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

Elaine H Coulter,Stefan Siebert,Marie Therese Mcdonald,Sara Cameron,Lorna Paul

doi:10.1007/s00296-019-04494-3

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.

Highlights

Axial spondyloarthritis, including ankylosing spondylitis and non-radiographic axial SpA, is a chronic inflammatory arthritis characterised by reduced spinal mobility and function and an increased risk of cardiovascular events [1, 2]
Physical activity (PA) and sedentary behaviour (SB) data were missing for five participants [allergy to Tegaderm dressing (n = 1), instrument error (n = 3) and researcher error (n = 1)]; complete data were available for 45 participants
The results demonstrate objective PA outcomes are associated with better function (BASFI), exercise capacity (6MWT) and spinal mobility (BASMI), while SB outcomes are associated with exercise capacity (6MWT) and quality of life (ASQoL) in people with axial SpA

Summary

Introduction

Axial spondyloarthritis (axial SpA), including ankylosing spondylitis and non-radiographic axial SpA, is a chronic inflammatory arthritis characterised by reduced spinal mobility and function and an increased risk of cardiovascular events [1, 2]. Physical activity (PA) and exercise, a subcategory of PA, are key aspects in the management of people with axial SpA [3, 4]. Rheumatology International (2020) 40:375–381 and predominance of sedentary behaviour (SB), are independent risk factors for co-morbidities, such as cardiovascular disease, in the general population [6] and, should be considered in axial SpA symptom and co-morbidity management. Physical fitness components (aerobic capacity, strength and body fat percentage) were associated with functional ability [8, 9] and disease activity [10]. The relationship between PA and/or SB with clinical measures such as spinal mobility, functional ability and exercise capacity in people with axial SpA is unknown. The aim of this study was to explore the associations between objectively measured PA and SB with axial SpA clinical measures

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Discussion

Conclusion