Background Physiotherapy is a cornerstone in the management of ankylosing spondylitis (AS) . Exercise interventions should be based on the available evidence as well as the patients' experiences and expectations.
Objectives To survey the use of individual and group physiotherapy and exercise preferences in people with AS from the Netherlands (NL) and Switzerland (CH).
Methods In NL, the questionnaires were sent by post-mail to 458 patients registered in hospitals in the Leiden area. In CH, an online survey was conducted. The link to the questionnaire was sent to 1742 German speaking members of the Swiss Ankylosing Spondylitis Association.
Results Response rate was 45% (n=206) in NL and 29% in CH (n=507). Dutch and Swiss participants had a similar mean age (56 (SD±15) vs 53 (SD±13) years, but the Dutch sample consisted of less women (31% vs 48%), had a longer mean disease duration (23 [range 1–58] vs 14 [1–66]) and was less healthy according to ASAS health index (6 [1–16] vs 4 [1–16]).
44% and 84% of the Dutch and 28% and 54% of the Swiss have currently or had at least once in the past respectively, individual physiotherapy treatment. The major reason for stopping was “I could do the exercises at home myself” in both countries. 9% and 31% of the Dutch and 30% and 27% of the Swiss are currently, or were in the past respectively, participating in group physiotherapy. The major reasons to stop were “It was too heavy for me” in NL (28%) and “It consumed too much of my time” in CH (7%).
8% and 18% of the Dutch and 20% and 23% of the Swiss have currently or had at least once in the past respectively, participated in hydro-group physiotherapy. Reasons to stop were “I did not experience any positive effects” in NL (28%) and again “It consumed too much of my time” in CH (7%). When asked about preferences regarding exercising without supervision, 40% of the participants in NL and CH wanted “individually designed exercise programmes” and approximately 50% in NL and CH to exercise self-responsible regarding mode, intensity, and frequency.
When asked about their preferred type of supervised exercises, around a quarter of the answers in both countries supported each: “AS specific exercise groups”, “fitness centers” and “individual physiotherapy”, however the Swiss clearly preferred AS specific exercise groups (47%).
With respect to the supervision and physiotherapists specialized in AS as supervisors (38% NL vs 60% CH).
Their willingness to pay for a supervised group session was 8€ in NL and 25€ in CHF.
Conclusions There are differences in the use of physiotherapy in both countries. But there are also similarities between the Dutch and Swiss AS patients regarding their preferences for exercises, except the financial valuation of group exercise classes. Findings may help to further develop patient-centred services in both countries. Especially, enabling people with AS to perform exercises independently would meet their needs and might enhance their daily physical activity.
Braun J et al. (2010) Update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2911; 70:896–904
Disclosure of Interest None declared