Poster Presentation 46th Annual ARA NSW-ACT Branch Meeting 2024

Adherence to National Physical Activity Guidelines in patients with Psoriatic Arthritis (#36)

Stella Watson 1 , Richard Holland 1
  1. Concord Hospital, Concord, NSW, Australia

BACKGROUND AND AIM
Psoriatic Arthritis (PsA) is chronic inflammatory arthritis that occurs in approximately 30% of patients with psoriasis (1). It affects both peripheral and axial joints, and is typified by the presence of enthesitis.  It is also known that patients with psoriatic arthritis have increased cardiometabolic risk (2,3).  Australian exercise guidelines state that adults should be perform moderate-vigorous physical activity on most (preferably all) days (4) to reduce the risk of cardiovascular disease and maintain strength. It is also known that physical activity can improve symptoms and quality of life in patients with PsA (5). Previous overseas observational studies have shown that between 32-87% of patients with PsA do not undertake regular physical activity (6-8).  This may be due to symptoms such as pain or stiffness, or fear of worsening of enthesitis or joint damage. Despite concerns, previous research has demonstrated no adverse effects of exercise on disease activity score or quality of life (5). The European Alliance of Associations for Rheumatology (EULAR) recommendations state that the public health guidelines are applicable for people with inflammatory arthritis (9), and thus physical exercise should form part of standard care.  The aim of this study is to understand the adherence of patients in our PsA clinic to the Australian guideline standards, and to examine if providing education around safe exercising will improve physical activity levels and how this impacts patient reported outcomes.

METHOD
We will perform a randomised controlled trial of patients aged 18-64 with psoriatic arthritis. Baseline physical activity levels and disease impact will be determined using the Active Australia Survey (AAS), and Psoriatic Arthritis Impact of Disease (PsAID) Questionnaire respectively. Patients will then be randomised to receive exercise education and be asked to record daily exercise over the following 12 weeks, or to continue with standard care. After 12 weeks the AAS and PsAID questionnaires will be repeated. 

RESULTS AND CONCLUSION - To be advised 

 

References:

  1. Zachariae H. Prevalence of joint disease in patients with psoriasis: implications for therapy. Am J Clin Dermatol. 2003;4(7):441-7.
  2. Jafri K, Bartels CM, Shin D, et al. Incidence and management of cardiovascular risk factors in psoriatic arthritis and rheumatoid arthritis: a population-based study. Arthritis Care Res2017; 69: 51–57.
  3. Ogdie A, Yu Y, Haynes K, et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis2015; 74: 326–332.
  4. https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians
  5. Kessler, J., Chouk, M., Ruban, T. et al. Psoriatic arthritis and physical activity: a systematic review. Clin Rheumatol 40, 4379–4389 (2021).
  6. Haglund E, Bergman S, Petersson IF, Jacobsson LTH, Strömbeck B, Bremander A (2012) Differences in physical activity patterns in patients with spondyloarthritis. Arthritis Care Res 64:1886–1894.
  7. Larkin L, Gallagher S, Fraser AD, Kennedy N (2016) Relationship between self-efficacy, beliefs, and physical activity in inflammatory arthritis. Hong Kong Physiother J 34:33–40.
  8. Wervers K, Herrings I, Luime JJ, Tchetverikov I, Gerards AH, Hazes JMW, Vis M (2019) Association of physical activity and medication with enthesitis on ultrasound in psoriatic arthritis. J Rheumatol 46:1290–1294.
  9. Rausch Osthoff et al 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018 Sep;77(9):1251-1260.