ESPA
Exercise as a treatment for patients with inflammatory rheumatic disease
Project Manager
ABOUT THE PROJECT
The purpose of the study is to investigate whether exercise can be effective as a treatment for patients with spondyloarthritis (SpA).
Recommended treatment for patients with SpA is a combination of medication and exercise. It has been traditional to recommend gentle exercise with an emphasis on joint mobility, with the aim of not increasing disease activity, pain, and fatigue. However, research has now shown that SpA may increase the risk of cardiovascular disease. This is believed to be due to both an increased degree of inflammation in the body and an increased occurrence of traditional risk factors. In healthy adults and other patient groups, exercise has been shown to have a positive effect on both inflammation and other risk factors for cardiovascular disease. This has not been investigated in patients with SpA. There is a demand for studies that investigate the effect that exercise can have on inflammation in patients with chronic inflammatory diseases. In addition, we have conducted a pilot study that showed promising results in relation to both disease activity and risk factors for cardiovascular health.
The purpose of the ESpA study is to investigate the effect of fitness and strength training on disease activity and risk factors for cardiovascular disease in patients with SpA. The results may provide new knowledge about exercise as a treatment measure to reduce disease activity and risk for cardiovascular disease in this patient group.
WHO CAN JOIN?
It is no longer possible to participate in the study as it has been completed.
The participants in the study had SpA, were between 18 and 70 years old and were suffering from the disease at the time of inclusion. They had not exercised regularly (>1 time of 60 min per week) muscle strength and/or cardio training during the past six months. Even if they had exercised mobility training or participated in pool training regularly during this period, they could participate in the study. In the case of other diseases with contraindications to high-intensity exercise, they could not participate in the study.
WHAT DOES THE STUDY INVOLVE?
At the beginning of the study (test 1), after 3 months (test 2) and 6 months follow-up (test 3):
- Cardiological examination, including measurement of blood pressure, height, weight and waist circumference, measurement of body composition using a scanning test (DXA scan), and ECG examination (electrodes are attached to the chest to measure the electrical activity of the heart).
- Blood samples that will be analyzed for both markers of disease activity and risk factors for cardiovascular disease.
- Measurement of pressure in the vein wall in the wrist, groin and neck.
- Measurements of blood flow in both index fingers before, during and after 5 minutes of clamping the arm's artery using a blood pressure cuff. The test is performed using a cap that is slipped onto the index finger and provides a measure of the stiffness of the artery wall, an early sign of atherosclerosis.
- Ultrasound examination of the blood vessels in the neck
- Physical fitness examination, including a maximal walking test on a treadmill, measurement of muscle strength and mobility.
- Questionnaire about illness complaints, physical function, fatigue, sleep, general health, self-reported physical fitness and physical activity level.
- MRI examination of the back and pelvic joints. This involves participants lying still for up to 30 minutes.
Those randomly selected to be in the exercise group were also offered an individually adapted exercise program supervised by a physiotherapist. The training consisted of cardio (40 minutes) and strength training (20 minutes). The goal was for the participants to participate in supervised exercise with a physiotherapist two days a week, and one day a week of self-training.