Interventions
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SEMI, ANKYLOSING SPONDYLITIS, STRETCHES
Participants in both exercise groups received 48 exercise sessions (40 min each), that is 4 sessions a week for twelve consecutive weeks. In both types of exercise, each session consisted of a five-minute warm-up, including side lunges, side stepping, half squat, biceps, triceps and deltoid warm-up exercises, and self-range of motion exercises for the cervical, thoracic and lumbar spine. In addition, 5 min of static stretches (including ‘downward facing dog’, ‘seated straddle’, ‘cat-cow’, ‘standing calf stretch’ and ‘upper trapezius stretch’ positions) were performed in both groups at the end of the exercise.Patients in the HS exercise group used the Dragon Hippotherapy Simulator (Code TA-022) as gym equipment and performed their exercise sessions in the gymnasium of XXX University Hospital. An experienced physiatrist (AYK) supervised the sessions to ensure that the patients performed the exercises correctly. The Dragon was built for indoor use and has a three-phase motor to mimic the three-dimensional movements of a live horse (up and down, forward and backward, and left to right). Participants sit in a leather-covered saddle and hold on to the saddle’s horn-like handles. Sitting in the simulator, the participant’s feet in the stirrups are in dorsiflexion, both knees and hips are in semiflexion and the hip joint is in semi abduction and external rotation. While the device was in motion, participants were verbally reminded to keep their head upright and look forward and to maintain correct posture (see (a and b) A Patient’s position for the horse stimulation exercise using the Dragon® hippotherapy simulator.Muscle groups that are active to ensure correct posture and balance are shown while the simulator is running.Position of patients with ankylosing spondylitis for the microFET® 2 dynamometer knee-extensor assessment.The conventional home exercise program consisted of a warm-up (mentioned above), body weight strength training, balance exercises, and static stretching (mentioned above), as demonstrated by the physiatrist (AYK) at the beginning of the study period. During the study period, participants were encouraged to participate and their continuity was checked by phone calls within 14 days. In addition, all patients received an exercise manual booklet and exercise diary.> Low- or moderate-intensity bodyweight exercise routines were physical tasks performed in the current study. The first exercise consisted of 6–8 knee or elevated push-ups, followed by 8–12 assisted bodyweight squats, 8–12 walking or jumping jacks, and finally 8–12 assisted lunges. The participants then performed 8–12 repetitions of leg drops, scissor kicks, and chin tucks (with towel support) in the prone position. The rest was allowed between movements, but the participants were required to complete each set of each exercise before starting a new round.>Simple, enjoyable and safe balance exercises were selected for people with AS to learn. Sessions began with a standing march and 3-way kicks for 20–30 s, followed by a one-leg stand (supported if necessary) for up to 30 s. Finally, heel-to-toe standing or walking was performed for up to 30 s. A set of 3 repetitions was performed.