Physical Activity and Attitudes Toward Exercise in People With Axial and Peripheral Spondyloarthritis

J Rheumatol. 2021 Apr;48(4):513-519. doi: 10.3899/jrheum.200354. Epub 2020 Oct 15.


Objective: To evaluate physical activity and attitudes toward exercise among people with axial (ax-) and peripheral (p-) spondyloarthritis (SpA).

Methods: Using baseline information from an ongoing, longitudinal, prospective SpA cohort study (n = 264), self-reported attitudes and beliefs toward exercise were assessed using questionnaires. Total metabolic equivalent (MET) hours of self-reported physical activity per week, time spent in activities, and activity levels were calculated from the Nurses' Health Study Physical Activity Questionnaire II (NHSPAQ II). Adjusted multivariable linear models estimated the relationship between physical activity and disease status (axial vs peripheral).

Results: Regardless of predominant anatomic distribution of disease, most participants were well-educated, non-Hispanic White men. Approximately 40% met the US Department of Health and Human Services physical activity recommendations. Positive attitudes, beliefs, and perceived benefits toward exercise were similar by anatomic distribution of disease. Despite similar MET h/week, participants with axial disease had greater concerns regarding discomfort and joint injuries than those with peripheral disease. Compared to those with pSpA (n = 201), participants with axSpA (n = 63) spent less time engaging in light and moderate activities (adjusted β in light activity: -1.94 min/week, 95% CI -2.96 to -0.93; adjusted β in moderate activity: -1.05 min/week, 95% CI -2.12 to 0.02).

Conclusion: Participants with axSpA had greater concerns regarding discomfort and injuries from exercise than those with pSpA. Although no differences in time spent in vigorous activities were observed, participants with axSpA spent less time than those with pSpA in light to moderate activities.

Keywords: ankylosing spondylitis; cohort studies; exercise; spondyloarthropathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude
  • Cohort Studies
  • Exercise
  • Humans
  • Male
  • Prospective Studies
  • Spondylarthritis*
  • Spondylitis, Ankylosing*
  • United States