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Abstract Number: 1385

Increased Body Mass Index in Ankylosing Spondylitis Is Associated with a Greater Burden of Symptoms and Poor Perceptions of the Benefits of Exercise

Laura J. Durcan1, Fiona Wilson2, Richard Conway1, Gaye Cunnane3 and Finbar (Barry) D. O'Shea4, 1Rheumatology, St James's Hospital, Dublin, Ireland, 2Physiotherapy, Trinity College, Dublin, Ireland, 3Dept of Rheumatology, St James's Hospital, Dublin, Ireland, 4Rheumatology Dept, St James's Hospital, Dublin, Ireland

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Ankylosing spondylitis (AS), body mass, exercise and obesity

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Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment

Session Type: Abstract Submissions (ACR)

Background/Purpose:

In Ankylosing Spondylitis (AS) the effect of obesity on disease characteristics and exercise perceptions is unknown. Exercise is an essential component in the management of AS. This study was undertaken to assess the attitudes of our AS patients to exercise and to evaluate the effect an increased BMI has on symptoms and disease activity.

Methods:

AS patients fulfilling the New York diagnostic criteria were recruited consecutively from our dedicated AS clinic. Demographic data and disease characteristics were collected. Disease activity, symptomatology and functional disability were examined using standard AS questionnaires. Body mass index (BMI) was calculated using standardised methods as kg/m2. Co-morbidity was analysed using the Charlson co-morbidity index. Patient’s attitudes towards exercise were assessed using the exercise benefits and barriers scale (EBBS). The total EBBS score was used to assess their overall perception of exercise and the barriers component was used to evaluate their conceptual barriers to exercise. We then compared the disease characteristics, perceptions regarding exercise and functional limitations in AS patients who were overweight to those who had a normal BMI. Continuous variables were compared using a t-test and categorical variables were assessed using chi squared testing.

Results:

Forty six AS patients were included. The mean disease duration in the group was 12.8 years (SD 10.2), 76.1% (N=35) were male, and 69.6% (N=32) were taking biologic therapy. There were 37% (N=17) either current or ex-smokers in the group. The mean BMI was 27.4 kg/m2(SD 4.0). 67.5% (N=32) were overweight or obese. There was a statistically significant difference between those who are overweight and those with a normal BMI regarding their perceptions of exercise (EBBS 124.7 Vs 136.6 (p=0.006)) indicating that those who are overweight have a worse perception of the benefits of exercise . With regards to those who were overweight versus those with a normal BMI  there were significant differences in both BASFI and HAQ (BASFI 4.7 Vs 2.5 (p=0.009), HAQ 0.88 Vs 0.26, (p=0.002)).  The disease activity in the groups were also significantly different (BASDAI 4.8 Vs 2.9 (p=0.007) and patient global score 5.0 Vs 2.7 (p=0.007)). There was no difference between the groups in terms of their co-morbid conditions as measured by the Charlson index (p=0.3), smoking (p=0.29), disease duration (p=0.78), gender (p=0.71), or treatment (p=0.89). 

Conclusion:

The majority of AS patients in this cohort are overweight. These overweight patients have a greater burden of symptoms, worse perceptions regarding the benefits of exercise and enhanced awareness of their barriers to exercising. This is of particular concern in a disease where exercise plays a crucial role.


Disclosure:

L. J. Durcan,
None;

F. Wilson,
None;

R. Conway,

Roche Pharmaceuticals,

2,

UCB Pharma,

2,

Merck Pharmaceuticals,

7;

G. Cunnane,
None;

F. D. O’Shea,
None.

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