Poster 7: Effects of a Rehabilitation and Educational-Behavioral Program on Pain, Disability and Quality of Life in Patients with Ankylosing Spondylitis in Anti-TNFα Therapy: A Randomized Controlled Trial

Article Outline

• Disclosures
• Objective
• Design
• Setting
• Participants
• Interventions
• Main Outcome Measures
• Results
• Conclusions
• Copyright

Keywords: Rehabilitation, Exercise, Ankylosing spondylitis

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Disclosures 

S. Masiero, None.

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Objective 

To evaluate the effects on pain, disability and quality of life of a rehabilitation and educational-behavioral program in patients with ankylosing spondylitis (AS) in anti-TNFα therapy.

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Design 

Randomized controlled trial, 6-month follow-up.

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Setting 

Outpatients of Rheumatologic Department.

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Participants 

Fifty-eight patients with SA in anti-TNFα therapy for more than 9 months were randomly allocated to 3 groups.

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Interventions 

Group A (n = 18) received an educational-behavioral meeting with a home guide (2 hours) associated with an intensive group exercise program under the supervision of a physiotherapist (1 hours twice a week for 5 weeks) that was then performed at home; group B (n = 18) received only educational-behavioral information by a meeting with a home guide (2 hours); group C (n = 17) not effected any treatment.

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Main Outcome Measures 

Visual analogue scale (VAS) of axial pain and stiffness (last month), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Activity Index (BASDAI), Health Assessment Questionnaire (HAQ), MOS 36-item short form health survey (SF-36).

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Results 

Group A showed significant gains at the evaluations defined as the difference between the 2 assessments (beginning and after 6 months) compared with groups B and C as resulted, respectively, for BASFI (-1.9 ± 1.7 vs -0.89 ± 0.9 and 0.08 ± 0.8; P = .001), BASDAI (-1.5 ± 1.3 vs 0.8 ± 1.2 and 0.4 ± 0.5; P = .040) and HAQ (-039 ± 0.11 vs -0.14 ± 0.19 and -0.09 ± 0.15; P = .021), but not for back pain at the VAS (P = .121), and SF-36 (P = .161 and .06).

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Conclusions 

Our study showed that after 6 months, attending an educational-behavioral program associated with intensive group exercise can reduce the intensity of pain and disability and improve the quality of life for patients with SA who were pharmacologically stabilized with anti-TNFα therapy. This approach may effectively complement drug therapy in these patients.