Physical Activity Assessment in Patients with Axial Spondyloarthritis Compared to Healthy Controls: A Technology-Based Approach

Abstract

IntroductionTraditionally, assessment in axial Spondyloarthritis (aSpA) includes the evaluation of the capacity to execute tasks, conceptualized as physical function. The role of physical activity, defined as movement-related energy expenditure, is largely unknown and almost exclusively studied using patient-reported outcome measures. The aims of this observational cross-sectional study are to compare physical activity between patients with aSpA and healthy controls (HC) and to evaluate the contribution of disease activity to physical activity differences between groups.MethodsForty patients with aSpA were matched by age, gender, period of data acquisition in terms of days and season to 40 HC. Physical activity was measured during five consecutive days (three weekdays and two weekend days) using ambulatory monitoring (SenseWear Armband). Self-reported disease activity was measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Differences in physical activity between patients with aSpA and HC were examined with Wilcoxon signed-rank tests and a mixed linear model. Difference scores between patients and HC were correlated with disease activity.ResultsAverage weekly physical activity level (Med(IQR); HC:1.54(1.41–1.73); aSpA:1.45(1.31–1.67),MET) and energy expenditure (HC:36.40(33.43–41.01); aSpA:34.55(31.08–39.41),MET.hrs/day) were significantly lower in patients with aSpA. Analyses across intensity levels revealed no significant differences between groups for inactivity and time spent at light or moderate physical activities. In contrast, weekly averages of vigorous (HC:4.02(1.20–12.60); aSpA:0.00(0.00–1.20),min/d), very vigorous physical activities (HC0.00(0.00–1.08); aSpA:0.00(0.00–0.00),mind/d) and moderate/(very)vigorous combined (HC2.41(1.62–3.48); aSpA:1.63(1.20–2.82),hrs/d) were significantly lower in patients with aSpA. Disease activity did not interact with differences in physical activity between patients with aSpA and HC, evidenced by non-significant and very low correlations (range: −0.06–0.17) between BASDAI and HC-aSpA patients' difference scores.ConclusionsPatients with aSpA exhibit lower physical activity compared to HC and these differences are independent of self-reported disease activity. Further research on PA in patients with aSpA should be prioritized.

Decreased physical activity and cardiorespiratory fitness in adults with ankylosing spondylitis: a cross-sectional controlled study

“…Sedentary behaviour in AS is under-researched and poorly understood. Few studies have objectively measured sedentary behaviour and PA in an SpA cohort [18,19]. Methodological limitations and heterogeneity of accelerometry outcome variables limit direct comparisons to these studies and prevent firm conclusions from being drawn [17].…”

“…A recent systematic review identified two studies which objectively measured PA in adults with AS and compared results to population controls [17][18][19]. Results from these studies are equivocal; PA levels among adults with AS may be lower than, or equivalent to, the general population.…”

Instrumented BASFI (iBASFI) Shows Promising Reliability and Validity in the Assessment of Activity Limitations in Axial Spondyloarthritis

“…Semiautomated accelerometer algorithms with proven psychometric properties exist in patients with parkinsonism and stroke, but are limited to selected tests such as walking, standing, and sit-to-stand (STS) activities 23,24,25 . In patients with axSpA, the use of body-worn sensors is still in its infancy and focuses on accelerometer algorithms for physical activity assessment 26 . Therefore, our proof-of-concept study aimed to (1) present the development of the instrumented BASFI (iBASFI), adding fully automated algorithms during PBM to obtain activity capacity outcomes in axSpA, (2) evaluate the test-retest reliability of the automated algorithms and their criterion validity in comparison with manual feature selection in axSpA, (3) compare these novel activity capacity outcomes for construct validity to chronometer-based PBM and the BASFI; and (4) create a preliminary optimal set of PBM that reflected the BASFI best.…”

Spondyloarthrites. La rééducation : pour qui, quand, comment ?

“…Des études cas-témoin montrent certes que la consommation maximale en oxygène à l'effort exprimée en moyenne est diminuée chez les patients atteints de spondyloarthrite comparativement aux témoins indemnes [5,6]. La diminution de l'activité physique attendue en conséquence chez ces patients n'est en revanche qu'inconstamment retrouvée [7][8][9][10]. Dans l'étude la plus vaste, regroupant plus de 2000 patients sué-dois, les deux tiers avaient une activité physique en accord avec les recommandations de l'Organisation mondiale pour la santé, et le risque standardisé d'activité physique était de 1,09 (IC95 1,04-1,15), indiquant un niveau d'activité physique légèrement supérieur à celui observé dans la population générale [8].…”