POS0990 FACTORS ASSOCIATED WITH ENGAGING IN PHYSICAL ACTIVITY IN AXIAL SPONDYLOARTHRITIS. RESULTS FROM THE EUROPEAN MAP OF AXIAL SPONDYLOARTHRITIS (EMAS)
Authors: M. Garrido-Cumbrera, D. Poddubnyy, C. Bundy, L. Christen, R. Mahapatra, S. Makri, C. J. Delgado-Domínguez, D. Gálvez-Ruiz, P. Plazuelo-Ramos, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2021)

Background: Physical activity is an essential component in axial spondyloarthritis (axSpA) care, improving physical and mental well-being. Objectives: This analysis aims to identify factors associated with engaging in physical activity among axSpA patients. Methods: Data from 2,424 unselected patients participating in EMAS (N=2,846), a cross-sectional study (2017-2018) across 13 European countries, were analysed. Engaging in physical activity was assessed by the following item: “Do you do any physical or sporting activity?” for which participants could report at least 1 physical activity or that they did not do any physical activity. BASDAI (0-10), spinal stiffness (3-12), functional limitation (0-54), and mental health using General Health Questionnaire GHQ-12 (0-12) were assessed. Mann-Whitney and Pearson’s χ 2 tests were used to analyse relationships between engaging in physical activity and sociodemographic factors, patient-reported outcomes, employment, lifestyle and comorbidities. Univariable and multivariable binary logistic regression were used to analyse variables possibly explaining engagement in physical activity. Results: Mean age was 43.9±12.3 years, 61.3% were female, 48.1% had a university degree and 67.9% were married. 81.8% (n= 2,329) engaged in at least one kind of physical activity. Those physically active were typically male (85.3% vs 79.7% female, p&lt;0.001), university educated (86.0% vs 78.0%, p&lt;0.001), married (83.1% vs 79.2% unmarried, p=0.046), and members of a patient organisation (86.4% vs 78.9% non-member, p&lt;0.001). 25.1% of obese patients (n=533) did not engage in physical exercise (v. 16.6% not obese, p&lt;0.001). Those not engaging in physical activity reported greater disease activity (6.0 vs 5.4 BASDAI, p&lt;0.001), functional limitation (21.6 vs 20.2, p=0.010), spinal stiffness (8.3 vs 7.6, p&lt;0.001), and poorer mental health (5.9 vs 4.8 GHQ-12, p&lt;0.001). Furthermore, 83.9% of those employed (n=1,457) were physically active, versus 73.7% unemployed (n=205; p&lt;0.001). In the multivariable binary logistic regression, the qualitative variables associated with engaging in physical activity were belonging to a patient organisation (OR= 1.91), not being obese (OR= 1.58), being university educated (OR= 1.54), and being male (OR= 1.39). The quantitative variables associated with engaging in physical activity were lower spinal stiffness (OR=0.90), better mental health (OR=0.96), and one-year age increase (OR=1.02). (Table 1). Table 1. Regression analysis for variables explaining engagement in physical activity (n=2,424) Univariable logistic analysis Multivariable logistic analysis Qualitative variables OR 95% CI 7 OR 95% CI 7 Gender. Male 1 1.48 1.21, 1.81 1.39 1.06, 1.82 Educational level. University 2 1.73 1.42, 2.11 1.54 1.18, 2.00 Marital Status. Married 3 1.73 1.06, 1.58 1.18 0.91, 1.54 Patient organization. Member 4 1.71) 1.39, 2.10 1.91 1.43, 2.55 Body Mass Index. Not Obese 5 1.69 1.35, 2.12 1.58 1.17, 2.13 Employment status. Employed 6 1.28 1.06, 1.56 1.00 0.76, 1.32 Quantitative variables OR 95% CI 7 OR 95% CI 7 Age 1.01 1.00, 1.02 1.02 1.01, 1.03 BASDAI (0-10) 0.86 0.82, 0.91 0.96 0.89, 1.04 GHQ-12 (0-12) 0.94 0.92, 0.96 0.96 0.93, 0.99 Functional Limitation (0-54) 0.99 0.99, 1.00 1.00 0.99, 1.01 Spinal Stiffness (3-12) 0.90 0.86, 0.94 0.90 0.84, 0.95 Proportion of life with axSpA (0-1) 2.83 1.50, 5.35 2.00 0.91, 4.39 1 Male vs Female; 2 University vs no university; 3 Married vs unmarried; 4 Member vs not; 5 Not obese (underweight, normal and overweight) vs obese; 6 Employed vs not (unemployed, sick leave, retirement, housework and student). 7 95% CI for test H 0 : OR=1 Conclusion: These results show that increasing age, being male, university educated, member of a patient organisation, not obese, having lower spinal stiffness, and better mental health increase the probability of engaging in physical activity. Physical activity is an important part of axSpA care and patient organizations play a critical role in enhancing access to and participation in physical activity. Acknowledgements: This study was supported by Novartis Pharma AG. The authors would like to thank all patients who participated in the study. Disclosure of Interests: Marco Garrido-Cumbrera: None declared, Denis Poddubnyy Consultant of: Abbvie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB., Grant/research support from: Abbvie, MSD, Novartis, and Pfizer, Christine Bundy Consultant of: Abbvie, Celgene, Janssen, Lilly, Novartis, and Pfizer, Laura Christen Employee of: Novartis Pharma AG, Raj Mahapatra: None declared, Souzi Makri: None declared, Carlos Jesús Delgado-Domínguez: None declared, David Gálvez-Ruiz: None declared, Pedro Plazuelo-Ramos: None declared, Victoria Navarro-Compán Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB.