Physical activity and sedentary behaviour and their associations with clinical measures in axial spondyloarthritis

Abstract

Engaging in physical activity (PA) is a key aspect in the management of axial spondyloarthritis (axial SpA), however, its relationship with clinical measures is unknown. Previous research has mainly focused on subjective methods of measuring PA and sedentary behaviour (SB). The aim of this study was to explore the associations between objectively measured PA and SB with clinical measures in people with established axial SpA. Fifty participants were recruited from secondary-care rheumatology outpatient services in Glasgow, UK. Clinical measures collected included; Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQOL) and the Six Minute Walk Test (6MWT). PA and SB were measured using the activPAL3 tri-axial accelerometer. Data from forty-five participants were included (23 males, average age 49 ± 12 years). Participants accumulated an average of 93.2 ± 41.5 min/day walking with an average of 7200 ± 3397 steps/day. The majority of the day (65%) was spent sitting, accumulated in prolonged bouts. Walking time and steps taken/day were associated with better BASFI (r = − 0.395, p = 0.007 and r = − 0.404, p = 0.006), ASQOL (r = − 0.375, p = 0.011 and r = − 0.361, p = 0.015) and 6MWT (r = 0.396, p = 0.007 and r = 0.421, p = 0.004); while longer walking events were associated with better BASMI (rho = − 0.352, p = 0.018), BASFI (rho = − 0.316, p = 0.034) and 6MWT (rho = 0.404, p = 0.006). SB was associated with worse ASQOL (r = 0.380, p = 0.010) and 6MWT (6MWT, r = − 0.357, p = 0.016). In people with axial SpA PA is associated with better function, exercise capacity and spinal mobility, while SB is associated with lower exercise capacity and poor quality of life. These findings support the promotion of PA and reduction of SB in people with axial SpA.

Objective Measurements of Physical Activity and Sedentary Behavior Using Wearable Devices in Patients With Axial Spondyloarthritis: Protocol for a Systematic Review

“…At this point, however, recent studies have demonstrated that self-reported physical activity is a less valid and less reliable method for measuring physical activity in patients with axSpA than device-measured physical activity [32,33]. These results support the use of wearable devices for objective assessment of physical activity or sedentary behavior in patients with axSpA [14,32,[34][35][36][37][38] as well as in patients with rheumatoid arthritis (eg, [34]). At this point, however, to the best of our knowledge, no systematic review has identified and synthesized the available evidence on the use of wearable devices for this specific population.…”

“…Some clinical manifestations of axSpA are inflammatory back pain and spinal stiffness [4][5][6][7]. It is now well established that practicing regular exercise results in health benefits in patients with axSpA by managing correctly inflammatory joint diseases [8][9][10], pain [11], and stiffness [11]; by decreasing disease activity [12]; and by improving physical functioning [13,14], spinal mobility [14,15], and cardiorespiratory function [16]. Interestingly, lack of exercise has been identified as a risk factor for the appearance of depressive symptoms [17], suggesting the benefits of practicing physical activity to manage mental comorbidities of axSpA [17].…”

Gait and Axial Spondyloarthritis: Comparative Gait Analysis Study Using Foot-Worn Inertial Sensors (Preprint)

“…Only a few studies have assessed gait in the broader spectra of axSpA [13,26,39]. What is more, these studies have used clinical measurements of gait (ie, 6-min walk test [26] or 6-meter maximum velocity test [39]) without a healthy control group for comparison. Inconsistent results were found in patients with AS regarding spatiotemporal gait parameters [15][16][17][18], which may be explained by the rather small sample sizes of these studies and by self-reported pain intensity scores reported by the patients at the time of the evaluation.…”

Spondyloarthritis on the Move: Biomechanical Benefits or Harm

“…In 45 AxSpA patients, physical activity was recorded for one week with an accelerometer. Walking time and number of steps taken per day were associated with better Bath AS Functional Index (BASFI), AS Quality of Life (ASQOL) and 6-Minute Walk Test (6MWT) outcomes, and longer walking events were associated with a better Bath AS Metrology Index (BASMI), BASFI and 6MWT reports [13]. Because of the cross-sectional nature of the study, causality cannot be determined, but multiple recent studies confirm the beneficial effect of general physical activity in SpA patients, in particular on disease activity and measurements of physical functioning.…”