with high disease activity reached HEPA compared to 61% of the patients with low disease activity (p = 0.02). Patients in general participated less in leisure PA performed outdoor and with higher intensities (MET ≥ 6) than controls.AS patients with high disease activity had lower weekly energy expenditure in PA than patients with low disease activity and controls, and were less likely to reach HEPA than patients with low disease activity. For optimal management, health professionals should focus on physical activity in their consultations with AS patients, especially those with high disease activity.

Affective temperament profile in ankylosing spondylitis patients using TEMPS-A

“…disease activity, severity, or treatment, or to patient-related characteristics? Whether the level of physical activity is related to disease activity is uncertain, some studies finding no correlation38 ) , others reporting that patients with high disease activity exercised less39, 40 ) or reversely, more41 ) . Furthermore, other factors such as patients’ willingness and motivations to exercise may be more important to explain physical activity.…”

Barriers and Facilitators for Being Physically Active in Patients with Ankylosing Spondylitis: A Cross-sectional Comparative Study

“…Not surprisingly, pain was also frequently reported as a barrier in our study. Studies have demonstrated that a large proportion of patients with AS are less physically active than is recommended for health promotion (Fongen et al, ; Haglund et al, ; Passalent et al, ; Santos et al, ; Sundstrom et al, ; Swinnen et al, ; Uhrin et al, ). This indicates that patients with AS cannot simply be given general physical activity recommendations; they also need advice from health professionals with the necessary knowledge about physical activity and disease pathology in order to overcome the disease‐related barriers to physical activity.…”

“…Regular exercise should be part of disease management through the course of the disease and may have beneficial effects on spinal mobility, physical function, general well‐being, pain and disability (Dagfinrud et al, ; van den Berg et al, ). Despite this, studies have demonstrated that a large proportion of patients with AS are less physically active than recommended (Fongen et al, ; Haglund et al, ; Passalent et al, ; Santos et al, ; Sundstrom et al, ; Swinnen et al, ; Uhrin et al, ), so more knowledge about factors that influence participation is needed.…”

“…However, in patients with AS, barriers such as fatigue, lack of time and the fact that exercise is tiring are reported to be negatively related to participation in physical activities (Da Costa et al, 2004;Passalent et al, 2010;Sundstrom et al, 2002). Factors that are related to being physically active are beliefs in the benefits of exercise, higher educational level, motivation and medical follow-up by a rheumatologist rather than a general practitioner (Brophy et al, 2013;Haglund et al, 2012;Passalent et al, 2010;Santos et al, 1998;Sundstrom et al, 2002), whereas inconclusive results have been found regarding self-efficacy (Barlow, 1998;Lim et al, 2005), disease activity (Arturi et al, 2013;Fongen et al, 2013;Haglund et al, 2012;Santos et al, 1998;Stockdale et al, 2014;Swinnen et al, 2014) and disability (Falkenbach, 2003;Haglund et al, 2012;Santos et al, 1998).…”

Spondyloarthrites. La rééducation : pour qui, quand, comment ?

“…Des études cas-témoin montrent certes que la consommation maximale en oxygène à l'effort exprimée en moyenne est diminuée chez les patients atteints de spondyloarthrite comparativement aux témoins indemnes [5,6]. La diminution de l'activité physique attendue en conséquence chez ces patients n'est en revanche qu'inconstamment retrouvée [7][8][9][10]. Dans l'étude la plus vaste, regroupant plus de 2000 patients sué-dois, les deux tiers avaient une activité physique en accord avec les recommandations de l'Organisation mondiale pour la santé, et le risque standardisé d'activité physique était de 1,09 (IC95 1,04-1,15), indiquant un niveau d'activité physique légèrement supérieur à celui observé dans la population générale [8].…”