High-Intensity Interval Training Safe for Psoriatic Arthritis Patients

A recent study investigating the impact of high-intensity interval training (HIIT) on patients with psoriatic arthritis has found no significant evidence of increased inflammation when objectively measured using ultrasound and MRI scans. The findings suggest that HIIT is a safe exercise regimen for psoriatic arthritis patients, particularly those with low to moderate disease activity.

The study published in BMC Musculoskeletal Disorders was an analysis of a randomized controlled trial designed to assess the effects of HIIT on disease activity in psoriatic arthritis patients. In the original trial, 67 participants were randomly assigned to either an intervention group, which underwent structured HIIT for 11 weeks, or a control group that was instructed to maintain their exercise habits.

The primary outcomes of interest in the original trial were differences in patient-reported global assessment, fatigue, and pain scores, as well as the composite Disease Activity Score in 44 joints at 3 and 9 months. While the trial did not show any long-term effects of HIIT on these outcomes at 9 months, participants in the exercise group reported less fatigue after the intervention period.

The current study aimed to delve deeper into this relationship by analyzing data from the trial. The researchers led by Thomsen RS used ultrasound and MRI imaging to assess changes in inflammation among psoriatic arthritis patients. All 67 participants had ultrasound measurements available for analysis, and a subgroup of 41 also had MRI data.

The primary outcomes of interest for this analysis were the proportions of patients with increased ultrasound bright-mode scores, power-doppler (PD) signals of joints and entheses, and Spondyloarthritis-Research-Consortium-of-Canada (SPARCC)-BME scores of the sacroiliac joint and spine for both groups.

• Upon analysis, the results revealed that the proportions of patients with increased ultrasound bright-mode scores were 32% and 28% in the exercise and control groups, respectively.
  
• PD scores indicated that increases occurred among 7% of the exercise group and 10% of the control group for joints, while increases in PD scores of entheses were observed in 32% of the exercise group and 31% of the control group.
• MRI analysis showed that bone marrow edema (BME) scores of the sacroiliac joint increased in 6% of the exercise group and 10% of the control group.
• For MRI BME of the spine, increases were observed in 6% of the exercise group and 5% of the control group.

In summary, this randomised controlled trial found no substantial evidence of increased inflammation after three months of high-intensity interval training, as evaluated by objective measures such as ultrasound of peripheral joints and entheses, as well as MRI assessments of bone marrow edema in the sacroiliac joint and spine, when comparing the HIIT group with the control group.

Reference:

Thomsen RS, Nilsen TIL, Haugeberg G, et al. Changes of inflammation in patients with psoriatic arthritis after high intensity interval training assessed by ultrasound and MRI, a randomized controlled trial. BMC Musculoskelet Disord. 2023;24(1):743. Published 2023 Sep 19. doi:10.1186/s12891-023-06871-3