Factors Associated With Physical Activity in Home-Based Rehabilitation Patients With Ankylosing Spondylitis: A Prospective Longitudinal Study.

BACKGROUND

To identify factors associated with physical activity levels among patients with ankylosing spondylitis (AS) who are undergoing home-based rehabilitation.

METHODS

A 6-month follow-up study of 225 AS patients in remission was conducted in a hospital. Data were collected at patient discharge (T0) and at 1 month (T1), 3 months (T2) and 6 months (T3) postdischarge via questionnaires that assessed a range of physiological, psychological, social and cognitive variables. The influence of these variables on physical activity levels was examined via generalised estimating equations (GEEs).

RESULTS

Physical activity levels significantly fluctuated over time, as they exhibited an initial decrease followed by a slight increase. Lower levels were observed at 3 months postdischarge (T0: 74.3 ± 81.9; T1: 70.1 ± 79.3; T2: 60.5 ± 73.1; T3: 75.4 ± 80.1). Univariate analysis revealed that anxiety level, depression severity, perceived exercise benefits/impairment, exercise self-efficacy and social support significantly influenced physical activity (p < 0.001). The GEE model revealed that educational level, the absence of biologics, the Bath Ankylosing Spondylitis Functional Index (BASFI) score, anxiety, perceived exercise benefits/barriers and social support were significant predictors of physical activity (p < 0.05). Specifically, patients with lower education levels and those not receiving biologics had higher physical activity levels, whereas increased BASFI scores, anxiety and perceived barriers were associated with reduced physical activity.

CONCLUSION

Physical activity is essential for improving the functional outcomes of AS patients, and various factors significantly influence their engagement in physical activities. This study provides a foundational framework for tailored home rehabilitation strategies and emphasises the need for personalised approaches in long-term management.