Analysis of adherence to rehabilitation therapy in patients with spondyloarthropathy
Objective:To assess adherence to rehabilitation therapy among patients with spondyloarthritis(SpA)and to analyze factors affecting adherence.Methods:Four hundred and thirty-five outpatients with SpA between March 2021 and July 2023 were retrospectively enrolled.Sociodemographic information,disease-related data,laboratory examinations,and imaging findings were collected.Patients'adherence to rehabilitation therapy was assessed using the 18-item Exercise Attitude Questionnaire(EAQ).Patients were categorized into groups of good adherence and poor adherence based on a cutoff score of 50,and intergroup comparisons were performed.Significant factors identified through univariate analysis were included in a multivariate logistic regression analysis to assess statistically significant factors related to poor adherence.Results:The median EAQ score was 48.1(40.7,55.6),with 249 patients(57.2％)determined to have poor adherence.Comparative analysis between the two groups revealed significant differences in the following parameters:age at diagnosis(P＜0.001),age at onset of symptoms(P=0.004),duration of illness(P＜0.001),diagnostic delay(P＜0.001),rural residence(P=0.021),comorbid psoriasis(P=0.012),comorbid inflammatory bowel disease(IBD)(P=0.012),hemoglobin level(P＜0.001),erythrocyte sedimentation rate(ESR)(P=0.006),C-reactive protein level(P=0.016),albumin level(P=0.001),current use of nonsteroidal anti-inflammatory drugs(NSAIDs)(P=0.005),Bath ankylosing spondylitis disease activity index(BASDAI)(P＜0.001),and Bath ankylosing spondylitis functional index(BASFI)(P=0.018).Multivariate logistic regression analysis revealed that factors associated with poor adherence to rehabilitation treatment in SpA patients included comorbid IBD(OR=3.132,P=0.047),current use of NSAIDs(OR=1.998,P=0.002),the BASDAI(OR=1.148,P=0.012),the duration of illness(OR=1.061,P＜0.001),and the ESR(OR=1.014,P=0.009).Conclusions:Factors associated with poor adherence to rehabilitation treatment in SpA patients include comorbid IBD,current use of NSAIDs,elevated BASDAI,prolonged duration of illness,and elevated ESR.
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