UMMS Affiliation

Division of Epidemiology, Department of Population and Quantitative Health Sciences; Division of Rheumatology, Department of Medicine; Clinical and Population Health Research Program, Graduate School of Biomedical Sciences

Publication Date


Document Type

Article Postprint


Epidemiology | Musculoskeletal Diseases | Rheumatology


OBJECTIVE: To evaluate physical activity and attitudes towards exercise among people with axial and peripheral spondyloarthritis (SpA).

METHODS: Using baseline information from an on-going, longitudinal, prospective SpA cohort study (n=264), self-reported attitudes and beliefs towards exercise were assessed using questionnaires. Total metabolic equivalent (MET) hours of self-reported physical activity per week, time spent in activities, and activity levels were calculated from the Nurses' Health Study Physical Activity Questionnaire II (NHSPAQ II). Adjusted multivariable linear models estimated the relationship between physical activity and disease status (axial versus peripheral).

RESULTS: Regardless of predominant anatomic distribution of disease, most participants were well-educated, non-Hispanic white men. Approximately 40% met the United States Department of Health and Human Services physical activity recommendations. Positive attitudes, beliefs, and perceived benefits towards exercise were similar by anatomic distribution of disease. Despite similar MET-hours per week, participants with axial disease had greater concerns regarding discomfort and joint injuries than those with peripheral disease. Compared to those with peripheral SpA (n=201), participants with axial SpA (n=63) spent less time engaging in light and moderate activities (adjusted beta in light activity: -1.94 minutes/week, 95% Confidence Interval (CI): -2.96 to -0.93; adjusted beta in moderate activity: -1.05 minutes/week, 95% CI: -2.12 to 0.02).

CONCLUSION: Participants with axial SpA had greater concerns regarding discomfort and injuries from exercise than those with peripheral SpA. Although no differences in time spent in vigorous activities were observed, participants with axial SpA spent less time than those with peripheral SpA in light to moderate activities.


Ankylosing spondylitis, Cohort studies, Exercise, Spondyloarthropathy

Rights and Permissions

© 2020 The Journal of Rheumatology. This is a PDF file of the authors' accepted manuscript that has been accepted for publication and posted with a 12 month embargo as allowed by the publisher's author self-archiving policy at

DOI of Published Version



Liu SH, Shridharmurthy D, Lapane KL, Dubé CE, Gravallese EM, Kay J. Physical activity and attitudes towards exercise in people with axial and peripheral spondyloarthritis. J Rheumatol. 2020 Oct 15:jrheum.200354. doi: 10.3899/jrheum.200354. Epub ahead of print. PMID: 33060306. Link to article on publisher's site

Journal/Book/Conference Title

The Journal of rheumatology

PubMed ID


Related Resources

Link to Article in PubMed

Available for download on Friday, October 15, 2021