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Factors Associated With Physical Activity in Home-Based Rehabilitation Patients With Ankylosing Spondylitis: A
Heng-Ying Fang1, Ying-Hua Pan2, Yi-Heng Zhang3,4
1Department of Nursing, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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.
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