AB0790 Effects of physical activity on disease activity and clinical enthesitis scores in patients with spondyloarthritis

Abstract

BackgroundRegular physical activity (PA) highly recommended for patients with inflammatory diseases [1]. It was shown to significantly improve disease activity [1]. However, data regarding the effects of physical activity on disease activity and clinical enthesitis scores in patients with SA are scarce.ObjectivesWe aim to assess the effects of performing PA on disease activity and clinical enthesitis scores in patients with SA.MethodsWe performed a cross-sectional study including patients with axial spondyloarthritis. Each patient was asked if he performed regular physical activity. Clinical disease activity scores were calculated: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score using C-Reactive Protein (ASDAS-CRP). Clinical enthesitis scores were calculated: Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) [2], Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC) [3] and Leeds Enthesitis Index (LEI) [4].ResultsThirty-seven patients were included: 29 males and 8 females. The mean age was 44.51±12.08 years. The mean disease duration of 9±7.8 years. Regular PA was reported by 51% patients (19). Aerobic exercise was performed by 48.6% of patients (walking: 27%, jogging: 8.1%, football: 5.4%, biking: 2.7%, handball: 2.7% and fitness exercise: 2.7%). Anaerobic exercise was performed by only one patient (2.7%) and consists of weightlifting.The mean weekly duration of PA was of 4.32±3.4 hours. Means BASDAI, ASDAS-CRP, and ASDAS-ESR were of 4.74±2.2, 3.02±1.2 and 3.26±1.3, respectively. Mean MASES was of 2.95±2.86, LEI of 1.51±1.72 and SPARCC of 2.97±3.42. Patients who performed regular PA had significantly lower disease activity evaluated with BASDAI (3.53 vs 5.45, p=0.007), ASDAS-CRP (2.64 vs 3.44, p=0.045) and ASDAS-ESR (2.84 vs 3.7, p=0.44).Clinical enthesitis scores were also significantly lower in physically active patients (MASES: 1.74 vs 4.22, p=0.007, LEI: 0.95 vs 2.11, p=0.038, SPARCC: 1.79 vs 4.22, p=0.029).However, no significative difference was found between the two groups regarding CRP (16.11 mg/L vs 39.67 mg/L, p=0.107).No correlation was found between the weekly number of hours of PA and the evaluated scores.ConclusionPhysical activity was associated with lower disease activity scores and lower clinical enthesitis score. This highlights the importance of physical activity as a non-pharmacologic treatment in SA for the management of disease activity and entheseal involvement.