Aktuelle Rheumatologie
DOI: 10.1055/a-2444-4156
Übersichtsarbeit

Stellenwert körperlicher Aktivität und Messung körperlicher Beweglichkeit bei Patienten mit axialer Spondyloarthritis

Importance of physical activity and assessment of mobility in patients with axial spondyloarthritis
David Kiefer
1   Rheumatologie, Ruhr-Universitat Bochum Medizinische Fakultat, Bochum, Germany
2   Medizinische Fakultät, Rheumazentrum Ruhrgebiet, Herne, Germany
,
1   Rheumatologie, Ruhr-Universitat Bochum Medizinische Fakultat, Bochum, Germany
3   Rheumatologie, Rheumazentrum Ruhrgebiet, Herne, Germany
,
Philipp Sewerin
1   Rheumatologie, Ruhr-Universitat Bochum Medizinische Fakultat, Bochum, Germany
3   Rheumatologie, Rheumazentrum Ruhrgebiet, Herne, Germany
,
Xenofon Baraliakos
1   Rheumatologie, Ruhr-Universitat Bochum Medizinische Fakultat, Bochum, Germany
3   Rheumatologie, Rheumazentrum Ruhrgebiet, Herne, Germany
› Author Affiliations

Zusammenfassung

Die axiale Spondyloarthritis (axSpA) ist eine chronische rheumatische Erkrankung, die auf Grund von entzündlichen Prozessen und strukturellen Veränderungen im Achsenskelett zu erheblichen Einschränkungen der körperlichen Funktionsfähigkeit und der Beweglichkeit der Betroffenen führen kann. Neben der medikamentösen Therapie spielt regelmäßige körperliche Aktivität eine zentrale Rolle im Management der axSpA. Verschiedene Messmethoden wie der BASFI oder der BASMI werden eingesetzt, um die körperliche Funktionsfähigkeit und Beweglichkeit zu evaluieren. Leistungstests und moderne Technologien wie Tracker oder elektronische Messmethoden bieten neue Ansätze zur objektiven und präzisen Erfassung von körperlicher Aktivität und Bewegungsausmaß. Dieser Übersichtsartikel beleuchtet die Bedeutung körperlicher Aktivität, aktueller Messmethoden und innovativer Ansätze für die Behandlung von Patienten mit axSpA.

Abstract

Axial spondyloarthritis (axSpA) is a chronic rheumatic disease characterised by inflammation and structural changes to the axial skeleton, leading to significant impairments in physical function and mobility. In addition to pharmacological therapies, regular physical activity plays a pivotal role in managing axSpA. Various assessment methods such as BASFI or BASMI are used to evaluate physical function and mobility. Performance-based tests and modern technologies like trackers or electronic measurement methods offer new approaches for objective and precise assessment of physical activity and range of motion. This review highlights the importance of physical activity, current assessment methods, and innovative approaches for the treatment of patients with axSpA.



Publication History

Received: 22 July 2024

Accepted: 15 October 2024

Article published online:
10 December 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Sieper J, van der Heijde D, Landewe R. et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Ann Rheum Dis 2009; 68: 784-788
  • 2 Sieper J, Poddubnyy D. Axial spondyloarthritis. Lancet (London, England) 2017; 390: 73-84
  • 3 Braun J, Sieper J. Ankylosing spondylitis. Lancet (London, England) 2007; 369: 1379-1390
  • 4 Landewe R, Dougados M, Mielants H. et al. Physical function in ankylosing spondylitis is independently determined by both disease activity and radiographic damage of the spine. Ann Rheum Dis 2009; 68: 863-867
  • 5 Wanders A, Landewe R, Dougados M. et al. Association between radiographic damage of the spine and spinal mobility for individual patients with ankylosing spondylitis: can assessment of spinal mobility be a proxy for radiographic evaluation. Ann Rheum Dis 2005; 64: 988-994
  • 6 Machado P, Landewe R, Braun J. et al. Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis. Ann Rheum Dis 2010; 69: 1465-1470
  • 7 Protopopov M, Sieper J, Haibel H. et al. Relevance of structural damage in the sacroiliac joints for the functional status and spinal mobility in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis research & therapy 2017; 19: 240
  • 8 Kiefer D, Baraliakos X, Adolf D. et al Successful evaluation of spinal mobility measurements with the Epionics SPINE device in patients with axial spondyloarthritis compared to controls. J Rheumatol 2021;
  • 9 Kiefer D, Schneider L, Braun J. et al. Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis. RMD Open 2024; 10
  • 10 van der Heijde D, Ramiro S, Landewé R. et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis 2017; 76: 978-991
  • 11 Ramiro S, Nikiphorou E, Sepriano A. et al ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. Ann Rheum Dis 2022;
  • 12 Wendling D, Hecquet S, Fogel O. et al. 2022 French Society for Rheumatology (SFR) recommendations on the everyday management of patients with spondyloarthritis, including psoriatic arthritis. Joint Bone Spine 2022; 89: 105344
  • 13 Kiltz U, Braun J, Becker A. et al. [Long version on the S3 guidelines for axial spondyloarthritis including Bechterew's disease and early forms, Update 2019 : Evidence-based guidelines of the German Society for Rheumatology (DGRh) and participating medical scientific specialist societies and other organizations]. Z Rheumatol 2019; 78: 3-64
  • 14 Garber CE, Blissmer B, Deschenes MR. et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359
  • 15 Rausch Osthoff AK, Niedermann K, Braun J. et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018; 77: 1251-1260
  • 16 Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100: 126-131
  • 17 Larkin L, Gallagher S, Cramp F. et al. Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review. Rheumatology international 2015; 35: 1631-1640
  • 18 Keogh A, Tully MA, Matthews J. et al. A review of behaviour change theories and techniques used in group based self-management programmes for chronic low back pain and arthritis. Manual therapy 2015; 20: 727-735
  • 19 Braun J, Baraliakos X, Kiltz U. Treat-to-target in axial spondyloarthritis – what about physical function and activity?. Nat Rev Rheumatol 2021; 17: 565-576
  • 20 Sveaas SH, Smedslund G, Hagen KB. et al. Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases: a systematic review and meta-analysis. Br J Sports Med 2017; 51: 1065-1072
  • 21 Sveaas SH, Bilberg A, Berg IJ. et al. High intensity exercise for 3 months reduces disease activity in axial spondyloarthritis (axSpA): a multicentre randomised trial of 100 patients. Br J Sports Med 2020; 54: 292-297
  • 22 Rausch Osthoff AK, Juhl CB, Knittle K. et al. Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis. RMD Open 2018; 4: e000713
  • 23 Hu X, Chen J, Tang W. et al. Effects of exercise programmes on pain, disease activity and function in ankylosing spondylitis: A meta-analysis of randomized controlled trials. European Journal of Clinical Investigation 2020; 50: e13352
  • 24 Kiefer D, Schneider L, Braun J. et al. Impact of daily physical therapy over 2 weeks on spinal mobility including objective electronic measurements and function in patients with axial spondyloarthritis. Ther Adv Musculoskelet Dis 2024; 16 1759720x231224212
  • 25 Boudjani R, Challal S, Semerano L. et al Impact of different types of exercise programs on ankylosing spondylitis: a systematic review and meta-analysis. Disabil Rehabil 2022; 1-12 10.1080/09638288.2022.2140842
  • 26 Sharan D, Rajkumar JS. Physiotherapy for Ankylosing Spondylitis: Systematic Review and a Proposed Rehabilitation Protocol. Curr Rheumatol Rev 2017; 13: 121-125
  • 27 Dagfinrud H, Kvien TK, Hagen KB. Physiotherapy interventions for ankylosing spondylitis. The Cochrane database of systematic reviews 2008; Cd002822 10.1002/14651858.CD002822.pub3
  • 28 Hosseini M, Rahimibarghani S, Ghorbanpour S. et al. The effects of supervision on the outcomes of exercise training in patients with ankylosing spondylitis: A single-blind randomized controlled trial. Int J Rheum Dis 2023; 26: 1120-1128
  • 29 Hilberdink B, van der Giesen F, Vliet Vlieland T. et al Supervised Group Exercise in Axial Spondyloarthritis: Patients' Satisfaction and Perspective on Evidence-Based Enhancements. Arthritis Care Res (Hoboken) 2020; 72: 829-837
  • 30 Klemm P, Hudowenz O, Asendorf T. et al. [Multimodal rheumatologic complex treatment of rheumatoid arthritis-a monocentric retrospective analysis]. Z Rheumatol 2019; 78: 136-142
  • 31 Klemm P, Preusler P, Hudowenz O. et al Multimodal rheumatologic complex treatment in patients with spondyloarthritis – a prospective study. Eur J Intern Med 2021; 10.1016/j.ejim.2021.07.005
  • 32 Kiltz U, Wiatr T, Kiefer D. et al [Effect of multimodal rheumatologic complex treatment in patients with axial spondylarthritis : A systematic evaluation with standardized outcome parameters, such as the ASAS Health Index]. Z Rheumatol 2022; 10.1007/s00393-022-01241-1
  • 33 Kiefer D, Braun J, Kiltz U. et al Patients´ awareness towards physical activity in the treatment of axial spondyloarthritis. Joint Bone Spine 2023; 105585 10.1016/j.jbspin.2023.105585
  • 34 Swinnen TW, Scheers T, Lefevre J. et al. Physical activity assessment in patients with axial spondyloarthritis compared to healthy controls: a technology-based approach. PLoS One 2014; 9: e85309
  • 35 Jacquemin C, Servy H, Molto A. et al. Physical Activity Assessment Using an Activity Tracker in Patients with Rheumatoid Arthritis and Axial Spondyloarthritis: Prospective Observational Study. JMIR Mhealth Uhealth 2018; 6: e1
  • 36 Liu SH, Shridharmurthy D, Lapane KL. et al. Physical Activity and Attitudes Toward Exercise in People With Axial and Peripheral Spondyloarthritis. J Rheumatol 2021; 48: 513-519
  • 37 Davergne T, Moe RH, Fautrel B. et al. Development and initial validation of a questionnaire to assess facilitators and barriers to physical activity for patients with rheumatoid arthritis, axial spondyloarthritis and/or psoriatic arthritis. Rheumatology international 2020; 40: 2085-2095
  • 38 WHO. World Health Organization guidelines on physical activity and sedentary behaviour. Geneva: 2020. Licence: CC BY-NC-SA 3.0 IGO. In
  • 39 Kiltz U, Celik A, Tsiami S. et al. Are patients with rheumatic diseases on immunosuppressive therapies protected against preventable infections? A cross-sectional cohort study. RMD Open 2021; 7
  • 40 Niedermann K, Rausch AK, Braun J. et al Lay version of the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis : Translation into German and linguistic validation in German-speaking countries with people affected. Z Rheumatol 2021 10.1007/s00393-021-01079-z
  • 41 Kiltz U, Kiefer D, Braun J. et al Translation of the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis and linguistic validation in German-speaking countries with healthcare professionals. Z Rheumatol 2021 10.1007/s00393-021-01078-0
  • 42 Beauvais C, Rodère M, Pereira B. et al. Essential knowledge for patients with rheumatoid arthritis or spondyloarthritis: Results of a multicentric survey in France among health professionals and patients. Joint Bone Spine 2019; 86: 747-752
  • 43 Navarro-Compán V, Boel A, Boonen A. et al. The ASAS-OMERACT core domain set for axial spondyloarthritis. Semin Arthritis Rheum 2021; 51: 1342-1349
  • 44 Calin A, Garrett S, Whitelock H. et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 1994; 21: 2281-2285
  • 45 Jenkinson TR, Mallorie PA, Whitelock HC. et al. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 1994; 21: 1694-1698
  • 46 Jones SD, Porter J, Garrett SL. et al. A new scoring system for the Bath Ankylosing Spondylitis Metrology Index (BASMI). J Rheumatol 1995; 22: 1609
  • 47 Kiefer D, Braun J, Chatzistefanidi V. et al Clinical Relevance of Axial Radiographic Damage in Axial Spondyloarthritis – Evaluation of Functional Consequences by an Objective Electronic Device. J Rheumatol 2023; 10.3899/jrheum.2022-1240
  • 48 van Weely SF, van Denderen CJ, van der Horst-Bruinsma IE. et al. Reproducibility of performance measures of physical function based on the BASFI, in ankylosing spondylitis. Rheumatology (Oxford, England) 2009; 48: 1254-1260
  • 49 van Weely SF, van Denderen JC, Steultjens MP. et al. Moving instead of asking? Performance-based tests and BASFI-questionnaire measure different aspects of physical function in ankylosing spondylitis. Arthritis research & therapy 2012; 14: R52
  • 50 Carbo MJ, Paap D, Maas F. et al. The mSQUASH; a valid, reliable and responsive questionnaire for daily physical activity in patients with axial spondyloarthritis. Semin Arthritis Rheum 2021; 51: 719-727
  • 51 Ainsworth BE, Haskell WL, Herrmann SD. et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc 2011; 43: 1575-1581
  • 52 Kiefer D, Vaupel K, Kiltz U. et al [German translation and linguistic validation of the modified short questionnaire to assess health-enhancing physical activity (mSQUASH) for patients with axial spondyloarthritis (axSpA)]. Z Rheumatol 2024; 10.1007/s00393-024-01508-9
  • 53 Craig CL, Marshall AL, Sjöström M. et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003; 35: 1381-1395
  • 54 Rezvani A, Ergin O, Karacan I. et al. Validity and reliability of the metric measurements in the assessment of lumbar spine motion in patients with ankylosing spondylitis. Spine 2012; 37: E1189-1196
  • 55 Calvo-Gutierrez J, Garrido-Castro JL, Gonzalez-Navas C. et al. Inter-rater reliability of clinical mobility measures in ankylosing spondylitis. BMC Musculoskelet Disord 2016; 17: 382
  • 56 Ermann J. A Move Toward Precision: Innovations in Measuring Spinal Mobility in Axial Spondyloarthritis. J Rheumatol 2023; 50: 1362-1363
  • 57 Levine D, Colston MA, Whittle MW. et al. Sagittal lumbar spine position during standing, walking, and running at various gradients. Journal of athletic training 2007; 42: 29-34
  • 58 Vogt L, Pfeifer K, Portscher M. et al. Lumbar corsets: their effect on three-dimensional kinematics of the pelvis. Journal of rehabilitation research and development 2000; 37: 495-499
  • 59 Drerup B, Ellger B, Meyer zu Bentrup FM. et al. [Functional rasterstereographic images. A new method for biomechanical analysis of skeletal geometry]. Der Orthopade 2001; 30: 242-250
  • 60 Mannion AF, Knecht K, Balaban G. et al. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2004; 13: 122-136
  • 61 Wunderlich M, Ruther T, Essfeld D. et al. A new approach to assess movements and isometric postures of spine and trunk at the workplace. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2011; 20: 1393-1402
  • 62 Garrido-Castro JL, Medina-Carnicer R, Schiottis R. et al. Assessment of spinal mobility in ankylosing spondylitis using a video-based motion capture system. Manual therapy 2012; 17: 422-426
  • 63 Garrido-Castro JL, Escudero A, Medina-Carnicer R. et al. Validation of a new objective index to measure spinal mobility: the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI. Rheumatology international 2014; 34: 401-406
  • 64 Aranda-Valera IC, Cuesta-Vargas A, Garrido-Castro JL. et al. Measuring Spinal Mobility Using an Inertial Measurement Unit System: A Validation Study in Axial Spondyloarthritis. Diagnostics (Basel) 2020; 10
  • 65 Blazek V, Loy N, Jukic E. et al. AB0930 TOWARDS OBJECTIVE MEASUREMENT OF SPINAL MOBILITY IN AXIAL SPONDYLOARTHRITIS – BENCHMARKING AN INERTIAL MEASUREMENT UNIT SYSTEM WITH AN OPTICAL MEASUREMENT SYSTEM. Annals of the Rheumatic Diseases 2024; 83: 1774-1775
  • 66 Loy N, Blazek V, Jukic E. et al. POS0494 FEAR OF MOVEMENT AFFECTS RANGE OF MOTION DURING REPEATED BASMI EXERCISES ASSESSED BY STATE-OF-THE-ART MOTION CAPTURE TECHNIQUES. Annals of the Rheumatic Diseases 2024; 83: 936-937
  • 67 Kiefer D, Baraliakos X, Buhring B. et al [Epionics SPINE-use of an objective method to examine spinal mobility in patients with axial spondyloarthritis]. Z Rheumatol 2019; 10.1007/s00393-019-00692-3
  • 68 Taylor WR, Consmuller T, Rohlmann A. A novel system for the dynamic assessment of back shape. Medical engineering & physics 2010; 32: 1080-1083
  • 69 Consmuller T, Rohlmann A, Weinland D. et al. Automatic distinction of upper body motions in the main anatomical planes. Medical engineering & physics 2014; 36: 516-521
  • 70 van Weely SF, Dekker J, Steultjens MP. et al. Objective evaluation of physical functioning after tumor necrosis factor inhibitory therapy in patients with ankylosing spondylitis: a selection of 3 feasible performance-based tests. J Rheumatol 2015; 42: 623-629
  • 71 Soulard J, Carlin T, Knitza J. et al. Wearables for Measuring the Physical Activity and Sedentary Behavior of Patients With Axial Spondyloarthritis: Systematic Review. JMIR Mhealth Uhealth 2022; 10: e34734
  • 72 Soulard J, Vaillant J, Baillet A. et al. Gait and Axial Spondyloarthritis: Comparative Gait Analysis Study Using Foot-Worn Inertial Sensors. JMIR Mhealth Uhealth 2021; 9: e27087
  • 73 Knitza J, Tascilar K, Messner EM. et al. German Mobile Apps in Rheumatology: Review and Analysis Using the Mobile Application Rating Scale (MARS). JMIR Mhealth Uhealth 2019; 7: e14991
  • 74 Gossec L, Guyard F, Leroy D. et al. Detection of Flares by Decrease in Physical Activity, Collected Using Wearable Activity Trackers in Rheumatoid Arthritis or Axial Spondyloarthritis: An Application of Machine Learning Analyses in Rheumatology. Arthritis Care Res (Hoboken) 2019; 71: 1336-1343
  • 75 Strunz PP, Le Maire M, Heusinger T. et al. The exercise-app Axia for axial spondyloarthritis enhances the home-based exercise frequency in axial spondyloarthritis patients – A cross-sectional survey. Rheumatology international 2024; 44: 1143-1154
  • 76 Nitschke M, Nwosu OB, Grube L. et al. Refinement and Usability Analysis of an eHealth App for Ankylosing Spondylitis as a Complementary Treatment to Physical Therapy: Development and Usability Study. JMIR Form Res 2023; 7: e47426
  • 77 Truong MT, Nwosu OB, Gaytan Torres ME. et al. A Yoga Exercise App Designed for Patients With Axial Spondylarthritis: Development and User Experience Study. JMIR Form Res 2022; 6: e34566
  • 78 V DR-LBe. Unsere App Rheuma-Auszeit. In: https://www.rheuma-liga.de/infothek/app 2024