POS0146-HPR THE REPORTING OF WORK AND OTHER SOCIETAL PARTICIPATION OUTCOMES IN EXERCISE THERAPY TRIALS IN PEOPLE WITH RHEUMATOID ARTHRITIS OR AXIAL SPONDYLOARTHRITIS: A SYSTEMATIC REVIEW
Authors: N. Bakker, J. Knoop, J. Schoones, T. P. M. Vliet Vlieland, S. F. E. Van Weely
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Restrictions in societal participation, such as fulfilling social roles and employment, are common in people with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA) [1, 2]. Exercise therapy is recommended in physiotherapy guidelines to maintain function and participation [3, 4], however, the effects of exercise therapy on work participation are unclear. <h3>Objectives:</h3> To systematically review (i) the reporting of and (ii) the effects on work participation outcomes, in clinical trials on supervised exercise therapy in people with RA or axSpA. <h3>Methods:</h3> Eight electronic databases were searched up to February 2023 for eligible randomized controlled trials (RCTs). RCTs evaluating supervised exercise therapy of at least 6 sessions compared to a control condition in adults with RA or axSpA were included. The study characteristics (year of publication, authors, intervention and control conditions) and the reporting of work and other societal participation outcomes, and, if available, the effects of exercise therapy on work participation outcomes, were extracted and described. The methodological quality of RCTs was evaluated using the risk of bias 2 (RoB-2) tool developed by the Cochrane Collaboration. <h3>Results:</h3> In total, 20 RCTs were included for RA and 18 for axSpA (Table 1). None of the studies used a specific work participation outcome, therefore, the effects of PT-led exercise therapy on work participation could not be determined. However, 6 (30%) of the RA and 6 (33%) of the RCTs in axSpA included an outcome including one or more items on work participation. Most frequently the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) subscale Role limitations due to physical health problems (in 4 RA and 5 axSpA RCTs) or the SF-36 subscale Role limitations due to personal or emotional problems (in 4 RA and axSpA RCTs) were used. <h3>Conclusion:</h3> While the improvement of participation including work is one of the target areas for exercise therapy in people with RA or axSpA, currently no specific work participation outcomes are used in exercise therapy trials in RA or axSpA. Therefore, the effects of exercise therapy on work participation could not be determined. To determine these effects, studies on exercise therapy including (self-)employed people with RA or axSpA should include outcomes specifically assessing work participation. <h3>REFERENCES:</h3> [1] Nikiphorou, E. and S. Ramiro, <i>Work disability in axial spondyloarthritis.</i> Current Rheumatology Reports, 2020. <b>22</b>: p. 1-8. [2] Kirkeskov, L. and K. Bray, <i>Employment of patients with rheumatoid arthritis - a systematic review and meta-analysis.</i> BMC Rheumatol, 2023. <b>7</b>(1): p. 41. [3] Hurkmans, E., et al. <i>KNGF guideline Rheumatoid Arthritis</i>. 2018. [4] van Weely, S., et al. <i>Aanbevelingen fysiotherapie bij mensen met axiale spondyloartritis ('Physiotherapy recommendations in people with axial spondyloarthritis'</i>). 2019. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> This study is funded by the Dutch Arthritis Society (ReumaNederland) and the Scientific College of Physical Therapy (WCF) of the Royal Dutch Society for Physical Therapy (KNGF). <h3>Disclosure of Interests:</h3> <b>None declared.</b>