Physical Activity Recommendations for Patients With Axial Spondyloarthritis

In a study evaluating a new concept of physical activity recommendation among patients with axial spondyloarthritis (axSpA), researchers found there was sufficient acceptance of and satisfaction with the new concepts.

At the Ankylosing Spondylitis Association of Switzerland (Schweizerische Vereinigung Morbus Bechterew, SVMB), new concepts were implemented within the existing exercise groups (EGs). The groups of 5 to 25 patients had previously met weekly, performing spinal flexibility and strength exercises under the supervision of a physiotherapist (PT). The authors wrote that new implementations included “(a) 2 days of training for supervising PTs, (b) exercises in all fitness dimensions, according to the exercise guidelines, (c) quarterly individual exercise counselling with a supervising PT to support more individual exercise training, (d) bi-annual fitness-assessments, and (e) individual exercise training in addition to group exercise.”

After 6 months, the activities were assessed with primary outcomes being adherence of patients to recommended exercise behavior as self-reported via electronic diary; fidelity of PTs to new concepts as self-reported via diary; and SVMB organizational changes. Secondary outcomes were feasibility and satisfaction with the new concept, and the tertiary outcome was patient fitness as evaluated through fitness assessments.

Participants included 30 patients with axSpA and 4 PTs. Self-reporting by patients was insufficient, which may be attributed to technical problems, according to the authors. Fidelity of PTs to the new concept was satisfactory. All levels of organization (patients, PTs, and SVMB administration) deemed the concept feasible and useful for supporting personalized exercise. As a result, SVMB management has implemented the new concept across all its EGs. The authors wrote, “Patients' cardiorespiratory fitness [ES 1.21 (95%CI 0.59, 1.89)] and core strength [ES 0.61 (95%CI 0.18, 1.06)] improved over the 6 months.”

While adaptions would be necessary to feasibly implement this program nationwide, the study confirmed “the need for evidence-based EGs, provided by a patient organization in order to support active [physical activity] behavior,” the authors concluded.

—Allison Casey

Reference:
Rausch Ostoff AK, Vliet Vlieland TPM, Meichtry A, et al. Lessons learned from a pilot implementation of physical activity recommendations in axial spondyloarthritis exercise group therapy. BMC Rheumatol. Published online: January 17, 2022. DOI:10.1186/s41927-021-00233-z