Background/Purpose: It is generally assumed that rheumatoid arthritis (RA) patients tend to exercise less than what is currently recommended. However, there is little data on the level of daily PA in RA patients vs. to healthy controls, using objective procedures, such as accelerometry. Moreover, there remain two important unanswered questions concerning PA vis-à-vis RA: 1) Do patients who are sufficiently physically active suffer from less severe disease? and viceversa, 2) Does disease activity influence PA in RA patients?. With regard to the former, there is considerably more evidence in favor of prescribing PA for RA patients than there is against. However, there is currently no evidence that decisively answers the latter.

The purposes of this study were to compare PA in a group of RA patients versus healthy controls through both objective (triaxial accelerometry) and subjective (International Physical Activity Questionnaire- IPAQ) methods, and to explore the impact of disease levels on PA in these patients. We also sought to determine the potential role of PA assessment as a measure of RA disease activity.

Methods:

A group of 50 RA patients and 50 age-and sex-matched healthy controls were included in this cross-sectional study. PA was assessed by accelerometry and with the IPAQ. We performed multiple regression analysis not only to compare PA between groups, but also to explore the relation between RA features, including disease activity and cardiovascular risk parameters, and PA. In a randomized group of 30 RA patients a test/re-test study was carried out in order to determine the correlation between variations in disease activity and PA.

Results:

The number of minutes of moderate and vigorous activity/day, as evaluated by accelerometry and adjusted for sex, age, work activity was significantly lower in RA patients than in healthy controls (23±16 vs 33±27 min/day, p=0.02). In RA patients, accelerometry and IPAQ demonstrated concordance to a moderate degree (quadratic weighed Kappa index of 0.27 [0.06-0.48], p=0.02). HAQ negatively correlated with both IPAQ and accelerometry data (beta coef. -1623 (-2742- -503) MET/min/week, p=0.00; beta coef -43 (-81- -6.46) counts/min, p 0.02). DAS28-CRP was also inversely related with IPAQ. Framinghan score and metabolic syndrome were inversely associated with PA in RA patients. Interestingly, variations in PA, as measured by accelerometry, inversely correlated with RA disease activity (r:-0.42, p= 0.02), particularly in the patient group that exhibited changes in DAS28 consistent with an RA flare or improvement.

Conclusion:

In RA patients, accelerometry is a reliable technique to evaluate PA. Not only showed that RA patients spend less time doing moderate and vigorous PA than healthy controls, but also PA, as assessed by accelerometry, was sensitive to any changes in disease activity.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/influence-of-disease-activity-on-the-physical-activity-of-rheumatoid-arthritis-patients/