POS1039 PSORIATIC ARTHRITIS AND PHYSICAL ACTIVITY, A SYSTEMATIC REVIEW
Authors: J. Kessler, M. Chouk, T. Ruban, C. Prati, D. Wendling, F. Verhoeven
Journal: Annals of the Rheumatic Diseases (2021)

Background: The beneficial effects of physical activity (PA) have been demonstrated in rheumatoid arthritis and ankylosing spondylitis on disease and co-morbidities while they are not clearly established in psoriatic arthritis. Objectives: Thus, the aim of this study was, on the basis of a systematic review of the literature, (i) to assess the level of physical activity in these patients and (ii) to determine the effects of physical activity on joint and extra articular symptoms and on well-being. Methods: The research strategy was performed on Pubmed, Cochrane,and PEDro databases using the following keywords: “psoriatic arthritis AND physical activity” without restriction. Articles published in English before October 2019 were identified and selected according to the PRISMA methodology by two independent investigators. In case of disagreement, a third investigator was interviewed. To be included in the qualitative synthesis, the studies had to meet the PICOS criteria. Results: Among the 259 studies identified, 13 were finally included. 241 were excluded because they did not address the topic or were not in English and 5 were duplicated. Two epidemiological studies revealed that 17 and 68 % of patients comply with WHO recommendations for the general population in terms of physical activity. The main explanations expressed by patients are; a lack of promotion of physical activity by the rheumatologist and the fear of pain during the movement also called “kinesiophobia”. Among the three prospective randomized clinical trials, one of them showed a significant 20% reduction in the BASDAI (Bath Ankylosing Spondylitis Disease) and a 25% reduction in pain. Fatigue was significantly reduced by 15% following a physical activity protocol on a cyclergometer for 11 weeks. Muscle strength and maximum VO2 were significantly improved after participation in the physical activity protocol in two of the clinical trials. Four retrospective studies evaluated the effect of physical activity on the risk of enthesitis or dactylitis. None were associated with an increased risk of enthesitis. However, physical activity was found to be a risk factor for structural remodelling of the Achilles tendon. And, avoiding physical activity seems to be a protective factor against the risk of enthesitis. On the other hand, the three clinical trials did not mention any increase in the disease’s activity score. Finally, the effects of four rehabilitation programs have been evaluated in psoriatic arthritis and other inflammatory rheumatism. The beneficial effects were modest and concerned the reduction of pain for all the programs and of fatigue for two of the programs. Conclusion: The studies showed a beneficial effect of physical activity on disease activity, on well-being and on comorbidities. The data on the risk of enthesitis are reassuring. Further investigations are necessary to confirm these results and to precise the modalities of exercise. Table 1. PICOS criteria according to PRISMA methodology. Participants Adults &gt; 18 years old, Psoriatic Arthritis defined to CASPAR classification criteria (2006) or Moll Wright criteria (1973) Intervention Any type of physical activity regardless of intensity and duration Comparison Control group (not mandatory) Outcomes Level of physical activity Disease activity score Comorbidities Study design No restriction Disclosure of Interests: None declared.