Background:Psoriatic arthritis (PsA) is associated with sleep disturbance, depression
and a lifetime risk of obesity and cardiovascular disease. To date, there
have been no studies investigating the relationship between
objectively-measured physical activity (PA) levels and circadian rhythm
disturbance with disease activity, daily symptoms and mood in patients with
PsA.Objective:This pilot study aimed to investigate the relationship between disease
activity, daily symptoms and mood on PA and circadian rhythm in PsA.Design:A prospective cohort study recruiting adults with PsA from rheumatology
clinics at a single centre in the UK.Methods:Participants wore an actigraph and recorded their symptoms and mood on a
daily basis via a smartphone app for 28 days. Time spent in sedentary, light
and moderate-to-vigorous physical activity (MVPA) and parameters reflecting
the circadian rhythm of the rest-activity pattern were derived. This
included the onset time of the least active 5-h (L5) and most active 10-h
(M10) daily consecutive periods and the relative amplitude (RA). The
relationship factors between baseline clinical status, daily symptoms, PA
and circadian measures were examined using linear mixed effect regression
models.Results:Nineteen participants (8/19 female) were included. Participants with active
PsA spent 63.87 min (95% CI: 18.5–109.3,p= 0.008) more in
inactivity and 30.78 min (95% CI: 0.4–61.1,p= 0.047) less
in MVPA per day compared to those in minimal disease activity (MDA). Age,
body mass index and disease duration were also associated with PA duration.
Participants with worse functional impairment had an M10 onset time 1.94 h
(95% CI: 0.05–3.39,p= 0.011) later than those with no
reported functional impairment. No differences were detected for L5 onset
time or RA. Higher scores for positive mood components such as feeling
energetic, cheerful and elated were associated with less time in inactivity
and greater time spent in MVPA overall.Conclusion:Our study highlights differences in PA and circadian rest-activity pattern
timing based on disease activity, disability and daily mood in PsA. Reduced
PA levels in patients with active disease may contribute to the observed
increased risk of cardiovascular and metabolic sequelae, with further
studies exploring this need.