SPARK
SPondylaritis Condition
Project Manager
Post doc
PhD fellow
ABOUT THE PROJECT
Spondyloarthritis (formerly called Bekhterev) is a chronic inflammatory joint disease that affects the pelvic joints and the spine. The disease can cause reduced mobility and pain, it most often debuts before the age of 45 and affects approximately 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 additional drug treatment is needed.
Drug treatment may 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 reliable evaluation of whether exercise has a sufficient effect on disease activity before the decision to start with biologic drugs is made.
The study will last for 6 months and is a randomized trial where participants will train for 3 or 6 months.
The training in SPARK follows the recommendations for the general population with 2 high-intensity sessions, one moderate cardio session and strength training each week.
The training program is delivered digitally with the SPARK app, where the individual sessions are located in the calendar. The SPARK calendar will also contain links to questionnaires that must be completed. Participants will also watch short video clips with information about spondyloarthritis in the app, as well as receive advice from healthcare professionals 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 training 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 INVOLVE?
Patients who wish to participate in the study will be divided into two groups by random drawing at 2 points in time: at baseline and after 3 months.
Draw No. 1 (at the start):
The training group will be assigned the SPARK training application for smartphones or tablets. They will be introduced to SPARK, training in general and different types of training. They will train at least 3 days per week. They will receive ongoing training guidance from a physiotherapist, both to ensure progression in training and to ensure adaptation of the training. Training data will be collected with a sports watch and by self-registration in the SPARK app.
The control group will follow the usual control and treatment program, which will most often include recommendations for exercise and possibly a referral to a physiotherapist for a one-time assessment.
After 3 months, it is evaluated whether SPARK has an effect or not.
Draw #2 (after 3 months):
All participants will train with the SPARK app for 3 months after draw #2.
The follow-up group will follow the same program as the Training Group after draw #1, with personal digital training guidance by a physiotherapist each week.
The non-follow-up group will follow the training programs in the SPARK app on their own without the weekly personal training guidance.
All participants will complete 3 large questionnaires and 4 short questionnaires, this will be done digitally. In addition, all participants will complete tests on 3 different days (approximately 2 hours in duration) with 12 weeks between them. The tests will involve physical tests for fitness and strength, functional tests and body composition measurements as well as two fingertip blood samples (CRP and lactate).
How to join SPARK?
If you would like 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 should be sent as usual and marked SPARK. You and your spondyloarthritis should be followed up with your rheumatologist at the same time as participation in the SPARK study.
The referral to SPARK should include 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 most recent CRP value, with the date of the sample collection.
Once you have been referred to us, you will receive a phone call to ensure that you meet the criteria for participation and do not have any of the exclusion criteria.
Exclusion criteria include current or previous use of biological drugs, pregnancy, contraindications to high-intensity exercise (e.g. severe or uncontrolled cardiovascular disease, lung disease or cancer).