HOW DOES WEEKLY SUPERVISED GROUP EXERCISE CONTRIBUTE TO FULFILLING EXERCISE RECOMMENDATIONS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS?

BackgroundSupervised group exercise (SGE) has been recommended for people with axial spondyloarthritis (axSpA) since decades, but the proportion and type of axSpA patients that engage in SGE is unknown. In addition, the 2018 EULAR recommendations for physical activity advocate that people with axSpA should engage in aerobic, strength and mobility exercises according to public health physical activity guidelines. However, it is unclear if SGE contributes to fulfilment of these exercise recommendations.ObjectivesTo compare characteristics, health status and fulfilment of exercise recommendations between axSpA patients with and without SGE.MethodsCross-sectional data from three Dutch axSpA study cohorts were analysed: two cohorts with patients recruited at rheumatology outpatient clinics (n=196 and n=153) in which participation in SGE was recorded (yes/no) and one cohort with only SGE participants (n=128). Assessments included sociodemographic and disease characteristics, health status (ASAS Health Index), spinal mobility and the ‘short questionnaire to assess health enhancing physical activity’ (SQUASH). The SQUASH was used to determine fulfilment of the public health recommendations for leisure-time aerobic exercise (≥150 min/week of moderate-intensity or ≥75 min/week of vigorous-intensity exercise) and for strength and mobility exercises (≥2 sessions/week). Differences between patients with and without SGE were analysed using the Mann-Whitney U test and the Chi-Square test. Multivariate regression models were performed to correct the association between SGE and fulfilment of the exercise recommendations for age, sex, employment and health status.ResultsIn the two outpatient axSpA cohorts, 17 of the 349 patients (5%) participated in SGE. The total group of SGE participants (n=145) was significantly older, had longer disease duration, was less frequently employed, used less disease related medication and had worse spinal mobility than the patients without SGE (n=332). There were no significant differences in health status. AxSpA patients with SGE performed more minutes per week of aerobic exercise (median 420; IQR 285-660) than patients without SGE (median 283; IQR 120-540), p < 0.001. As shown in Figure 1, SGE participants fulfilled the recommendations for moderate-intensity aerobic exercise (89% vs. 69%, p < 0.001) and for strength and mobility exercise (44% vs. 29%, p < 0.01) more often than patients without SGE. However, the recommendation for vigorous-intensity aerobic exercise was fulfilled less often by the SGE participants (5% vs. 12%, p < 0.05). After correcting for age, sex, employment and health status, the differences in fulfilment of the moderate-intensity aerobic and strength and mobility exercise recommendations remained significant.ConclusionSGE is used by just few and especially older axSpA patients and contributes to fulfilling recommendations for moderate-intensity aerobic as well as mobility and strength exercise. However, both in patients with and without SGE, only a minority fulfilled the recommendations for vigorous-intensity aerobic and strength and mobility exercises. Therefore, future promotion of physical activity should focus on implementing these types of exercise.AcknowledgementsThe authors would like to thank ASAS and the Dutch Arthritis Society for supporting the three cohorts.Disclosure of InterestsBas Hilberdink: None declared, Marlies Carbo: None declared, Davy Paap: None declared, Suzanne Arends: None declared, T.P.M. Vliet Vlieland: None declared, Florus van der Giesen: None declared, Anneke Spoorenberg Paid instructor for: AbbVie, Consultant of: AbbVie, Novartis Pharma, Pfizer, UCB Pharma, Lilly, Grant/research support from: Novartis Pharma, Pfizer, Salima van Weely: None declared