Stéphanie Fabre

Is the widely-used score in axial spondyloarthritis, Bath Ankylosing Spondylitis Disease Activity Index, influenced by patients’ optimism? A cross-sectional study of 206 patients

The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) [1] is widely used to assess disease activity in axial spondyloarthritis (axSpA) and initiate tumor necrosis factor α-inhibitor therapy [2]. Because BASDAI is a patient-reported outcome, and therefore subject to variability, there may be questions regarding the link between BASDAI results and pathogenesis of axSpA. Specifically, BASDAI score is partly explained by psychological distress (i.e., anxiety/depression) [3], which may be an issue when using it to decide on treatment strategies.

AB0791 Why Do Patients with Axial Spondyloarthritis (AXSPA) Perform Little Aerobic Exercise? A Study of Perceived Barriers and Benefits in 153 Axspa Patients

Background Regular exercise is considered a cornerstone of axSpA treatment, together with medication (1). However, only around half the patients reach the levels of physical activity recommended for health-enhancement and very few regularly perform aerobic exercise (2). Understanding why could help motivate axSpA patients to exercise more. Objectives To explore the benefits and barriers to physical exercise in axSpA patients. Methods A cross-sectional study was performed in two tertiary care hospitals and one office-based practice in France (2). Patients had definite axSpA according to the rheumatologist. Auto-questionnaires evaluating the frequency and type of aerobic exercise, and perceived benefits of and barriers to exercising through the Exercise Benefits/Barriers Score (EBBS) (3), were collected. EBBS comprises 43 items categorised into 5 subscales for benefits (life enhancement, physical performance, psychological outlook, social interaction and preventive health) and 4 subscales for barriers (exercise milieu, time expenditure, physical exertion, family discouragement). Analyses were comparative between men and women. Results In all, 153 patients were analysed: mean age, 45.7±11.1 years, mean disease duration 14.2±9.7 yrs, mean BASDAI (0-100) 36.7±20.7, mean BASFI (0-100) 28.1±25.5, mean BMI 25.2±4.8 kg/m2; 56.2% were men. The main benefits of exercise (for which more than 90% of patients agreed or strongly agreed with the item) were all in the ‘physical performance’ subscale. Highest agreement was found for: improving functioning of cardiovascular system (94.8%), increasing muscle strength (93.5%), level of physical fitness (92.8%), stamina (90.9%), and for women: flexibility (91.0%). The three main barriers were ‘people looking funny in exercise clothes’ (87.6%), ‘too few places to exercise’ (80.4%), and ‘lack of encouragement from family members’ (81.1%). Results were similar for men and women. Conclusions The main barriers to exercising for axSpA patients were ‘exercise milieu’ problems and ‘family discouragement’ while the main perceived benefit was a better physical performance. These findings could be helpful when encouraging physical activity in axSpA patients. References Braun J et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011;70:896–904. Fabre S, et al. Do Patients with Axial Spondyloarthritis (AxSpA) Perform Enough Physical Activity? a Cross-Sectional Study of 207 Patients. Arthritis Rheum 2014, 66(suppl):S1125. Sechrist KR, et al. Development and psychometric evaluation of the exercise benefits/barriers scale, Res Nurs Health 1987;10:357-65. Disclosure of Interest None declared