Ab1498 the Biopsychosocial-Based Exercise Model via Telerehabilitation in Patients With Inflammatory and Non-Inflammatory Rheumatic Diseases: A Prospective Cohort Study During the Covid-19 Pandemic

Abstract

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