Background:Axial spondyloarthritis (AxSpA) and rheumatoid arthritis (RA) are two common rheumatic diseases that can result in joint damage and deformities, leading to reduced physical function and quality of life. Physical activity (PA) and exercise have been shown to improve general well-being and reduce cardiovascular risk in patients with AxSpA and RA, and are part of the non-pharmacological management in the EULAR guidelines. Despite this, PA levels are reduced in AxSpA and RA patients1,2. In addition, it has also been reported that Asians have lower levels of PA3.Objectives:This study aims to examine the patterns of PA in a multi-ethnic Asian cohort.Methods:This was a cross-sectional study conducted between May 2016 and Jan 2017. Consecutive patients with AxSpA and RA were recruited at an outpatient rheumatology clinic at Singapore General Hospital, the largest tertiary hospital in Singapore. Controls were based on a previous cross-sectional study4. PA was assessed using the Global Physical Activity Questionnaires (GPAQ) developed by the world health organization (WHO)5.Results:74 AxSpA and 69 RA patients were recruited and compared to 886 controls. AxSpA patients were younger (median age [IQR], 37.0 [26.3] years) and predominantly male (75.7%), while RA patients were the oldest (median age [IQR], 59.0 [16.5] years) and predominantly female (81.2%). BMI was similar between all three groups. RA patients had more comorbidities (such as hypertension, hyperlipidemia, diabetes mellitus) compared to AxSpA patients and controls.All three groups had similar proportion of participants meeting WHO recommendations for PA (AxSpA = 77.0%, RA = 79.7%, controls = 83.1%, p=0.35) and median (IQR) time (95% CI) of PA per day [60 (107.1) vs 57.9 (122.9) vs 51.4 (94.3), p=0.93). More AxSpA patients had a high level of sedentary activity compared to RA or controls (AxSpA = 56.8%, RA = 23.2%, controls = 7.2%, p < 0.01). When comparing AxSpA and RA patients with inactive disease or in remission versus active disease, levels of PA did not differ between the 2 groups (p=0.33).Conclusion:Levels of PA did not differ significant between AxSpA and RA patients compared to the general population, and disease activity levels did not affect the level of PA in patients with AxSpA and RA. Of note was that patients with AxSpA and RA demonstrated higher levels of sedentary activity compared to the general population. Improving PA and decreasing sedentary activity could reduce the cardiovascular risk, especially in patients with RA.References:[1]Summers G, Booth A, Brooke-Wavell K, Barami T, Clemes S. <p>Physical activity and sedentary behavior in women with rheumatoid arthritis: a comparison of patients with low and high disease activity and healthy controls</p>.Open Access Rheumatol Res Rev. 2019;Volume 11:133-142. doi:10.2147/oarrr.s203511[2]Sundstrom B, Ekergård H, Sundelin G. Exercise habits among patients with ankylosing spondylitis.Scand J Rheumatol. 2002;31(3):163-167. doi:10.1080/rhe.31.3.163.167[3]Lip GY, Luscombe C, McCarry M, Malik I, Beevers G. Ethnic differences in public health awareness, health perceptions and physical exercise: implications for heart disease prevention.Ethn Health. 1996;1(1):47-53. doi:10.1080/13557858.1996.9961769[4]Win AM, Yen LW, Tan KH, Lim RBT, Chia KS, Mueller-Riemenschneider F. Patterns of physical activity and sedentary behavior in a representative sample of a multi-ethnic South-East Asian population: A cross-sectional study.BMC Public Health. 2015;15(1):1-11. doi:10.1186/s12889-015-1668-7[5]Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): Nine country reliability and validity study.J Phys Act Heal. 2009;6(6):790-804. doi:10.1123/jpah.6.6.790Disclosure of Interests:Andrew Khor: None declared, Chin Teck Ng: None declared, Warren Fong Consultant of: Abbvie, Janssen, Novartis, Speakers bureau: Abbvie, Janssen, Novartis
Physical activity in patients with axial spondyloarthritis in a multi-ethnic south-east Asian country
