SAT0639-HPR HOW DO PEOPLE WITH AXSPA PERCEIVE THE IMPACT OF DISEASE AND PHYSICAL ACTIVITY?
Authors: A. K. Rausch Osthoff, S. Buechi, T. P. M. Vliet Vlieland, K. Niedermann Schneider
Journal: Annals of the Rheumatic Diseases (2020)

Background: The Ankylosing Spondylitis Association of Switzerland (SVMB) offers weekly group exercise therapy for people with axial Spondyloarthritis (axSpA) supervised by physiotherapists (PTs). Given the EULAR physical activity (PA) recommendations [1] and recent research [2, 3], the SVMB has implemented a new concept including assessments evaluating all fitness dimensions, daily PA and disease activity. Based on its results, individual exercise-coaching by the group PT is provided to support the adherence to exercising in correct mode and dose. PTs use the visual-tactile instrument PRISM (Pictorial Representation of Illness and Self Measure) [5] to explore patients’ perceived burden of disease (BD) and importance of PA as starting-point for the exercise-coaching. Objectives: To measure to what extent the perceived BD and importance of PA, measured with PRISM, change over time and to evaluate if the PRISM results are associated with established measures of disease activity and daily PA across four pilot groups including four PTs and 30 people with axSpA. Methods: Each participant had three exercise-coaching sessions within six months. Each session was started by applying the PRISM, which is a white A4 board with a yellow disk at the bottom right hand corner. The participant was asked to imagine that the board represented his/her life and the yellow disk represented his/her “Self”. Then, a red disk, representing axSpA, and later a blue disk, representing PA, were handed and the participant was asked to place the disks where they represented best their importance in the participant’s life. The distances between Self and the red and blue disk respectively were measured in centimeters to quantify BD/importance of PA, and correlated with the Bath Ankylosing Spondylitis Disease Activity Inventory, BASDAI (measuring disease activity) and weekly METs (measured with the International PA Questionnaire, IPAQ) by means of spearman rank correlation. The analysis was based on the first session at baseline (T0) and the third session after six months (T1) and paired t-test was applied, to identify changes between sessions. Results: Complete data were available for 23 participants. Neither BD (distance to Self at T0: 13.7±7.2cm; T1: 12.1±6.2cm; t=0.386, p=0.703) nor importance of PA (distance to Self at, T0: 7.3±5.3cm; T1: 7.0±4.5cm); t=0.246, p=0.808) changed within six months. The perceived importance of PA correlated with IPAQ measured METs at T1 (r=0.572, p=0.00), no correlation between BD and METs was found. Conclusion: The stable perceived BD could be explained by long disease duration of participants and established disease management. The stable importance of PA could be due to the sample, as for group exercise participants PA may already be important. The correlation between importance of PA and MET at T1 could indicate that people learned more about the meaning of PA leading to a better understanding of the importance of PA. Future research should evaluate factors influencing the perceived importance of PA as well as further explore the use of PRISM in the context of exercise-coaching. References: [1]Rausch AK, et al. Ann Rheum Dis 2018; 9(77):1251-1260. 45 [2]Sveaas SH, et al. Br J Sports Med 2019;0:1-7. [3]Rausch AK, et al. RMD open, 2018; 4:e000713. [4]Garber CE, et al. Med Sci Sports Exerc 2011;43:1334–59. [5]Buchi S, et al. Psychother Psychosom 2002; 71 (6):333-341. Acknowledgments: We thank Beatrice Walker and René Braem from Swiss Ankylosing Spondylitis Association. Disclosure of Interests: None declared