Evaluating the Impact of High Intensity Interval Training on Axial Psoriatic Arthritis Based on MR Images

Abstract

High intensity interval training (HIIT) has been shown to benefit patients with psoriatic arthritis (PsA). However, magnetic resonance (MR) imaging has uncovered bone marrow edema (BME) in healthy volunteers after vigorous exercise. The purpose of this study was to investigate MR images of the spine of PsA patients for changes in BME after HIIT. PsA patients went through 11 weeks of HIIT (N = 19, 4 men, median age 52 years) or no change in physical exercise habits (N = 20, 8 men, median age 45 years). We acquired scores for joint affection and pain and short tau inversion recovery (STIR) and T1-weighted MR images of the spine at baseline and after 11 weeks. MR images were evaluated for BME by a trained radiologist, by SpondyloArthritis Research Consortium of Canada (SPARCC) scoring, and by extraction of textural features. No significant changes of BME were detected in MR images of the spine after HIIT. This was consistent for MR image evaluation by a radiologist, by SPARCC, and by texture analysis. Values of textural features were significantly different in BME compared to healthy bone marrow. In conclusion, BME in spine was not changed after HIIT, supporting that HIIT is safe for PsA patients.

Keywords: computer assisted image processing; exercise; magnetic resonance imaging; psoriatic arthritis; spondyloarthropathies.

Figure 1

Flow chart of patient inclusion, follow-up, and analysis.

Figure 2

MR image examples. Sagittal short tau inversion recovery (STIR) MR images of upper spine in two patients. (A) (baseline) and (B) (11 weeks) are of a patient with low SPARCC scores (4 and 2, respectively). The images show the spine from the second cervical vertebrae (C2) to thoracic vertebrae 12 (TH12). Segmented region in red in B shows minor BME in corner of TH10. (C) (baseline) and (D) (11 weeks) are of patient with high SPARCC scores (39 and 50, respectively). The images show the spine from the second cervical vertebrae (C2) to thoracic vertebrae 11 (TH11), and segmented regions in red in (C) and (D) show BME in C5 to C7, and in TH5 to TH9.