Abstract
IntroductionThis study aimed to compare the engagement in moderate- and vigorous-intensity PA in axSpA patients with and without current physical therapy (PT).MethodsIn this cross-sectional study, a survey, including current PT treatment (yes/no) and PA, using the ‘Short QUestionnaire to ASsess Health-enhancing PA’ (SQUASH), was sent to 458 axSpA patients from three Dutch hospitals. From the SQUASH, the proportions meeting aerobic PA recommendations (≥ 150 min/week moderate-, ≥ 75 min/week vigorous-intensity PA or equivalent combination; yes/no) were calculated. To investigate the association between PT treatment and meeting the PA recommendations, odds ratios (OR) with 95% confidence intervals (95% CI) were estimated using logistic regression models, adjusting for sex, age, health status and hospital.ResultsThe questionnaire was completed by 200 patients, of whom 68%, 50% and 82% met the moderate-, vigorous- or combined-intensity PA recommendations, respectively. Ninety-nine patients (50%) had PT treatment, and those patients were more likely to meet the moderate- (OR 2.09 [95% CI 1.09–3.99]) or combined-intensity (OR 3.35 [95% CI 1.38–8.13]) PA recommendations, but not the vigorous-intensity PA recommendation (OR 1.53 [95% CI 0.80–2.93]). Aerobic exercise was executed in 19% of individual PT programs.ConclusionAxSpA patients with PT were more likely to meet the moderate- and combined-intensity PA recommendations, whereas there was no difference in meeting the vigorous-intensity PA recommendation. Irrespective of having PT treatment, recommendations for vigorous-intensity PA are met by only half of the patients. Implementation should thus focus on aerobic PA in patients without PT and on vigorous-intensity PA in PT programs.
Highlights
This study aimed to compare the engagement in moderate- and vigorous-intensity physical activity (PA) in axSpA patients with and without current physical therapy (PT)
This study found that people with axSpA who were having PT treatment were more likely to meet the moderate- and combined-intensity aerobic PA recommendations than those without PT, whereas there were no differences in meeting the vigorous-intensity PA recommendation
The finding that having PT treatment was associated with meeting aerobic PA recommendations was not necessarily expected, because PT programs may not include aerobic PA and those who need PT treatment are expected to have more physical limitations and may be less physically active
Summary
This study aimed to compare the engagement in moderate- and vigorous-intensity PA in axSpA patients with and without current physical therapy (PT). Dosed aerobic physical activity (PA) according to public health recommendations improves cardiorespiratory fitness in people with axSpA [13, 14] and might reduce the cardiovascular risk. For this reason, it is advocated in international recommendations on PA in people with rheumatic and musculoskeletal conditions [15]. Recent studies suggest that vigorousintensity PA is most effective in improving cardiorespiratory fitness and reducing cardiovascular risk [10, 16,17,18] and it shows to be both beneficial and safe for people with axSpA [19, 20]. Especially vigorous-intensity PA should be pursued by people with axSpA, at least by those without an increased risk of cardiovascular complications during exercise
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