SPARK
SPondylaritis Condition
Project Manager
Post doc
PhD fellow
ABOUT THE PROJECT
Spondyloarthritis (formerly called Ankylosing spondylitis) is a chronic inflammatory joint disease that affects the pelvic joints and spine. The disease can cause reduced mobility and pain, it most often starts before the age of 45 and affects approx. 1% of the population. It is typical for spondyloarthritis that the disease activity varies over time and this can also mean that the treatment varies.
Exercise is a cornerstone in the treatment of spondyloarthritis and is always part of the treatment, regardless of whether there is also a need for drug treatment.
The drug treatment can consist of mild anti-inflammatory drugs (e.g. Ibux, Naproxen), if necessary, or potent immunosuppressive biological drugs in the form of tumor necrosis factor inhibitors (e.g. etanercept/Enbrel, adalimumab/Amgevita).
Patients with spondyloarthritis and rheumatologists need a safe evaluation of whether exercise has a sufficient effect on disease activity before the decision to start with biological drugs is made.
The study lasts for 6 months and is a randomized study where the participants will train for 3 or 6 months.
The training in SPARK follows the recommendations for the general population with 2 high-intensity sessions, a moderate cardio session and strength training each week.
The training program is delivered digitally with the SPARK app, where the individual sessions are in the calendar. In the SPARK calendar there will also be links to questionnaires that must be completed. The participants will also see small video clips with information about spondyloarthritis in the app, as well as get advice from healthcare personnel and a patient representative on how to live as best as possible with the disease.
SPARK is evaluated on several parameters, but the most important is whether exercise can sufficiently reduce disease activity.
WHO CAN JOIN?
Adult patients with newly diagnosed spondyloarthritis (within the last 2 years), without biological treatment.
WHAT DOES THE STUDY INCLUDE?
Patients who wish to participate in the study are divided into two groups by lottery at 2 points in time: at the start and after 3 months.
Lottery no. 1 (at start):
The training group will be awarded the SPARK training application for smartphones or tablets. They will be introduced to SPARK, training in general and different types of training. They must carry out training at least 3 days per week. They will receive ongoing training guidance from a physiotherapist, both to ensure progression in the training and to ensure adaptation of the training. Training data is collected with a sports watch and by self-registration in the SPARK app.
The control group will follow the usual control and treatment plan, which will most often include a recommendation for exercise and possibly a referral to a physiotherapist for a one-off assessment.
After 3 months, it is evaluated whether SPARK has an effect or not.
Lottery no. 2 (after 3 months):
All participants must train with the SPARK app for 3 months after lottery no. 2.
The follow-up group must follow the same plan as for the Training Group after lottery no. 1, with personal digital training guidance by a physiotherapist every week.
The non-follow-up group must follow the training programs in the SPARK app on their own without the weekly personal training guidance.
All participants must answer 3 larger questionnaires and 4 short questionnaires, this is done digitally. In addition, all participants must complete tests on 3 different days (around 2 hours duration) at 12-week intervals. The tests involve physical tests for fitness and strength, function tests and measurement of body composition as well as two fingertip blood samples (CRP and lactate).
How to join SPARK?
If you want to be considered for participation in the SPARK study, you can ask your rheumatologist to refer you to the project at Diakonhjemmet hospital. The referral must be sent as usual and marked with SPARK. You and your spondyloarthritis must be followed up by your rheumatologist at the same time as participation in the SPARK study.
The referral to SPARK must contain your diagnosis, a description of your MRI images of the pelvic joints and/or spine with information about where the MRI images were taken. We also want the latest CRP value, with the date of the sampling time.
Once you have been referred to us, you will receive a telephone call to ensure that you meet the criteria for participation and do not have any of the exclusion criteria.
Exclusion criteria include use of biological drugs now or in the past, pregnancy, contraindications to high-intensity exercise (e.g. severe or uncontrolled cardiovascular disease, lung disease or cancer).