Study Examines Activity Levels in Patients With Psoriatic Arthritis

Researchers have found that patients with psoriatic arthritis (PsA) show similar levels of physical activity (PA) to healthy patients.

The rationale behind the study stems from previous research indicating that patients with rheumatoid arthritis—another chronic inflammatory arthropathy of the peripheral joints—tend to exercise less than what is recommended, with a multinational study revealing that between 60% and 80% of these patients were physical inactive.

“Although it is known that patients who develop PsA suffer a compromised quality of life and an inability to perform many daily activities, surprisingly no studies have focused on evaluating PA in these patients with respect to controls using either subjective or objectives methods. In addition, the influence of disease activity on PA and, vice versa, on PsA patients remains to be fully clarified.”

The current study leveraged both objective (accelerometry) and subjective (International Physical Activity Questionnaire [IPAQ]) methods to study the behaviors of 70 patients with PsA coupled with 53 healthy controls.

According to accelerometry measurement, there were no differences in the activity kilocalories per day, total kilocalories per day, global vector magnitude, or average total counts per day. Both groups of patients spent comparable amounts of time in sedentarism, as well as in low, moderate, and vigorous activity and in moderate and vigorous activity minutes per day (MVPA) each day.

Both accelerometry and IPAQ concluded that patients with higher disease activity, whether reflected by Disease Activity Score (DAS) 28 and Disease Activity Index for Psoriatic Arthritis (DAPSA), had significantly lower levels of PA.

“When a second determination of PA (time doing MVPA, as measured by accelerometry) and disease activity (by DAPSA and DAS28-CRP) was carried out 6 months later, the relationship between the variations of both parameters with respect to basal levels correlated inversely,” wrote the researchers, who carried out the retest in a group of 36 patients. Between the 2 visits, the amount of MVPA dropped from 42 to 30 min/day.

The researchers added, “In agreement with this finding, previous studies in RA patients in dictate that PA levels (as measured by questionnaires or by accelerometry) have an inverse relationship with disease activity (as assessed by DAS28 or SDAI).”

According to the researchers, when accelerometry measured MVPA and kilocalories per day and IPAQ was determined by metabolic equivalent-of-task-minutes per week and the data were considered as terciles, the agreement was “evident to a moderate degree,” with a median quadratic weighed Kappa index of 0.27 and 0.24, respectively.

Reference

Hernández‐Hernández M, Sánchez‐Pérez H, Luna‐Gómez C, Ferraz-Amaro I, Díaz‐González F. Impact of disease activity on physical activity in psoriatic arthritis patients. Arthritis Care Res. Published online August 16, 2020. doi:10.1002/acr.24422