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OP0314-PARE Group Exercise Therapy in Ankylosing Spondylitis (AS): The Patients' Perspective
  1. F. Van Der Giesen1,
  2. F. Van Gaalen2,
  3. R. De Jong3,
  4. M. Van Goeverden4,
  5. H. Slootweg5,
  6. T. Vliet Vlieland1
  1. 1Orthopaedics
  2. 2Rheumatology, Leiden University Medical Center, Leiden
  3. 3Praktijk voor Mensendieck, Sassenheim
  4. 4Praktijk voor Fysiotherapie, Leiden
  5. 5Slootweg Legal Support., Noordwijk, Netherlands

Abstract

Background Group exercises have been recommended for patients with AS with, some exercise classes having been instituted more than 20 years ago. Current practice may therefore not be consistent with the current needs and preferences of AS patients and new scientific insights into required components and dosage (exercises improving joint mobility, strength, cardiopulmonary fitness and neuromotor abilities) dosage (intensity x duration/repetitions, dependent on age and health status), frequency (at least 2–3 times a week).

Objectives To determine to what extent patients with AS are satisfied with a long-existing group exercise programme and what their preferences are regarding the current and required features of group exercise classes.

Methods A survey was administered to patients participating in a group exercise programme used in a randomised trial (1). The programme, once a week during 2.5 hours, consisted of mobility exercises, sports activities (e.g. volleyball, badminton) and hydrotherapy, addressing strength, mobility and fitness without specification of dosage, regular monitoring or home exercises. The survey investigated experiences with the dosage of the programme components (too high/too low), its subjective effects, patients' preferences regarding potentially novel elements (heart rate controlled training, regular standardized assessments of mobility, physical function and activity limitations) and increased exercise frequency (in favour/not in favour/don't know).

Results 43 of 48 patients (90%) returned the survey, 31 (72%) were male, their median age was 58 years (range 33–80). Overall, there were patients finding the dosage of various programme components either high/too high or low/too low and/or deserving less or more attention. The top 3 of most frequently perceived positive effect of the programme were the prevention of deterioration (74%), moving less stiff (61%) and an improved cardiopulmonary fitness (30%). Regarding potential adaptations, the majority of patients favoured implementing heart rate-guided cardio-vascular training (63%) and standardized and periodic assessments (74%), whereas a minority favoured increasing the frequency of exercise classes (23%).

Satisfaction of 43 AS patients regarding a group exercise programme

Conclusions The variety regarding patients' perception with a group exercise programme of its intensity and preferred components underlines the need for individual adaptions, according to results of regular assessments. As only a minority of patients favours group exercises more than once a week, the delivery of home-based exercises meeting minimum requirements to enhance health status in patients with AS is a future challenge.

  1. Is group physical therapy … A randomized controlled trial. Hidding A. et al. Arthritis Care Res. 1993;6:117–25.

Acknowledgement Dutch Arthritis Association, grant number: BP 14–1-161.

Disclosure of Interest None declared

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