Background/Purpose: Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are at increased risk for premature cardiovascular disease. As sedentary behaviour and lack of physical activity (PA) are known cardiovascular risk factors, we studied PA levels in SLE and RA patients, in comparison to healthy controls, using accelerometry.

Methods: For this cross-sectional study, RA and SLE patients were recruited from rheumatology clinics at an academic medical center. Age- and gender-matched healthy controls were recruited through local advertising. RA and SLE patients met the respective ACR classification criteria and disease activity was assessed by the SLEDAI-2K and DAS28-CRP, respectively. PA was assessed by self-report patient questionnaires and measured by triaxial accelerometer worn during waking hours for seven consecutive days. Minutes per day of sedentary, light, and moderate-vigorous physical activity (MVPA) were recorded and compared between SLE, RA, and healthy control participants using ANOVA.

Results:  There were 59 participants: 20 SLE patients, 19 RA patients, and 20 healthy controls. Disease activity was quiescent in both patient groups with mean (SD) SLEDAI-2K and DAS28-CRP scores of 2.9 (2.1) and 2.3 (1.4), respectively. All three groups demonstrated high levels of sedentary behaviour, with mean (SD) sedentary time of 10.1 (1.3) hours/day, or 76.4% of total accelerometer wear time. Total MVPA (mean ± SD, minutes/day) was significantly lower in SLE (34.5 ± 22.7) and RA (41.5 ± 21.3) patients compared to controls (64.9 ± 22.4) (p<0.001). Physical activity guidelines¹ for MVPA (≥ 150 minutes/week) were less frequently met by SLE (2/20, 10.0%) and RA (3/19, 15.8%) patients compared to healthy controls (9/20, 45.0%) (p=0.02). There was no significant difference between SLE, RA and control participants in the amount of time spent in sedentary behaviour (p=0.80) or light activity (p=0.17). Self-reported PA data by patients and controls correlated poorly with accelerometry data, with all participants over-reporting time spent performing MVPA, and underestimating sedentary time.

Conclusion: Given the increased cardiovascular risk, low MVPA and high sedentary behaviour identified by accelerometry among RA and SLE patients with inactive disease is concerning. Investigation of factors impacting PA and sedentary behaviour in RA and SLE patients is necessary, in order to design effective interventions to target this modifiable cardiovascular risk factor in these vulnerable patient populations. ¹ Tremblay MS, Warburton DER, Janssen I, Paterson DH, Latimer AE, Rhodes RE, Kho ME, Hicks A, Leblanc AG, Zehr L, Murumets K, Duggan M. New Canadian physical activity guidelines. Appl Physiol Nutr Metab 2011;36:36–46.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/physical-activity-and-sedentary-behaviour-in-patients-with-systemic-lupus-erythematosus-and-rheumatoid-arthritis/