Mental health status and leisure‐time physical activity contribute to fatigue intensity in patients with spondylarthropathy

Abstract

Objective. To examine the relationship between disease-related variables, leisure-time physical activity (LTPA), and mental health status with fatigue severity in patients with spondylarthropathy (SpA). Methods. Sixty-six SpA patients completed questionnaires assessing disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), functional ability (Bath Ankylosing Spondylitis Functional Index), and health-related quality of life (Short Form 36). LTPA patterns, demographics, and disease-related data were obtained by interview. A clinical examination determined tender point count. Fatigue was assessed with the BASDAI fatigue item. Results. The mean BASDAI fatigue score was 5.5 (SD ‫؍‬ 2.7) with 59% of the sample obtaining a score >5. Disease activity, functional disability, and worse mental health contributed to greater fatigue (R 2 ‫؍‬ 0.56). The relationship between exercise duration and fatigue intensity was moderated by mental health status. For patients with poorer mental health scores, exercise did not influence fatigue severity. However, for patients reporting better mental health status, engaging in more LTPA decreased fatigue severity. Conclusion. In addition to increased disease activity and functional disability, greater fatigue severity in SpA is associated with poorer mental health status. Integrating regular leisure physical activity into the comprehensive treatment of SpA may be useful for modulating fatigue.

Fatigue in patients with ankylosing spondylitis: prevalence and relationships with disease-specific variables, psychological status, and sleep disturbance

“…Similar relationships between fatigue and measures of self-reported disease activity, limitations in functional abilities, stiffness, and pain have also been reported by others [9,18,20,24,25].…”

“…In studies where BASDAI fatigue questions were used and threshold value for fatigue taken as C5, the frequency was reported as 53-63% [9,23,24]. In our research, 66.4% of all patients experienced fatigue, defined as a BASDAI fatigue score of C5.…”

Assessment of Fatigue in Undifferentiated Spondyloarthritis (USpA)

“…Our findings suggest that fatigue is an important symptom in USpA. The other study reported that Fifty-nine percent of patients with SpA moderate to high levels of fatigue [15]. In this study, fatigue levels of the patients were found to be related to disease-specific variables [duration of morning stiffness, history of night pain, chest expansion, BASDAI, BASFI], level of axial and peripheral joint pain, the MAF and HRQOL.…”

Determinants of sleep problems in patients with spondyloarthropathy

“…Poor sleep may play a more important role than is generally believed in the level of fatigue experienced by patients with SpA (Da Costa et al, 2004). Our fi ndings highlight the need to routinely assess sleep problems in this patient population.…”