What are the barriers to physical activity in patients with chronic plaque psoriasis?

Abstract

Background: Psoriasis is associated with an increased risk of cardiovascular disease. Despite recommendation that exercise is important for cardiorespiratory fitness, patients with psoriasis avoid participation in physical activities for reasons that are, as yet, unclear.

Objectives: This study investigated the relationship between psoriasis-specific experiences and self-reported patterns of exercise, hypothesizing that individuals with psoriasis are less likely to engage in physical activity for reasons that are related to their psoriasis.

Methods: In total 404 patients with chronic plaque psoriasis were recruited. History, examination and physical activity were assessed for each participant.

Results: Overall, 52·8% (n = 188) of patients with psoriasis aged 18-65 years and 66% (n = 37) of those aged > 65 years engaged in less than the recommended amount of physical activity for cardiorespiratory fitness. As the severity and psychosocial impact of psoriasis increased, the participation in exercise (of all intensities) decreased. There was a significant negative correlation between Psoriasis Area and Severity Index and total activity in women aged 18-65 years (r = -0·19, 95% confidence interval -0·36 to 0; P = 0·04) and a significant negative correlation between physical activity and Dermatology Life Quality Index (DLQI) in all participants (r = -0·11, 95% confidence interval -0·21 to 0; P = 0·04). Individual components of the DLQI identified barriers to physical activity including skin sensitivity and reluctance to participate in leisure activities.

Conclusions: Psoriasis-specific factors - severity, skin sensitivity, clothing choice, participation in social/leisure activities, and treatments - contribute to exercise avoidance and may augment the increased risk of cardiovascular disease in patients with psoriasis.