The effects of the home exercise program on the depression, fatigue and quality of life in patients with spondyloarthritis

Objectives: Spondyloarthritis is a group of diseases characterized by various clinical symptoms, common laboratory and imaging findings, mainly inflammation in the axial skeleton and sacroiliac joints. The frequency of depression and fatigue in spondyloarthritis patients increased compared to the normal population. Depression and fatigue can negatively affect patients' quality of life and create important problems for patients. Methods: We have included 100 patients classified as aks-SpA according to the ASAS / EULAR criteria who applied between 01 April 2019 and 31 December 2019, at Manisa Celal Bayar University Hafsa Sultan Hospital Department of Physical Medicine and Rehabilitation Policlinics. The patients were divided into two groups as 50 patients in the exercise group and 50 patients in the control group according to the randomization scheme reached via the internet. In addition to the current medical treatments, the exercise group was asked to apply 10 exercises, 12 week home programs and a minimum frequency of 2 days/week, mainly consisting of flexibility, mobility and posture exercises. No intervention was made to the control group. The control group was given an exercise program at the end of 12 weeks. The patients were evaluated at the beginning and at the 12th week in terms of depression (BDI), fatigue (FSS), quality of life (SF-36), disease activity (BASDAI) and functional status (BASFI). Results: We found depressive symptoms in 52.2% of our patients and fatigue in 72.8% of them. We found that the mean quality of life scores of our patients were lower than the average values of the Turkish society. We found that ankylosing spondylitis and nr-axSpA patients were similar in terms of depression, fatigue and quality of life. We found that the factors most associated with depression are disease activity and fatigue, while the factors most associated with fatigue are disease activity and pain. We have shown a statistically significant improvement in patients' depression, fatigue, quality of life, disease activity and functional status with the home exercise program consisting of 12-week flexibility, mobility and posture exercises. In the control group, while BASDAI scores improved significantly, the improvement in the exercise group was more evident. Conclusion: The frequency of depression and fatigue is high in patients with spondyloarthritis. Patients' quality of life is worse than the normal population. There is no difference between ankylosing spondylitis and nr-axSpA patients in terms of depression, fatigue and quality of life. The 12-week home exercise program is effective in improving depression, fatigue and quality of life.