Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: effects on Bath Ankylosing Spondylitis Indices, quality of life and depression The effectiveness of intensive group exercise on patients with ankylosing spondylitis Outcome of an education and home-based exercise programme for patients with ankylosing spondylitis: a nationwide randomized study. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up Efficacy of rehabilitation for patients with ankylosing spondylitis: comparison of a four-week rehabilitation programme in a Mediterranean and a Norwegian setting. Inspiratory muscle training improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study Home-based exercise therapy in patients with ankylosing spondylitis: effects on pain, mobility, disease activity, quality of life, and respiratory functions Effects of two exercise interventions on pulmonary functions in the patients with ankylosing spondylitis. Effects of Pilates, McKenzie and Heckscher training on disease activity, spinal motility and pulmonary function in patients with ankylosing spondylitis: a randomized controlled trial Effect of Pilates training on people with ankylosing spondylitis The effect of balneotherapy on patients with ankylosing spondylitis Group education for people with arthritis. A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial. Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain. Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial. One-Year Follow-up of Two Exercise Interventions for the Management of Patients with Ankylosing Spondylitis: A Randomized Controlled Trial Respiratory muscle performance as a possible determinant of exercise capacity in patients with ankylosing spondylitis. Are swimming or aerobic exercise better than conventional exercise in ankylosing spondylitis patients? A randomized controlled study. Efficacy of Incentive Spirometer Exercise on Pulmonary Functions of Patients with Ankylosing Spondylitis Stabilized by Tumor Necrosis Factor Inhibitor Therapy Long-term benefits of radon spa therapy in rheumatic diseases: results of the randomised, multi-centre IMuRa trial
The objective of this non-r and omised controlled trial was to evaluate the impact of group-based exercise programme and a home-based exercise programme on Bath Ankylosing Spondylitis Indices , depression and quality of life in patients with ankylosing spondylitis ( AS ) . Approximately 41 patients in a rehabilitation unit were divided into two groups , either group- or home-based exercise programme . Exercise sessions were performed three times a week for a period of 6 weeks . The patients were compared before and after the rehabilitation programme , with respect to Bath Ankylosing Spondylitis Functional Index ( BASFI ) , Bath Ankylosing Spondylitis Disease Assessment Index ( BASDAI ) , Bath Ankylosing Spondylitis Metrology Index ( BASMI ) , Beck Depression Inventory ( BDI ) and The Nottingham Health Profile ( NHP ) . A statistically significant improvement was observed on BASDAI , BASMI and energy , pain , reaction of emotional and sleep subscores of NHP in both exercise groups after the exercise programme ( p < 0.05 ) . No statistically significant changes were detected in BASFI , BDI and social and mobility subscores of NHP in both exercise groups ( p > 0.05 ) . No statistically significant differences were found between the two exercise programmes ( p > 0.05 ) . Group and home-based exercise programmes are efficient in improving symptoms and mobility and had an important effect on quality of life in patients with AS . Home-based exercise programme , as it is cheaper , more easily performed and efficient , may be preferable for the management programme in AS Objective : To compare , in patients with ankylosing spondylitis ( AS ) , the effectiveness on pain , functional and psychological status of an intensive group exercise programme under the supervision of a physiotherapist and a home physiotherapy programme . Design : Fifty-one patients with AS were r and omly allocated into study and control groups . The study was design ed as a prospect i ve , double-blind study . Setting : Outpatient department , Istanbul Medical Faculty . Subjects : Patients who consulted with complaints of pain , morning stiffness and restricted range of movement with a confirmed diagnosis of ankylosing spondylitis . Interventions : Before exercise , both groups were given an education programme about AS . For group I patients an intensive exercise programme was organized under the supervision of a physiotherapist for six weeks . Group II patients had to practise exercises individually at home . Main outcome measures : Both groups were evaluated and compared for pain , functional and psychological status before treatment , at the end of treatment and three months after treatment using a visual analogue scale ( VAS ) for pain , Beck Depression Scale and Bath Ankylosing Spondylitis Functional Index ( BASFI ) . Results : Six patients withdrew , four from group I. Results from the remaining 45 showed more positive changes in the patients undertaking group exercise at six weeks and three months after treatment . Values showed a statistical significant difference in favour of group I. Conclusion : Group exercise in hospital may be more effective than home-based exercises at reducing impairment associated with ankylosing spondylitis OBJECTIVES This study aims to assess the impact of a structured education and home exercise programme in daily practice patients with ankylosing spondylitis . METHODS A total of 756 patients with ankylosing spondylitis ( 72 % males , mean age 45 years ) participated in a 6-month prospect i ve multicentre controlled study , 381 of whom were r and omised to an education intervention ( a 2-hour informative session about the disease and the implementation of a non-supervised physical activity programme at home ) and 375 to st and ard care ( controls ) . Main outcome measures included Bath Ankylosing Spondylitis Disease Activity and Functional Index ( BASDAI , BASFI ) . Secondary outcome measures were 0 - 10 cm visual analog scale ( VAS ) for total pain , nocturnal pain and global disease activity and quality of life ( ASQoL ) , knowledge of disease ( self-evaluation ordinal scale ) and daily exercise ( diary card ) . RESULTS At 6 months , the adjusted mean difference between control and educational groups for BASDAI was 0.32 , 95 % confidence interval ( CI ) 0.10 - 0.54 , p=0.005 , and for BASFI 0.31 , 95%CI 0.12 - 0.51 , p=0.002 . Significant differences were found also in VAS for total pain , patient´s global assessment and in ASQoL. Patients in the education group increased their knowledge about the disease and its treatments significantly ( p<0.001 ) and practised more regular exercise than controls ( p<0.001 ) . CONCLUSIONS A structured education and home exercise programme for patients with ankylosing spondylitis in daily practice was feasible and helped to increase knowledge and exercise . Although statistically significant , the magnitudes of the clinical benefits in terms of disease activity and physical function were poor Objective : To assess the 12-month ’s follow-up effects on pain , mobility , and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy . Design : Controlled clinical trial ( sequentially determined allocation ) with 12-months ’ follow-up . Setting : Patients ’ homes . Subjects : A total of 69 subjects were allocated to either a rehabilitation programme ( rehabilitation group , n = 22 ) , an educational-behavioural programme ( educational group , n = 24 ) , and to neither programme ( control group , n = 23 ) . Interventions : Rehabilitation programme included supervised training and home exercises ( stretching , strengthening , aerobic , chest , and spine/hip joint flexibility exercises ) ; educational-behavioural programme included information on ankylosing spondylitis , pain and stress mechanisms , and control . Main measures : Spinal pain intensity , Bath Ankylosing Spondylitis Metrology Index , Bath Ankylosing Spondylitis Functional Index , Bath Ankylosing Spondylitis Disease Activity Index , chest expansion , and cervical and lumbar spine active range of motion measured by a pocket goniometer . Results : At baseline , the three groups exhibited comparable demographic characteristics and basal evaluations . Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains ( p < 0.05 ) for all outcomes . At 12-months follow-up , compared with the control and educational-behavioural , the rehabilitation group exhibited significant differences in chest expansion ( p = 0.001 and p < 0.001 ) , Bath Ankylosing Spondylitis Disease Activity Index ( p = 0.012 and p = 0.050 ) , and in some goniometric measurements as cervical rotation ( p = 0.007 and p = 0.014 ) , toraco-lumbar rotation ( p = 0.009 and p = 0.050 ) , and total cervical movements ( p = 0.009 and p = 0.001 ) . Conclusion : In comparison with the educational-behavioural programme or no intervention , supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis OBJECTIVE To investigate the sustained effect of a rehabilitation programme for patients with ankylosing spondylitis , and to compare the effect of this intervention given in a Mediterranean vs a Norwegian setting . METHODS A total of 107 patients with ankylosing spondylitis applying for rehabilitation were r and omized to a  4-week inpatient rehabilitation programme in a Mediterranean country or in Norway . The participants were evaluated clinical ly before and after the rehabilitation period ( week 0 and 4 ) and in week 16 . The ASsessment s in Ankylosing Spondylitis working group 's Improvement Criteria ( ASAS-IC ) , and tests of spinal mobility and physical capacity were used to measure treatment response . RESULTS An ASAS20 improvement was still present at week 16 in 50 % of the patients treated in a Mediterranean and 23 % in a Norwegian centre ( p = 0.006 ) . The tests of spinal mobility , physical capacity , and almost all patient 's assessment s of health status ( ASAS-IC components ) were still improved at week 16 after therapy in both climatic setting s. While the improvements in physical capacity were comparable , the spinal mobility and ASAS-IC components improved more , and improvements were sustained longer , after rehabilitation in a Mediterranean setting . CONCLUSION Patients with ankylosing spondylitis benefit from a 4-week rehabilitation programme in Norway , but even more so from a similar programme in a Mediterranean setting Objective : To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonary function in patients with ankylosing spondylitis . Design : R and omized controlled study . Setting : Rheumatic Rehabilitation Centre . Subjects : A total of 54 ankylosing spondylitis patients , all males , were r and omized to a conventional exercise training associated with an inspiratory muscle training group , or to a conventional exercise training group . Interventions : Group 1 ( 27 patients ) performed eight weeks of conventional exercise training ( supervised weekly group sessions followed by a home-based exercise programme ) associated with inspiratory muscle training sessions . Group 2 ( 27 patients ) received eight weeks of conventional exercise training only . Main measures : Resting pulmonary function ( forced vital capacity − FVC , forced expiratory volume in one second − FEV1 ) ; effort ventilatory efficiency ( lowest ventilatory equivalent ratio for oxygen and carbon dioxide – VE/VO2 and VE/VCO2 ) and aerobic capacity ( peak oxygen uptake – VO2peak ) were assessed at baseline and after eight weeks of exercise-based intervention . Results : After eight weeks follow-up , patients in Group 1 had a significant increased chest expansion and VO2peak compared with Group 2 ( 3.6 ±0.8 cm vs. 3.2 ±0.5 cm , P = 0.032 ; 2.0 ±0.5 l/min vs. 1.8 ±0.3 l/min , P = 0.033 ) . There were no significant differences of spirometric measurements , except FVC which significantly improved in patients who performed inspiratory muscle training ( 82.7 ±5.1 % vs. 79.5 ±3.5 % , P = 0.014 ) . VE/VCO2 also improved significantly in Group 1 ( 26.6 ±3.6 vs. 29.2 ±4.7 , P = 0.040 ) . Conclusions : Ankylosing spondylitis patients who performed eight weeks of inspiratory muscle training associated to conventional exercise training had an increased chest expansion , a better aerobic capacity , resting pulmonary function and ventilatory efficiency than those who performed conventional exercise training only The home-based exercise therapy recommended to the patients with ankylosing spondylitis ( AS ) is a simply applicable and cheap method . The aim of this study was to investigate the effects of home-based exercise therapy on pain , mobility , function , disease activity , quality of life , and respiratory functions in patients with AS . Eighty patients diagnosed with AS according to the modified New York criteria were included in the study .  Home-based exercise program including range of motion , stretching , strengthening , posture , and respiratory exercises was practically demonstrated by a physiotherapist . A training and exercise manual booklet was given to all patients . Patients following home-based exercise program five times a week at least 30 min per session ( exercise group ) for 3 months were compared with those exercising less than five times a week ( control group ) . Visual analog scale pain ( VASp ) values at baseline were significantly higher in the exercise group . The exercise group showed improvements in VASp , tragus – wall distance , morning stiffness , finger – floor distance , modified Schober 's test , chest expansion , the Bath Ankylosing Spondylitis Disease Activity Index , the Bath Ankylosing Spondylitis Functional Index , Ankylosing Spondylitis Quality of Life Question naire ( ASQoL ) , forced expiratory volume in first second , and forced vital capacity at third month . There was significant difference in ASQoL scores between the two groups in favor of the exercise group at third month . Regular home-based exercise therapy should be a part of main therapy in patients with AS . Physicians should recommend that patients with AS do exercise at least five times a week at least 30 min per session OBJECTIVE The aim of this study was to evaluate the impact of two different home-based daily exercise programs on pulmonary functions in the patients with ankylosing spondylitis ( AS ) . METHODS Fifty-one patients with AS were distributed into three groups . Group 1 ( n=19 ) was given a conventional exercise regimen . Group 2 ( n=19 ) received exercises based on the Global Posture Reeducation ( GPR ) method . Group 3 ( n=13 ) was accepted as the control group . Patients were assessed according to pain , functional capacity ( The Bath Ankylosing Spondylitis Functional Index - BASFI ) , disease activity ( The Bath Ankylosing Spondylitis Disease Activity Index - BASDAI ) , chest expansion , pulmonary function parameters , and 6-min walk distance ( 6MWD ) test . RESULTS Although there were significant improvements for BASDAI and BASFI scores in all groups , significant improvements in the VAS pain , chest expansion , pulmonary function parameters and 6MWD test were observed in the exercise groups . The improvements in pain , functional capacity , disease activity , chest expansion , pulmonary function parameters and 6MWD test were better in the exercise groups than in the control group . The GPR method result ed in greater improvements than the conventional exercise program in specific pulmonary function parameters like forced vital capacity , forced expiratory volume in 1s , and peak expiratory flow parameters . CONCLUSION Both exercises are efficient in improving pulmonary functions . Since the improvements in pulmonary function tests were greater in the patients who performed the exercise according to GPR method , motivated patients should be encouraged to perform this exercise program The optimal management of ankylosis spondylitis ( AS ) involves a combination of nonpharmacologic and pharmacologic treatment aim ing to maximize health-related quality of life . The primary objective of our study was to demonstrate the benefits of an original multimodal exercise program combining Pilates , McKenzie and Heckscher techniques on pulmonary function in patients with AS , while secondary objectives were to demonstrate the benefits of the same program on function and disease activity . This is a r and omized controlled study on ninety-six consecutive patients with AS ( axial disease subset ) , assigned on a 1:1 rationale into two groups based on their participation in the Pilates , McKenzie and Heckscher ( group I ) or in the classical kinetic program ( group II ) . The exercise program consisted of 50-min sessions performed 3 times weekly for 48 weeks . St and ard assessment s were done at week 0 and 48 and included pain , modified Schober test ( mST ) and finger – floor distance ( FFD ) , chest expansion ( CE ) and vital capacity ( VC ) , as well as disease activity Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) , functional Bath Ankylosing Spondylitis Functional Index ( BASFI ) and metrology index Bath Ankylosing Spondylitis Metrology Index ( BASMI ) . Groups were comparable at baseline ; we demonstrated significant improvement between baseline and after 48 weeks of regular kinetic training for all AS-related parameters in both groups . However , significant improvement was found in pain , lumbar spine motility ( mST , FFD ) , BASFI , BASDAI and BASMI in AS performing the specific multimodal exercise program at the end of study ( p = 0.001 ) . Although there were significant improvements in CE in both groups as compared to baseline ( group I , p = 0.001 ; group II , p = 0.002 ) , this parameter increased significantly only in group I ( p = 0.001 ) . VC measurements were not significantly changed at the end of the study ( group I , p = 0.127 ; group II , p = 0.997 ) , but we found significant differences within groups ( p = 0.011 ) . A multimodal training combining Pilates , McKenzie and Heckscher exercises performed regularly should be included in the routine management of patients with AS for better control of function , disease activity and pulmonary function The objective of this study was to investigate the effects of Pilates on pain , functional status , and quality of life in patients with ankylosing spondylitis . The study was performed as a r and omized , prospect i ve , controlled , and single-blind trial . Fifty-five participants ( 30 men , 25 women ) who were under a regular follow-up protocol in our Rheumatology Clinic with the diagnosis of AS according to the modified New York criteria were included in the study . The participants were r and omly assigned into two groups : in group I , Pilates exercise program of 1 h was given by a certified trainer to 30 participants 3 times a week for 12 weeks , and in group II , design ed as the control group , 25 participants continued previous st and ard treatment programs . In groups , pre-(week 0 ) and post treatment ( week 12 and week 24 ) evaluation was performed by one of the authors who was blind to the group allocation . Primary outcome measure was functional capacity . Evaluation was done using the Bath Ankylosing Spondylitis Functional Index ( BASFI ) . Exploratory outcome measures were Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) , Bath Ankylosing Spondylitis Metrology Index ( BASMI ) , Chest expansion , and ankylosing spondylitis quality of life ( ASQOL ) question naire . In group I , BASFI showed significant improvement at week 12 ( P = 0.031 ) and week 24 ( P = 0.007 ) . In group II , this parameter was not found to have significantly changed at week 12 and week 24 . Comparison of the groups showed significantly superior results for group I at week 24 ( P = 0.023 ) . We suggest Pilates exercises as an effective and safe method to improve physical capacity in AS patients . Our study is the first clinical study design ed to investigate the role of Pilates method in AS treatment . We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method in AS Objective : To compare the effect of balneotherapy on physical activity and quality of life as well as the symptoms of pain and stiffness with exercise alone in ankylosing spondylitis ( AS ) patients . Methods : A total of 60 patients who had a diagnosis of AS according to the modified New York criteria were included in the study . The patients were r and omly assigned to two groups . In Group I ( n = 30 ) the patients received balneotherapy in a therapeutic pool for 30 min once a day for 3 weeks . All patients received instructions on the exercise programme , which they were requested to repeat once a day for 30 min during the study . The patients in this group continued the same exercise programme after the end of the balneotherapy protocol to complete a course of 6 months . In Group II the patients were given the same exercise protocol but did not receive balneotherapy . Patients were evaluated before the start of the study and at 3 weeks and 24 weeks . Evaluation parameters were daily and night pain , morning stiffness , the patient 's global evaluation and the physician 's global evaluation ( according to a scoring system of 1 to 5 ) , the Bath Ankylosing Spondilitis Disease Activity Index ( BASDAI ) , Bath Ankylosing Spondylitis Functional Index ( BASFI ) , Dougados Functional Index ( DFI ) , tragus – wall distance , chest expansion , modified Shober test ( MST ) , fingertip – fibula head distance , and Nottingham Health Profile ( NHP ) . Results : Evaluations were completed in 54 patients in the two groups . Comparison of the groups showed significantly superior results for Group I for parameters of BASDAI , NHP total , pain , physical activity , tiredness and sleep score , patient 's global evaluation and the physician 's global evaluation at 3 weeks , but only for the parameters of patient 's global evaluation and MST at 24 weeks . Conclusion : Balneotherapy has a supplementary effect on improvement in disease activity and functional parameters in AS patients immediately after the treatment period . However , in the light of our medium‐term evaluation results , we suggest that further research is needed to assess the role of balneotherapy applied for longer duration s in AS patients Arthritis is a common chronic disease causing pain and progressive disability to millions of people . The purpose of the study was to examine the effectiveness of group patient education for people with one form of arthritis , ankylosing spondylitis ( AS ) , in terms of change in : arthritis self-efficacy ; psychological well-being ; physical well-being ; and home exercise activities . The Self-Management Course-Ankylosing Spondylitis ( SMC-AS ) demonstrated positive effects on arthritis self-efficacy and psychological well-being at 6-month follow-up . Analysis of change over time in the intervention group showed improvements in depression , self-efficacy and severity at 3 weeks , with trends towards continued improvement evident at 6 months . In contrast , the positive effects on range and frequency of home exercise activities at 3 weeks were not maintained at 6 months . In conclusion , the effectiveness of short , intensive patient education courses was demonstrated . However , the need for strategies to sustain improvements in exercise behaviour need to be explored OBJECTIVE To evaluate the mean overall effects over a 1-year period of a multidisciplinary in-patient rehabilitation programme for patients with ankylosing spondylitis . DESIGN Observer-blinded , r and omized controlled trial , with assessment s made after 4 and 12 months . PATIENTS Forty-six patients received a 3-week in-patient rehabilitation programme and 49 patients received treatment as usual .  METHODS Primary outcomes were disease activity measured with the Bath Ankylosing Spondylitis Disease Activity Scale ( BASDAI ) , and function measured with the Bath Ankylosing Spondylitis Functional Index ( BASFI ) . Secondary outcomes included well-being , spinal and hip mobility , and health-related quality of life measured with the Medical Outcome Study Short Form-36 . Overall treatment effects were estimated with Mixed models repeated measures analyses . RESULTS Significant overall treatment effects in favour of the rehabilitation group were found in the BASDAI score ( mean difference over the 1-year period -10.0 , 95 % confidence interval : -3.7 to -16.3 ) , in well-being ( -7.3 , 95 % confidence interval : -1.0 to -14.7 ) , and in the Medical Outcome Study Short Form-36 variables social functioning , role physical , role mental and bodily pain ( mean differences ranging from 5.8 ( pain ) to 10.7 ( role physical ) ) . CONCLUSION A 3-week in-patient rehabilitation programme had positive overall effects on disease activity , pain , function and well-being , and should be considered an important complement to medical disease management in persons with ankylosing spondylitis BACKGROUND Chronic knee pain is a major cause of disability in the elderly . Management guidelines recommend exercise and self-management interventions as effective treatments . The authors previously described a rehabilitation programme integrating exercise and self-management [ Enabling Self-management and Coping with Arthritic knee Pain through Exercise ( ESCAPE-knee pain ) ] that produced short-term improvements in pain and physical function , but sustaining these improvements is difficult . Moreover , the programme is untried in clinical environments , where it would ultimately be delivered . OBJECTIVES To establish the feasibility of ESCAPE-knee pain and compare its clinical effectiveness and costs with outpatient physiotherapy . DESIGN Pragmatic , r and omised controlled trial . SETTING Outpatient physiotherapy department and community centre . PARTICIPANTS Sixty-four people with chronic knee pain . INTERVENTIONS Outpatient physiotherapy compared with ESCAPE-knee pain . OUTCOMES The primary outcome was physical function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index . Secondary outcomes included pain , objective functional performance , anxiety , depression , exercise-related health beliefs and healthcare utilisation . All outcomes were assessed at baseline and 12 months after completing the interventions ( primary endpoint ) . ANCOVA investigated between-group differences . RESULTS Both groups demonstrated similar improvements in clinical outcomes . Outpatient physiotherapy cost pound 130 per person and the healthcare utilisation costs of participants over 1 year were pound 583 . The ESCAPE-knee pain  programme cost pound 64 per person and the healthcare utilisation costs of participants over 1 year were pound 320 . CONCLUSIONS ESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain . Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits , but ESCAPE-knee pain cost less and was more cost-effective We investigated the effects of home-based daily exercise on joint mobility , functional capacity , pain , and depression in patients with ankylosing spondylitis ( AS ) . The patients were r and omly assigned to a wait-list control group or to an exercise-therapy group . The exercise-therapy group performed a 20-min exercise program once per day for 8 consecutive weeks . After 8 weeks , compared with the control group , the exercise group showed improvements in joint mobility ( cervical flexion , extension , shoulder flexion , abduction , hip abduction , and knee flexion ) , finger – floor distance , and functional capacity . Pain and depression scores were significantly lower after the exercise program in the exercise group than in the control group . These findings indicate that exercise therapy increases joint mobility and functional capacity , and decreases pain and depression in patients with AS .  Home-based exercise , which is easily accessible to patients , might be an effective intervention for AS BACKGROUND Exergames are a well-known type of game based on a virtual avatar 's body movements . This hightech approach promotes an active lifestyle . OBJECTIVES The aim of this r and omized controlled trial was to evaluate the effects of exergames on pain , disease activity , functional capacity and quality of life in patients with ankylosing spondylitis ( AS ) . MATERIAL AND METHODS The study involved 60 patients , who were r and omized into either the exergame group ( EG ) or the control group ( CG ) . The EG patients engaged in exergaming , and CG patients did not engage in any exercises . The exergaming sessions were performed five times a week for eight weeks ( 40 sessions in total ) . The patients were assessed before and after the eight-week program on a visual analog scale ( VAS ) , the Bath Ankylosing Spondylitis Functional Index ( BASFI ) , the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) and the Ankylosing Spondylitis Quality of Life ( ASQOL ) question naire . RESULTS A statistically significant improvement was observed in VAS , BASFI , BASDAI and ASQoL scores in the EG group after completion of the exercise program ( p < 0.05 ) . CONCLUSIONS This study is a first step in investigating the possibilities of using an exergame platform to help patients with spondyloarthropathies to adopt a more physically active lifestyle . The results of this study suggest that exergames increase physical activity and decrease the pain scores in AS patients and also could , therefore , be feasible and safe Fernández-de-las-Peñas C , Alonso-Blanco C , Alguacil-Diego IM , Miangolarra-Page JC : One-year follow-up of two exercise interventions for the management of patients with ankylosing spondylitis : A r and omized controlled trial . Am J Phys Med Rehabil 2006;85:559–567 . Objective : To assess the long-term effects on functional and mobility outcomes of two exercise interventions for the management of patients with ankylosing spondylitis . Design : In an extended 12-mo follow-up of a r and omized controlled trial , 40 patients who were diagnosed with ankylosing spondylitis according to the modified criteria of New York , allocated to control or experimental groups using a r and om numbers table , and who performed their respective exercise program at least three times per month , were included in this long-term study . The control group was treated during 15 sessions with a conventional exercise regimen in ankylosing spondylitis , whereas the experimental group received 15 sessions of exercises based on the treatment of the shortened muscle chains following the guidelines described by the Global Posture Reeducation method . These patients were followed up and assessed again 1 yr after entering the study , reapplying the same vali date d indexes : BASMI ( Bath Ankylosing Spondylitis Metrology Index [ tragus to wall distance , modified Schober test , cervical rotation , lumbar side flexion , and intermalleolar distance ] ) , BASDAI ( Bath Ankylosing Spondylitis Disease Activity Index ) , and BASFI ( Bath Ankylosing Spondylitis Functional Index ) . Results : The intragroup comparison between follow-up and postintervention data showed that both groups decrease their clinical and functional measures during the follow-up period . This decrease was only significant for lumbar side flexion and intermalleolar distance measurements , being more significant in the control group ( P = 0.001 and P = 0.002 , respectively ) . Intragroup differences between follow-up and preintervention assessment s revealed that improvements in all mobility measures of the BASMI index and in the BASFI index were partially maintained at the 12-mo follow-up in the experimental group but not in the control group . The intergroup comparison ( unpaired t test analysis ) between changes on each outcome during the long-term follow-up ( post – follow-up ; and pre – follow-up ) showed no significant differences in the decrease between postintervention and follow-up data between the study groups . On the other h and , the intergroup comparison between preintervention and follow-up data revealed significant differences in almost all mobility measures of the BASMI index ( except for cervical rotation ) and in the BASFI index , in favor of the experimental group . Conclusions : An exercise regimen based on the Global Posture Reeducation method and focusing on specific strengthening and flexibility exercises of the shortened muscle chains offers promising short- and long-term results in the management of patients who have ankylosing spondylitis Reduction of exercise capacity in patients with ankylosing spondylitis is associated with skeletal muscle performance . The contribution of respiratory muscle performance is question able . This pilot study was design ed to investigate the relationship between respiratory muscle performance and exercise capacity in ankylosing spondylitis . Subjects were 12 patients with ankylosing spondylitis . Measurements of maximal respiratory pressures and inspiratory muscle endurance were performed and correlated with maximal exercise capacity . Lung function and chest wall expansion were reduced on average . Maximal inspiratory and expiratory pressures were reduced to 82 + /- 20 % of predicted values and 75 + /- 22 % of predicted values respectively . On average there was no reduction in inspiratory muscle endurance which remained at 103 + /- 36 % of predicted values . No overall reduction was found in maximal exercise capacity , either expressed as maximal workload or as peak oxygen uptake ; however , a wide range was found . Maximal workload and peak oxygen uptake correlated significantly with maximal respiratory pressures and respiratory muscle endurance . The best regression model for explaining the total variation of maximal workload and peak oxygen uptake selected maximal inspiratory pressures as the independent variable ( r(2 ) = 59.6 % , p = 0.003 and r(2 ) = 62.5 % , p = 0.05 respectively . ) These data suggest respiratory pressure and respiratory muscle endurance , in particular maximal inspiratory pressure , may be determinants of exercise capacity in patients with ankylosing spondylitis AIM The aim of the study was to compare the effects of conventional exercise ( CE ) , swimming and walking on the pulmonary functions , aerobic capacity , quality of life , Bath indexes and psychological symptoms in patients with ankylosing spondylitis ( AS ) . METHODS Forty-five patients were r and omised into either swimming ( group 1 ) , walking ( group 2 ) , CE group ( group 3 ) . Patients in Group 1 performed CE and swimming , patients in Group 2 performed CE and walking and patients in Group 3 performed CE only . Exercise sessions were performed three times a week for a period of six weeks . Patients were assessed before and after the rehabilitation program , with respect to , pulmonary function test ( forced vital capacity [ FVC , mL ] , forced expiration volume in one second [ FEV1 , mL ] , FEV1/FVC ( % ) and vital capacity [ VC , mL ] ) , maximal oxygen uptake ( pV.O2 ) , 6-minute walking test ( 6MWT ) , Bath Ankylosing Spondylitis Functional Index , Bath Ankylosing Spondylitis Disease Activity Index , Bath Ankylosing Spondylitis Metrology Index , Nottingham Health Profile and Beck Depression Inventory . RESULTS There were significant increases in pVO2 and 6MWT after treatment in Groups 1 and 2 ( P<0.05 ) . FeV1 , FVC and VC improved significantly with treatment in all three groups ( P<0.05 ) . A statistically significant improvement was observed in energy , emotional reaction and physical mobility sub-scores of NHP in three exercise groups after completion of the exercise program ( P<0.05 ) . CONCLUSIONS Swimming , walking and CE had beneficial effects on the quality of life and pulmonary functions . Aerobic exercises such as swimming and walking in addition to CE increased functional capacities of patients Objective . To evaluate the effect of combining incentive spirometer exercise ( ISE ) with a conventional exercise ( CE ) on patients with ankylosing spondylitis ( AS ) stabilized by tumor necrosis factor ( TNF ) inhibitor therapy by comparing a combination group with a CE-alone group . Methods . Forty-six patients ( 44 men , 2 women ) were r and omized to the combination group ( ISE plus CE ; n = 23 ) or the CE group ( n = 23 ) . The CE regimen of both groups consisted of 20 exercises performed for 30 min once a day . The ISE was performed once a day for 30 min . The trial duration was 16 weeks . Patients were assessed before and at the end of treatment by measuring the Bath Ankylosing Spondylitis Disease Activity Index , Bath Ankylosing Spondylitis Functional Index ( BASFI ) , chest expansion , finger to floor distance , pulmonary function measures , and 6-min walk distance . Results . Both groups improved significantly in terms of chest expansion ( p < 0.01 ) , finger to floor distance ( p < 0.01 ) , and BASFI ( p < 0.05 ) after completing the exercise program . However , only the combination group showed significant improvements in the forced vital capacity ( p < 0.05 ) , total lung capacity ( p < 0.01 ) , and vital capacity ( p < 0.05 ) . Although this did not achieve statistical significance , the combination group was mildly superior to the CE-alone group in functional disability and pulmonary function measures . Conclusion . Combining ISE with a CE can provide positive results in patients whose AS has been clinical ly stabilized by TNF inhibitor therapy In chronic rheumatic diseases , recent treatment regimens comprise multimodal concepts including pharmacologic , physical/exercise , occupational and psychological therapies . Rehabilitation programmes are used for long-term management of disease . Spa therapy is often integrated in various middle and south European and Asian countries . Here , we investigated radon spa therapy as applied in health resorts compared to a control intervention in rheumatic out- patients . R and omised , blinded trial enroling 681 patients [ mean age 58.3 ( st and ard deviation 11.1 ) ; female 59.7 % ] in 7 health resorts in Germany and Austria with chronic back pain ( n1 = 437 ) , osteoarthritis ( OA ) ( n2 = 230 ) , rheumatoid arthritis ( n3 = 98 ) , and /or ankylosing spondylitis ( n4 = 39 ) ; multiple nominations in 146 cases ) . Outcomes were pain ( primary ) , quality of life , functional capacity , and medication measured before start , after end of treatment , and 3 times thereafter in 3 monthly intervals . Adverse events were documented . To analyse between-group differences , repeated- measures analysis of covariance was performed in metric endpoints and Fisher ’s exact test in rates . Two-sided significance level of 5 % was chosen . Until end of follow-up , superiority of radon therapy was found regarding pain relief ( p = 0.032 ) and analgesic drug consumption ( p = 0.007 ) , but not regarding quality of life . Functional capacity was assessed specific to the underlying indication . Significant benefits were found in radon-treated OA patients until 6-month follow-up ( p = 0.05 ) , but not until end of study ( p = 0.096 ) . Neither the back pain sub- population nor the two smaller patient population s with inflammatory indications benefited significantly in functional capacity . Results suggest beneficial analgesic effects of radon spa therapy in rheumatic diseases until 9 months post-intervention
There was no important clinical meaningful benefit .
Adverse effectsWe found very low- quality evidence of the effect of exercise versus either no intervention , or usual care .
We found moderate- to low- quality evidence that exercise programmes probably slightly improve function , may reduce pain , and probably slightly reduce global patient assessment of disease activity , when compared with no intervention , and measured upon completion of the programme .
We found moderate- to low- quality evidence that exercise programmes probably have little or no effect on improving function or reducing pain , when compared with usual care , and may have little or no effect on reducing patient assessment of disease activity , when measured upon completion of the programmes .
We are uncertain whether exercise programmes improve spinal mobility , reduce fatigue , or induce adverse effects
BACKGROUND Exercise programmes are often recommended for managing ankylosing spondylitis ( AS ) , to reduce pain and improve or maintain functional capacity .
OBJECTIVES To assess the benefits and harms of exercise programmes for people with AS .