OP0280-HPR Physical activity in established ra and variables associated with physical activity maintenance over a seven year period
Authors: A Bremander, K. Malm, M.L. Andersson
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Interventions to promote a healthy lifestyle also in patients with rheumatoid arthritis (RA) have been in focus over the last years. Physical activity (PA) defined as moderate-to-vigorous physical activity (MVPA) has the possibility to reduce disease burden in RA and may contribute to improved quality of life (QoL). It is well known that a large number of patients with RA have a sedentary life style and are less active than their healthy peers. However, less information is known about the long term change of MVPA and possible associated variables. <h3>Objectives</h3> To study self-reported change of MVPA over seven years in a well-defined RA cohort. <h3>Methods</h3> A lifestyle questionnaire was sent twice to patients in the BARFOT cohort, in 2010 (n 1525) and in 2017 (n 1046) with a response rate of 73% and 68% respectively and 950 patients responded to both questionnaires. All patients fulfilled the ACR criteria for classification of RA and had a disease duration at inclusion (1992 to 2006) of ≤12 months. Patients were dichotomized as being active on recommended levels of MVPA (MVPA<sub>rec</sub> ;physically active on a moderate level ≥150 min/week (MPA) or on an intense level ≥75 min/week (VPA)) or not (sedentary). The patients reported body mass index, smoking habits, tender (TJC) and swollen joint count (SJC, 28-joints), patient global assessment (PatGA), pain intensity (NRS) and distribution (pain mannequin), fatigue (NRS), physical function (HAQ), health related QoL (EQ5D), comorbidities and medical treatment. Possible associated variables with meeting MVPA<sub>rec</sub> at both time points or not (dependent variable) was studied by using a logistic regression analysis. All variables were adjusted for age, gender and smoking habits. <h3>Results</h3> Forty-one percent (n 389) of the patients met MVPA<sub>rec</sub> at both occasions, and they reported better EQ5D scores compared with the sedentary group (mean 0.77 (SD 0.18) vs 0.68 (0.27). The patients who met MVPA<sub>rec</sub> were younger, (mean age (SD) 59<sup><sup>13</sup></sup> years vs 62<sup><sup>13</sup></sup> years, p&lt;0.001) and were to higher extent never smokers 46% vs 38%, p=0.021. There was a negative association with meeting MVPA<sub>rec</sub> and being overweight (OR 0.58, 95% CI: 0.43 to 0.96) or obese (OR 0.38, 95% CI: 0.25 to 0.59), the presence of cardiovascular (OR 0.56, 95% CI: 0.41 to 0.75) and pulmonary diseases (OR 0.51, 95% CI: 0.31 to 0.85), TJC (OR 0.98, 95% CI: 0.95 to 0.995), high pain intensity (OR 0.99, 95% CI: 0.987 to 0.998), and pain distribution (OR 0.93, 95% CI: 0.90 to 0.96), worse fatigue (OR 0.99, 95% CI: 0.998 to 0.997) and a worse physical function (HAQ, OR 0.58, 95% CI: 0.45 to 0.76). Patients with higher values in QoL (EQ5D, OR 3.1, 95% CI: 1.52 to 6.2) were positively associated with meeting MVPA<sub>rec</sub>. In 2010 there were no differences in medical treatment between the groups, p=0.377. In 2017 the group meeting MVPA<sub>rec</sub> included a lower number of untreated patients compared to 2010 (25% vs 34%, p=0.017). <h3>Conclusions</h3> Only four out of ten patients with established RA reported to maintain recommended levels of PA over a seven year period. Experiencing high quality of life seems to be important for PA maintenance together with lower levels of pain, fatigue and better physical function. Health care professionals need to take the patient perspective into account andsupport maintenance of physical activities accordingly. <h3>Disclosure of Interest</h3> None declared