062 Associations between sedentary behavior and pain in rheumatoid arthritis

Background: There is ample evidence that physical activity and exercise have numerous health benefits in rheumatoid arthritis (RA), including decreasing pain while improving physical function and cardiovascular health, without aggravating symptoms or inducing further joint damage. Despite the strong evidence supporting the benefits of physical activity, high numbers of people with RA remain physically inactive or sedentary. A better understanding of the clinical characteristics related to sedentary behavior may facilitate future targeting of this behavior to improve health outcomes for people with RA. This study aimed to quantify sedentary behavior using subjective and objective measures in a cohort of Irish patients with RA, and to determine the associations between objectively measured sedentary behaviour and clinical factors, including pain, mood, fatigue, sleep quality and disease activity.

Methods: Patients with RA were recruited for this cross-sectional study, from a rheumatology clinic at a publically funded hospital over a six-month period. Sedentary behavior, defined as sitting or lying, was measured objectively over a 7-day period using the activPAL accelerometer. Information about pain symptoms, quality of life, mood and sleep quality was recorded using validated questionnaires. Disease activity was measured using the Clinical Disease Activity Index (CDAI). Bivariate correlation coefficients (Spearman rho [r]) were calculated between clinical measures and sedentary behavior variables.

Results: Fifty patients with RA provided clinical and accelerometer data for this analysis. Participants’ mean age (SD) was 60.5 years (12.3) and 62% were female. The average time since diagnosis was 17.1 years (SD 11.4). Disease activity score averaged 10.7 on the CDAI representing borderline mild to moderate disease activity. The proportion taking biologic agents to treat their disease was 56%. Mean arthritis VAS pain score was 4.7 (SD 3.0), fatigue VAS was 5.4 (SD 3.0) and depression as measured on Hospital Anxiety and Depression Score was 5.1 (SD 3.6). The average score on the Pittsburg Sleep Quality Index was 7.0 (SD 5.1). Participants’ mean subjective estimate of their sedentary time was 5.2 hours (SD 2.2). However according to accelerometer data participants spent on average 8.75 hours (SD 1.6) in sedentary activities, excluding time in bed at night. Analysis revealed that sedentary time had a positive low correlation with pain intensity (r = 0.29, p = 0.04), depression (r = 0. 31, p = 0.03) and disease activity (r = 0.30, p < 0.03). Neither sleep quality nor fatigue was found to be related to sedentary behaviour.

Conclusion: Participants spent a significant proportion of waking hours engaged in sedentary activities and tended to underestimate this time. Results suggest that self-report pain intensity, depression and disease activity are related to volume of sedentary behavior. Future research should investigate the direction of these relationships in order to develop interventions to reduce sedentary time in this patient group.

Disclosures: K. Quinn: None. H. O’ Leary: None. G. Murphy: None.