Background The recent update of the ASAS-EULAR management recommendations for axial spondyloarthritis highlights effectiveness of home exercises and physical therapy. However, the adherence rates to these structured exercises are low, what could limit their long-term effectiveness. An option could be to replace or to complete the practice of specific exercises with the regular practice of a recreational sport activity. Data concerning the effectiveness and tolerance of sports in ankylosing spondylitis (AS) are scarce.
Objectives To assess the tolerance and effectiveness of recreational sports practice on function, spinal mobility, disease activity, pain and quality of life in patients with AS.
Methods A systematic review was performed according the PRISMA guidelines, using the following search engines: MEDLINE (Pubmed), COCHRANE Library, Google Scholar and Physiotherapy Evidence Database (PEDro), completed by a manual research. We included randomized controlled trials (RCTs) from 1984 to September 2016, with participants with AS fulfilling the New York modified criteria, and interventions involving sports practice. We defined “sports” according to the MeSH definition as “Activities or games, usually involving physical effort or skill [with purpose of] pleasure, competition, and/or financial reward.” Exercise therapy and physiotherapy were not included in the research. The outcomes measured were the followings: stiffness/spinal mobility, function, disease activity, quality of life, pain, side effects. Methodological quality was assessed using the PEDro scale.
Results From the 40 studies identified after screening, only 5 articles were selected for eligibility. One study was excluded (poor quality). The 4 RCTs concerned a total of 187 AS patients. Interventions were Pilates, Tai Chi, swimming, walking, and exergames. Control groups received either no specific intervention or standard exercise therapy. The studies were too heterogeneous to be pooled but the comparisons inter and intra-groups in each study tended to show significant effectiveness of sports practice on function, activity and spinal mobility. Data on tolerance were scarce, but no significant side effect was reported.
Conclusions Recreational sports practice may improve function, activity and spinal mobility in patients with AS. However, there are very few studies available, and evidence-level is low. More controlled randomized clinical trials should be conducted in the future to confirm the effectiveness and safety of sports in AS.
Disclosure of Interest None declared
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