BackgroundRheumatoid arthritis (RA) and ankylosing spondylitis (AS) are among the most common rheumatic (joint) conditions. RA and AS are different types of arthritis. Living with RA or AS can significantly affect your quality of life, mental health, and emotional well-being.ObjectivesWe report the preliminary results of an ongoing prospective observational study that compare the body awareness, physical activity, kinesiophobia, pain catastrophizing and psychosocial status in individuals with RA and AS.MethodsA total of 78 individuals (RA=48; AS=30; women/men=48/30) recruited from two university hospitals in Turkey. All individuals were assessed regarding physical characteristics (age, BMI, duration of disease, BASDAI, DAS-28); body awareness by Body Awareness Questionnaire, physical activity level by International Physical Activity Questionnaire Short Form, fear of movement by Tampa Scale of Kinesiophobia, pain catastrophizing by Pain Catastrophizing Scale and psychosocial status by Beck Depression Inventory.ResultsIndividuals’ characteristics and outcome measures are presented in Table 1. As expected, there were statistical differences between age and gender in study groups (p<0.001). However, disease duration and disease activity, mild depression level were similar between groups. Individuals with AS were significantly more physically active compared to individuals with RA (p<0.005). Body awareness, kinesiophobia, pain catastrophizing and psychosocial status were similar between groups (p>0.05). In addition, disease activity was moderately correlated with body awareness, pain catastrophizing and kinesiophobia individuals with AS (r=-0.529; r=0.613; r=0.427, p<0.05).ConclusionTreatment of RA and AS is similar, but there are key differences. According to our results, individuals with AS is more physically active than individuals with RA regardless of disease duration and disease activity. Health professionals can also focus on correlation between disease activity and higher body awareness, pain catastrophizing and kinesiophobia in individuals with AS.References[1]Oskay D, Tuna Z, Düzgün İ, Elbasan B, Yakut Y, Tufan A. Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis. Turk J Med Sci. 2017 Nov 13;47(5):1340-1347. doi: 10.3906/sag-1702-93. PMID: 29151302.[2]Baday-Keskin D, Ekinci B. The relationship between kinesiophobia and health-related quality of life in patients with rheumatoid arthritis: A controlled cross-sectional study. Joint Bone Spine. 2022 Mar;89(2):105275. doi: 10.1016/j.jbspin.2021.105275. Epub 2021 Sep 15. PMID: 34536623.Table 1.Characteristics of patients and outcome measuresPatients’ characteristicsRA n=48AS n=30p*Age (year): mean ± SD51.34 ± 11.040.27 ± 10.380.000*BMI (kg/m2): mean ± SD28.21 ± 4.4726.66 ± 5.780.101Gender (n, %)Female41 (85.4%)7 (23.3%)0.000*Male7 (14.6%)23 (76.7%)Duration of disease (year): mean ± SD7.20 ± 9.395.91 ± 7.280.488ESR (mm/h)13 (2-58)9 (3-54)0.115CRP (mg/dl)3.65 (0.18-37.70)5.2 (0.60-49.06)0.300BASDAI (0-10)n (%)Active disease18 (60)Inactive disease12 (40)DAS-28n (%)Remission24 (50)Low activity12 (25)Moderate activity12 (25)Outcome measuresBDI (0-29)14.5 (0-45)14 (0-42)0.991IPAQ-SF594 (0-4380)1188 (66-5805)0.005*PCS (0-52)29 (4-51)27 (7-50)0.610TSK (0-68)39 (23-56)42.5 (25-57)0.102BAQ (18-126)94 (50-126)91.5 (49-1200)0.463RA= Rheumatoid arthritis; AS= Ankylosing spondylitis; SD= Standard deviation; BMI= Body mass index; ESR= Erythrocyte sedimentation rate; CRP= C reactive protein; Bath Ankylosing Spondylitis Disease Activity Index, BDI= Beck Depression Inventory. IPAQ-SF= International Physical Activity Questionnaire-Short Form; PCS= Pain Catastrophizing Scale; TSK= Tampa Scale for Kinesiophobia; BAQ: Body Awareness Questionnaire.*Mann-Whitney U test.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundAnkylosing spondylitis (AS) is a rheumatic disease that affects patients in a biopsychosocial framework due to its chronic inflammatory nature. It is known that patients with AS experience negative body judgment and insecurity and anxiety about their bodies [1], high levels of fear of movement, depression [2], low level of physical activity [3].ObjectivesThe aim of this study was to investigate the effects of disease activity (DA) on depression, physical activity, pain catastrophizing, fear avoidance, and body awareness in patients with ankylosing spondylitis.MethodsThirty AS patients were included in the study. Socio-demographic informations of patients were collected. The mean age of the patients was 40.27 ± 10.38 years. Beck Depression Inventory (BDI), International Physical Activity Questionnaire-Short Form (IPAQ-SF), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), and Body Awareness Questionnaire (BAQ) were used for depression, physical activity, pain catastrophizing, kinesiophobia and body awareness levels of the patients, respectively. DA was measured with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and a score of four and higher than four was considered active.ResultsPatients characteristics were similar between the groups (p>0.05). A statistically significant difference was observed in PCS (p= 0.004), TSK (p=0.007), and BAQ scores (p=0.015) when the groups were compared (Table 1). The patients in the low DA group had mild depression, and the group with high DA had moderate depression. Catastrophizing pain and fear of movement were higher in the group with higher DA; body awareness level was lower (p<0.05). A high kinesiophobia level was detected in both groups.ConclusionIt was observed that high disease activity negatively affected catastrophic thoughts, body awareness, and kinesiophobia in patients with AS. These parameters should be considered in the management of disease activity in AS patients for optimum results.References[1]Guenther, V., et al.,Body image in patients with ankylosing spondylitis.Clin Exp Rheumatol, 2010.28(3): p. 341-7.[2]Oskay, D., et al.,Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis.Turkish journal of medical sciences, 2017.47(5): p. 1340-1347.[3]O’Dwyer, T., F. O’Shea, and F. Wilson,Physical activity in spondyloarthritis: a systematic review.Rheumatology international, 2015.35(3): p. 393-404.Table 1.Patients characteristics and outcome measuresPatients CharacteristicsTotal n=30High Disease Activity n= 18Low Disease Activity n= 12p-value*Age (year): mean ± SD40.27 ± 10.3839.39 ± 9.4141.58 ± 12.00.518BMI (kg/m2): mean ± SD26.66 ± 5.7827.00 ± 6.9226.16 ± 3.810.790Gender (n, %)Female7 (23.3%)520.632Male23 (76.7%)1310Duration of disease (year): mean ± SD5.91 ± 7.284.77 ± 6.547.56 ± 8.360.556CRP (mg/dl)5.2 (0.60-49.06)5 (0.70-49.06)5.6 (0.60-23.40)0.884ESR (mm/h)9 (3-54)10 (3-54)7.5 (3-21)0.811BASDAI (0-10)5.2 (1.40-8.90)6.75 (4.0-8.90)3.05 (1.40-3.85)0.000Outcome MeasuresBDI (0-63)14 (0-42)18 (6-42)13.5 (0-24)0.107IPAQ-SF1188 (66-5805)1287 (198-5805)1089 (66-4158)0.450PCS (0-52)27 (7-50)35.5 (7-50)17 (10-30)0.004TSK (0-68)42.5 (25-57)44.5 (34-57)39 (25-47)0.007BAQ (18-126)91.5 (49-120)80 (49-118)108 (83-120)0.015Values are medians (minimum-maximum) unless otherwise stated. AS= Ankylosing spondylitis; SD= Standard deviation; BMI= Body mass index; m= meter; kg= kilogram; CRP= C reactive protein; ESR= Erythrocyte sedimentation rate; BDI= Beck Depression Inventory; IPAQ-SF= International Physical Activity Questionnaire-Short Form; PCS= Pain Catastrophizing Scale; TSK= Tampa Scale for Kinesiophobia; BAQ= Body Awareness Questionnaire.*= Mann-Whitney U test.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundDuring the COVID-19 pandemic, the patients with rheumatic disease in the biopsychosocial perspective have been adversely affected by social isolation, uncertainty, and the thought that their chronic disease will worsen and increase in their symptoms. ACR/EULAR (American College of Rheumatology / European League Against Rheumatism) defines recommendations about continuing current pharmacotherapy and the significance of the biopsychosocial approach and exercise for patients with rheumatic diseases during a COVID-19 infection 1, 2.ObjectivesThis study aims to investigate the effectiveness of the biopsychosocial exercise performed by telerehabilitation on biopsychosocial status, general health status, and anxiety-depression levels in the patients with inflammatory and non-inflammatory rheumatic diseases.MethodsFourteen patients with inflammatory rheumatic diseases (rheumatoid arthritis: 4; ankylosing spondylitis: 4; sjogren’s syndrome: 3; polymyalgia rheumatica: 2; and vasculitis: 1) and eight patients with non-inflammatory rheumatic diseases (fibromyalgia: 6; and osteoarthritis: 2) performed a biopsychosocial-based exercise model (named as “Bilişsel Egzersiz Terapi Yaklaşimi”-(BETY) in original; “Cognitive Exercise Therapy Approach” in English) via telerehabilitation continued for three sessions per week for 12 months 3. Outcome measures were Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), and BETY-Biopsychosocial Questionnaire (BETY-BQ) 4. All outcomes were measured baseline and at the 12th month. The Wilcoxon’s test was used for statistical analysis.ResultsAll of the 22 patients were female. The mean age was 57.4 and 55.8 years in the inflammatory and non-inflammatory rheumatic diseases groups respectively, and they had a mean BMI of 25.9 and 25.3 kg/m2. There was no significant difference by time for HAQ score (p = 0.125), HADS anxiety and depression (p = 0.916 and p = 0.663, respectively), and BETY-BQ score (p = 0.753) between the baseline and at the 12th month follow-up in the patients with inflammatory rheumatic diseases. Similarly, in the patients with non-inflammatory rheumatic diseases, there was no significant difference by time for HAQ score (p = 0.546), HADS anxiety and depression (p = 0.343 and p = 0.527, respectively), and BETY-BQ score (p = 0.068) between the baseline and at the 12th month follow-up.ConclusionThis study showed that biopsychosocial-based exercise through real-time telerehabilitation was able to maintain their conditions before pandemic in biopsychosocial status, general health, and anxiety-depression levels on the patients with inflammatory and non-inflammatory rheumatic diseases during COVID-19 pandemic period in one-year follow-up.References[1]England BR, Barber CE, Bergman M, Ranganath VK, Suter LG, Michaud K. Brief Report: adaptation of American College of Rheumatology Rheumatoid Arthritis Disease Activity and functional status measures for telehealth visits. Arthritis Care Res (Hoboken). 2020.[2]Landewé RB, Machado PM, Kroon F, Bijlsma HW, Burmester GR, Carmona L, Combe B, Galli M, Gossec L, Iagnocco A. EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2. Ann Rheum Dis. 2020;79(7):851-8.[3]Kisacik P, Unal E, Akman U, Yapali G, Karabulut E, Akdogan A. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Complementary therapies in clinical practice. 2016;22:38-43.[4]Edibe Ü, Gamze A, KARACA NB, KİRAZ S, AKDOĞAN A, KALYONCU U, ERTENLİ Aİ, BİLGEN ŞA, KARADAĞ Ö, ERDEN A. Romatizmali hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzunun oluşturulmasi. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):67-75.Disclosure of InterestsNone declared
BackgroundAnkylosing spondylitis (AS) is a rheumatic disease that affects patients in a biopsychosocial framework due to its chronic inflammatory nature. It is known that anti-TNF therapy is given to patients with persistently high disease activity despite conventional treatments according to the ASAS recommendations [1].ObjectivesThe aim of this study was to examine the factors associated with the biopsychosocial status of patients with AS who were decided to be treated with anti-TNF therapy for the first time.Methods76 AS patients who were decided to treated with anti-TNF therapy included in the study. Socio-demographic informations of patients were collected. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) values were recorded for disease activity levels. Biopsychosocial status of the patients was evaluated by the BETY-Biopsychosocial Questionnaire (BETY-BQ). The Bath Ankylosing Spondylitis Functional Index (BASFI) and Health Assessment Questionnaire (HAQ) were used to assess functional and and daily living activities. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression levels.ResultsThe mean age of the patients was 39.99 ± 10.0 years. The mean BASDAI scores indicated active disease and were 5.98 ± 1.78. There was a statistically significant moderate correlation between the BETY and the anxiety and depression subscales of HADS and BASDAI, in the positive direction (r= 0.692, p <0.001 and r= 0.685, p <0.001 and r= 0.552, p <0.001). A statistically significant, strong correlation was found between the BETY, HAQ and BASFI scores in the positive direction (r= 0.834, p <0.001 and r= 0.747, p <0.001) (Table 1). It was observed that patients showed anxiety and depression characteristics according to HADS cut-off values (>10 and >7).ConclusionIt was concluded that the biopsychosocial status of anti-TNF naive patients with AS was affected by anxiety-depression levels, functionality, and disease activity score. In addition to anti-TNF therapy, it was interpreted that the treatment of biopsychosocial characteristics of patients should also be taken into consideration in disease management.Reference[1] Braun Jv, Van Den Berg R, Baraliakos X, Boehm H, Burgos-Vargas R, Collantes-Estevez E, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Annals of the rheumatic diseases. 2011;70(6):896-904.Table 1.Patients characteristics and correlation of outcome measuresPatients Characteristics (n=76)Age (year)39.99 ± 10.0BMI (kg/m2)27.81 ± 5.51Duration of disease (year)4.21 ± 5.65BETY-BQ (0-120)60.0 ±23.7BASDAI (0-10)5.98 ± 1.78BASFI (0-10)5.16 ± 2.31HADS anxiety10.43 ± 4.92 depression8.53 ± 4.34HAQ15.70 ± 9.48CorrelationsBASDAIBASFIHAQHADS-aHADS-dBETY-BQr0.552*0.747*0.834*0.692*0.685*p*0.0000.0000.0000.0000.000*Pearson testAcknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundJuvenile idiopathic arthritis is a chronic rheumatological disease characterized by persistent joint inflammation [1, 2]. This disease, which we can consider to be relatively rare, causes pediatric patients to encounter health problems at an early age and therefore struggle with more questions and problems than their peers [3]. At this point, it is important that both children and their families have access to adequate and accurate information about health and that they can use this information [4]. Access to health-related information has brought the concept of “health literacy”, which has become more important in recent years, to the agenda [5].ObjectivesOur primary aim is to reveal the health literacy levels of children with JIA and their caregivers by using the Turkish Health Literacy-32 (THL-32), Adult Health Literacy Scale (AHLS) and Turkish version of the Health Literacy for School-Aged Children (HLSAC-T) the validity and reliability studies of which have been done before [6-8]. In addition, revealing the relationship between health literacy and the health status and quality of life of children with JIA is the secondary main aim of the study. Another secondary aim is to evaluate the physical limitations and functional capacity caused by JIA.MethodsThis cross-sectional study was conducted between September and December 2022 at Hacettepe University. Inclusion criteria were a confirmed JIA diagnosis according to the International League Against Rheumatism (ILAR) criteria, aged between 9–18 years. Children and one of their parents were invited to study. Demographic data, clinical findings, laboratory findings, and previous treatment information were recorded retrospectively from patient files and by asking the participants themselves.THL-32, AHLS, and HLSAC-T questionnaires were used to assess health literacy. Functional ability was assessed with the Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) [9]. The Juvenile Arthritis Biopsychosocial Questionnaire (JAB-Q) was used to evaluate the problems experienced by both the child and the parent from a biopsychosocial perspective [10]. The 6-minute walk test (6MWT), 10-meter walking test (10-MWT) and 10-stair climbing test (10-SCT) were used to evaluate the physical and exercise capacity of children [11, 12].ResultsSeventy-nine patients with JIA and one of their parents were included in the study. The patients’ mean age was 13.67 ± 2.80 years, and 60.8% of them were female. The mean disease duration was 6.75 ± 4.28 years. The JIA subtypes were as follows: 39 (49.4%) had oligoarticular JIA; 15 (19.0%) had polyarticular JIA; 19 (24.1%) had enthesitis-related arthritis; and 6 (7%) had systemic JIA.Following the THL-32 scale scoring, level of parents’ health literacy resulted in the following percentages: inadequate, 3.8%; problematic, 22.8%; sufficient, 34.2%; and excellent, 39.2%. From a total of 79 patients with JIA, 16.5% had low HL, %55.7 had moderate HL, and 27.8% had high HL. The mean age of children with high health literacy was statistically older than the group with medium health literacy (p< 0.017). There was no statistically significant relationship between the children’s health literacy and parent health literacy.ConclusionAccording to the results of our study, children’s health literacy levels show a positive increase as they get older, and there is no significant relationship between parents’ health literacy levels. Parents’ health literacy levels and education levels are compatible with the AHLS, which includes objective questions. As the education level of the families increases, positive changes are observed in the CHAQ, JAB-Q parameters and 10-SCT test results. Our study shows that the education level of the families is positively related to the quality of life and physical condition of the children, but health literacy is not statistically related to other parameters other than the age of the children.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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