OP0272 HPR FITNESS STATUS OF PEOPLE WITH AXIAL SPONDYLOARTHRITIS (AXSPA): FIRST RESULTS AFTER IMPLEMENTATION OF FITNESS ASSESSMENTS IN AXSPA EXERCISE GROUPS
Authors: Karin Niedermann, Anne-Kathrin Rausch, André Meichtry, Béatrice Walker, René Braem, Adrian Ciurea
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Public health recommendations for physical activity (PA) advice that exercise programs include all four fitness dimensions, i.e. cardiorespiratory, muscle strength, flexibility and neuromotor exercise training at well-defined frequency, intensity and duration/repetitions, and regular evaluations (1). The 2018 EULAR recommendations for PA (2) state that this is also effective, feasible and safe for people with rheumatic diseases. Therefore, the Ankylosing Spondylitis Association of Switzerland (SVMB) has started to implement assessments of all four fitness dimensions in their exercise groups (n=68). Criteria for selection of an assessment were its psychometric properties and feasibility for group setting, i.e. low costs and material requirements: Chester step test (CST) for cardiorespiratory fitness (3); adapted Core Strength Endurance test battery (CSE) for muscle strength (4); Bath AS Metrology Index (BASMI) for flexibility (5); Single-Leg-Stance test (SLS) for balance (as proxy for neuromotor activities) (6). For all assessments, except CSE, norm values for healthy people are available. <h3>Objectives</h3> To assess the fitness status of people with axSpA across four volunteering pilot groups and evaluate if between-subject variables of interest are associated with fitness status. <h3>Methods</h3> Participants were assessed at baseline and after 6 months on all four fitness dimensions. For each dimension, a linear mixed model with random intercept was fitted to the data with the within-subject variables time and measurement condition and the between-subject variables age, disease duration, disease activity (Bath AS Disease Activity Index, BASDAI) and PA level (weekly Metabolic Equivalent of Task MET) as explanatory variables. <h3>Results</h3> Of 30 patients assessed, 10 (33%) were women, mean age was 58.8 (SD 9.68) years, mean disease duration was 32.6 (SD 9.68) years, mean disease activity was 3.1. (SD 2.36) and mean PA per week was 5013 (SD 3479.77) METs. Mean estimated VO<sup>2</sup>max for cardiorespiratory fitness was 35.2 (SD 6.59). Disease activity was negatively (slope=-1.49, p=0.01) and PA level positively (slope=3.28, p=0.01) associated with cardiorespiratory fitness. Mean core muscle strength endurance was 78.8 (SD 51.98) seconds. PA level was positively associated with core muscle strength (slope= 8.62, p=0.05). Mean flexibility score was 3.1 (SD 2.36), with age being positively associated with flexibility (slope=0.100, p=0.04). Mean balance was 43.1 (SD 21.09) and 7.7 (SD 5.84) seconds with open and closed eyes respectively. Age was negatively associated with balance (slope = -0.84 (p=0.00). <h3>Conclusion</h3> The SVMB has made an important step by implementing regular fitness evaluations in their axSpA exercise groups. The test scores of the assessed people with axSpA were lower than in healthy people but within the norms. PA level was positively associated with cardiorespiratory fitness and core muscle strength. Disease duration and disease activity were negatively associated with cardiorespiratory fitness only, but not with the other fitness dimensions, which may be different from what is usually assumed. <h3>References</h3> [1] Garber CE, et al. MedSciSportsExerc 2011;43:1334–59. [2] Rausch AK, et al. AnnRheumDis 2018; 9(77): 1251-1260. [3] Buckley JP. B J Sports Med, 2004;38(2);197-205 [4] Rausch AK, et al. Intra-rater reliability and construct validity of a core strength-endurance test battery in people with axial Spondyloarthritis (manuscript in preparation) [5] Jenkinson TR. 1994;21(9):1694-8. Epub 1994/09/01 [6] Springer BA. J Ger Phys Ther. 2007;30(1);8-15 <h3>Disclosure of Interests</h3> Karin Niedermann Speakers bureau: Novartis, Anne-Kathrin Rausch: None declared, André Meichtry: None declared, Béatrice Walker: None declared, René Braem: None declared, Adrian Ciurea Consultant for: AbbVie, Celgene, Janssen-Cilag, MSD, Eli Lilly, Novartis, Pfizer, UCB, Speakers bureau: Abbvie, Celgene, Janssen-Cilag, MSD, Eli Lilly, Novartis, Pfizer, UCB