¹Universitätsklinikum Leipzig, Bereich Rheumatologie, Leipzig

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Introduction: Rheumatic diseases (RD) are associated with reduced quality of life as well as psychological and musculoskeletal morbidities.

Physical activity is a component of therapy for patients with RD.

However, it is unknown whether patients with RD actually are physically active in daily practice.

Objective: To identify RD patients of the outpatient clinic who are physical inactive.

Methods: 94 patients with systemic lupus erythematosus (SLE) (92% female; age 44.2 ± 12.5; 42.5% with SLEDAI score ≥ 6) and 200 patients with rheumatoid arthritis (RA) (72,5% female, age 66.2 ± 11.4 with DAS 2.48 ± 0.85) were analysed using the Health Assessment Questionnaire, Beck Depression Inventory II, PainDETECT Questionnaire, fibromyalgia score, International Physical Activity Questionnaire Long Form (IPAQ-LF) and the Short-form Health Survey (SF 36). A 2-minute walk assed physical performance. Patients were classified by the IPAQ-LF: inactive (low), active (moderate & high). An alternative grouping (inactive: low & moderate, active: high) was tested. A total physical activity in metabolic equivalent (MET) minutes per week was calculated. Binary logistic regression with forward selection (likelihood ratio test) was used, adjusting for multiple variables.

Results: According to the WHO recommendations on physical activity for healthy adults, every second patient with examined RD was physically inactive (SLE: 2448 ± 932,4 MET-Min/Week; RA 3.798 ± 3.292 MET-Min/Week). Inactivity of SLE patients was primarily linked to depression (p = 0,04) and functional impairments (p < 0,05) and for RA patients to depression (p = 0,045), presence of fibromyalgia (p = 0,033) and neuropathic pain (p < 0,05). The alternative grouping with logistic regression showed a significant association between physical functioning (SF-36) and higher physical activity in SLE patients (p = 0.011; overall model p = 0.006). In RA patients, the 2-minute walking test significantly predicted higher physical activity (p = 0,020; overall model p = 0,008). Furthermore, the average 2-minute walking distance was 126.8 ± 37.8 m (76% of reference) in RA patients as well 166.8 ± 68.0 m (80.8% of reference) in SLE patients. Self-reported physical activity correlated positively with the walking test performance (p < 0,001) of RA patients. According to SLE patient reports, “lupus flare-up” (40%), “fatigue” (25%), and “joint pain” (15%) were the most common reasons for low physical activity in SLE patients.

Conclusion: Despite the increased attention and awareness of the benefits of being physically active, the percentage of RD patients who meet the recommended level of physical activity is not sufficient. Programs for RD patients to optimise physical activities should be included, taking account comorbidities (such as depression, fibromyalgia, neuropathic pain) in daily practice.

Literatur

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