FRI0170\u2005PHYSICAL ACTIVITY LEVEL IN RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW

Abstract

Background: Rheumatoid arthritis (RA) is one of the most common inflammatory rheumatism characterized by an increased cardiovascular risk. Regarding the last EULAR recommendations, physical activity is an important part of the management of RA. The evaluation of Physical activity level is needed to know RA patients practices. However, to our knowledge, there is no consensual measure tool of the physical activity level for patients suffering RA. Objectives: The aim of this study is to evaluate the different methods of measurement of physical activity levels in RA. Methods: This is a systematic review of literature realized on the pubmed and Cochrane databases and meeting the PRISMA recommendations. We used the following key words: « physical activity », « physical activity level » AND « rheumatoid arthritis ». We included only article written in English language and with RA patients older than 18 years old. Results: We identified 190 studies with the key words, 51 were selected on title and 23 articles have been identified as eligible. Finally, 19 studies were included in this review. In total, of the 19 selected studies, 13567 RA patients were evaluated on their level of physical activity. There were 73,4% female with a mean age of 56,1 years. In 10 studies, the BMI was available with results between 25 and 30 kg/m2. Two methods for measuring physical activity levels have been identified. Questionnaires, a subjective tool, were used in 13 studies. It should be noted that 8 different questionnaires were used in these studies with recurrent use of the IPAQ (international validated questionnaire in general population) and SQUASH (validated in English language in RA). In these studies, patients were predominantly sedentary with a proportion of patients meeting WHO physical activity recommendations ranging from 20 to 77%. It appears that Scandinavian patients are clearly the most active. Concerning objective measurement tools, 9 studies evaluated the level of physical activity using activity tracker. 7 studies used the accelerometer, 1 used the VO2 max, 1 used an actimeter. All studies showed a sedentary behavior. In these studies, the results were expressed as energy expenditure and not as a percentage of patients meeting WHO recommendations. Thus, the comparison between the two methods is difficult, but accelerometer showed a significant decrease in the level of physical activity in RA. The oldest studies (2002 and 2007) showed that only 30% of patient met the WHO recommendations, but the recent studies (2017 and 2018) showed the same prevalence of sedentary behavior. The disease activity and the disease duration were comparable between the different studies. Conclusion: Patients with rheumatoid arthritis present a sedentary behavior. Objective and subjective tools showed the low level of physical activity over the past decade. These data illustrate the necessity of the promotion of physical activity in rheumatoid arthritis. Disclosure of Interests: None declared