Axial spondyloarthritis patients are less likely to be physically active

Patients with both active and inactive axial spondyloarthritis (axSpA) were more likely to have more sedentary activity and lower quality of life (QOL) compared to the general population, emphasizing the need for physical activity promotion (PA) interventions for this patient population, according to one in BMC published study. 1

“Patients with axSpA mostly have inflammatory back pain, often the axillary skeleton and the sacroiliac joints are affected. This leads to limited mobility and function of the spine, which can lead to reduced physical function and quality of life, ”said the researchers. “PA and exercise have been shown to improve general well-being and reduce the risk of cardiovascular disease (CVD) in the general population. Despite these recommendations, studies show that the PA values ​​are reduced in patients with axSpA. “

This cross-sectional study included patients with axSpA who were enrolled in an outpatient department at Singapore General Hospital between May 2016 and January 2017. The patients were at least 21 years old and met the axSpA classification criteria. PA values ​​were determined using the Global Physical Activity Questionnaire (GPAQ). Age, gender, race, smoking and alcohol status, educational level, income, comorbidities and the body mass index (BMI) were recorded.

The C-reactive protein ankylosing spondylitis disease activity score (ASDAS-CRP) measured back pain, swelling, morning stiffness, an overall patient rating, and C-reactive protein. The self-assessment of the Bath Ankylosing Spondylitis Functional Index (BASFI) analyzed functional limitations. The average number of minutes spent on work, commuting, and leisure activities were recorded, including those who achieved 150 minutes of moderate physical activity, 75 minutes of vigorous physical activity, or a combination of the two with a climax of 600 minutes per week.

A total of 74 patients with axSpA were compared with 2679 controls. The majority of patients in the axSpA cohort were male (75.7%) and the BMI was similar in both groups.

A smaller proportion of patients in the axSpA group fulfilled the recommendations of the World Health Organization (WHO) for PA (77% vs. 89.7% p <0.001). However, the disease activity level did not affect the PA in this patient population. A larger number of patients with axSpA showed a higher degree of sedentary behavior compared to the control group (56.8% and 36.1%, respectively, p <0.001).

The demographics and comorbidities of patients with inactive and active disease did not differ significantly. While higher PA levels were observed in patients with inactive disease (51.9% vs. 38.3%), the investigators did not consider this to be statistically significant. Compared to the control group, patients with axSpA had more leisure activities (0 [17.1] Minutes vs 13.9 [51.4] Minutes p = 0.01).

The small sample size hampered analysis among other ethnic groups and the cross-sectional study design prevented analysis of PA levels prior to the onset of axSpA. Since the GPAQ was also self-reported, this could have led to an overestimation of PA.

“Although PA levels did not differ between patients with active and inactive axSpA disease, patients with axSpA were less likely than the general population to meet the WHO recommendations for PA and were more likely to have a higher level of sedentary activity compared to the general population.” closed. “This underscores the need for interventions to promote PA in patients with axSpA.”


Phang JK, Khor AYK, Kwan YH, Ng CT, Fong W. Physical activity in patients with axial spondyloarthritis in a multiethnic Southeast Asian country. BMC Rheumatol. 2021; 5 (1): 38. Published August 31, 2021. doi: 10.1186 / s41927-021-00211-5