Background/Purpose: While physical activity (PA) has been recommended as a part of the non-pharmacological management of inflammatory arthritis (IA), previous research within this area has strong predominance of women and thus knowledge of the men’s PA behavior is lacking. Accordingly, the aim was to examine PA behavior in men with IA, and the association between selected clinical and demographic variables and engagement in regular physical activity. Also men’s motivation, barriers and preferences for PA was explored.

Methods:  A cross-sectional study based on the Danish nationwide DANBIO registry covering patient with IA treated in routine care. Men, ≥18 years and rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) recruited consecutively from one hospital. PA level was determined using the patient-reported Saltin-Grimby PA Level Scale, categorized into groups of low PA (level 1 and 2 on the scale: mainly sedentary or only light physical activity) or regular PA (moderate-vigorous PA min. 2 h/w; level 3 and 4). Other measures included VAS for global, pain and fatigue, C-reactive protein (CRP) level, Clinical Disease Activity and Health Assessment Questionnaire (HAQ). Logistic regression analyses were performed to identify factors associated with engagement in regular physical activity.

Results:  In total, 325 were included in the analyses (47% RA, 29% AS and 25% PsA); median age 55 y, 10 y median disease duration. Totally, 129 (40%) reported regularly physically active (i.e. recommended level), 196 (60%) reported mainly sedentary or engage in only light PA. Those regularly physically active were significantly younger, smoked less (p<0.05), reported less pain, fatigue and global (p<0.01) compared to the group who reported PA at a suboptimal level. Also a better score on physician’s global, lower disease activity and a better functional status than the less active (p<0.01). Only VAS fatigue remained independently associated with engagement in regular PA (OR=0.814, 95%CI=0.741-0.895); p<0.001) (multivariable logistic regression analysis). The most frequently reported motivators for PA were to maintain/improve health (62%), be in shape (50%) and maintain/reduce weight (42%), whereas the most frequently reported barriers were being too tired (29%), lacking energy (27%) and prioritizing work/studies (23%). In total, 42% stated they would be motivated for participating in an intervention or other initiative aiming at promoting PA in men with IA. Most preferred interventions including strength training (43%), swimming (34%) or road cycling (20%). 41% would like the training to be individual and 30% to exercise in groups.

Conclusion:  A majority of men with IA are not meeting the recommendations of regular engagement in PA. This group seems to perform worse than their more active counterparts on clinical, subjective and objective parameters. Fatigue seems to play a crucial role in explaining motivation and barriers for PA. However, a causal relationship cannot be established. Taking into account preventive and general health promoting effects of physical activity, further focus on strategies to increase the engagement in PA in men with IA is needed.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/physical-activity-behavior-in-men-with-inflammatory-arthritis-a-cross-sectional-register-based-study-of-physical-activity-correlates-motivators-barriers-and-preferences/