Moving forward in physical activity, disease activity and acceptable symptom state in patients with axial spondyloarthritis
Moving forward in physical activity, disease activity and acceptable symptom state in patients with axial spondyloarthritis
Physical Activity, Disease Activity and Acceptable Symptom State in Axial Spondyloarthritis.
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease primarily affecting the sacroiliac joints and spine. The disease usually begins in early adulthood and has a considerable impact on daily functioning and quality of life due to pain and stiffness.
The dissertation "Moving Forward in Physical Activity, Disease Activity and Acceptable Symptom State in Patients with Axial Spondyloarthritis" of Marlies Carbo investigated how these aspects together influence the well-being of patients with axSpA.
Despite initiation of biological medication, half of the patients did not fully discontinue NSAID use, suggesting that symptom control with biologicals alone is often insufficient. Three- quarters of the total cohort of patients rated their symptoms as acceptable (measured with PASS), while simultaneously half had active disease (measured with ASDAS ≥2.1). This highlights the added value of PASS alongside ASDAS in treatment decisions and shared decision-making.
For measuring physical activity, the modified SQUASH was developed and validated, showing better validity and responsiveness than the original SQUASH and IPAQ. Only one third of axSpA patients fulfilled all WHO physical activity guidelines; muscle-strengthening activities in particular are insufficiently performed. Supervised group exercise therapy is helpful, but attention to vigorous-intensity activity remains lacking. Higher BMI and the passive coping strategy of reducing activities were independently associated with lower physical activity levels.
Findings from the Groningen Leeuwarden axSpA (GLAS) cohort advocate the need for an integrated biopsychosocial treatment approach in which, alongside medication, attention is given to physical activity, lifestyle and behavioural support.