Background Apart from pharmacological treatment (NSAIDs and anti-TNF-α treatment), exercise and physiotherapy are cornerstones in the management of ankylosing spondylitis (AS) (1).
Objectives To evaluate the effect of a 2-weeks rehabilitation program on disease activity and physical function in patients with AS.
Methods We searched retrospectively the Hospital database for AS patients aged 18 years and older who participated in our 2-week rehabilitation program in the period from January 2007 to June 2011. All patients had to fulfill the modified New York criteria for AS. Data collection prior and after the 2-weeks training period included variables on: demographics, patients reported outcome measures (Bath Ankylosing Spondylitis of Disease Activity (BASDAI) and Functional Index (BASFI)), objective measures of physical function and impairment (BAS-Metrology Index (BASMI), Gait Velocity (GV), Timed-Stands Test (TST), Occiput-Wall Distance (OWD), Finger-Floor Distance (FFD), Chest Expansion (CE) and laboratory data as Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP). The daily rehabilitation program consisted of water exercises (30 min), exercises for flexibility, muscle strength (45 min), and cardio respiratory fitness (40 min), aiming at keeping the training intensity as recommended (2). The training was conducted by a physiotherapist in groups, but with an individual focus according to the goals and status of the patients. Every patient was also followed and given advice on an individual basis. We used paired Student’s t-test for continues variables and Chi square test for categorical variables comparing data at admission and at discharge.
Results 87 AS patients were eligible for evaluation (60 men and 27 women). Mean age was 49 yrs, disease duration 14 yrs, and body mass index 26.7 kg/m2. 92.5% were HLA-B27 positive, 27.2% current smokers, and 59.8% employed. 62% were current users of NSAIDs and 17% of biologics. After the 2-weeks program a statistical significant improvement (p<0.001) was seen for patient reported outcomes (BASDAI 4.3 vs. 3.1, BASFI 3.1 vs. 2.4) and physical measured outcomes (BASMI 3.23 vs. 2.29, GV 2.2m/s vs. 2.6 m/s, TST 22.5 s vs. 16.3 s, OWD 3.7 cm vs. 2,5 cm, FFD 17.9 cm vs. 8.9 cm, CE 3.9 cm vs. 4.6 cm). No difference was seen for ESR (16.5 vs. 16.9 mm/hr) and CRP (8.2 vs. 8.3 mg/l).
Conclusions Our study shows that short term rehabilitation in AS patients improves patient reported disease activity, patient reported and objective measured physical function. However, short term rehabilitation did not reduce the biologic markers of disease activity ESR and CRP.
 Zochling J, van der Heijde D, Burgos Vargas R et al. ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2006; 65:442-52.
 Position Stand of the American College of Sports Medicine. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc 1998; 22:265-74.
Disclosure of Interest None Declared
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