Health status, objective physical fitness and physical therapy use in psoriatic arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory joint disease strongly linked to psoriasis. PsA affects 1% of the general population, but among patients with psoriasis the prevalence increases to 6-42%. PsA is characterized by inflammation in the synovium or enthesis, and by structural damage to the skeleton, either bone destruction or pathological bone formation. With a peak onset of disease at 36 years, PsA impacts on the working population. These features contribute to the large physical and psychosocial burden of PsA. In addition, there is a remarkable increased risk for metabolic and cardiovascular comorbidities. To the best of our knowledge, up till now the cardiorespiratory fitness (a variable of cardiovascular risk) in PsA-population has not been examined yet. Also, the relation between cardiorespiratory fitness and disease activity has not been explored in literature. However, theory suggests that a better physical fitness can contribute to less inflammation mainly due to an improvement of fat mass and fat metabolism. This project will explore the cardiorespiratory fitness of PsA-patients and compare to healthy persons. Other parameters related to disease activity, muscle strength, cardiovascular risk factors, quality of life, physical activity in daily life will be evaluated too. Lastly, this project will try to investigate the application of physiotherapy in PsA-population from the patient, the physiotherapist, rheumatologist and general practitioner point of view. The results of this project will facilitate future studies to examine the impact of non-pharmacological treatments on comorbidities related to PsA and to explore the disease mechanisms of PsA. Furthermore, it aims to optimize the evidence based practice of physiotherapists in PsA-patients.