Poster 8: Effects of a Rehabilitation and Educational-Behavioral Program on Spinal Mobility 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 spinal mobility 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 AS in anti-TNFα therapy that started more than 9 months earlier 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 hour 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 

Bath Ankylosing Spondylitis Metrology Index (BASMI), chest expansion (in centimeters), standing thoracic kyphosis and lumbar lordosis, and active range of motion of spine by goniometer (IncliMed^®): angular measures in 3 planes of cervical, lumbo-sacral spine were expressed in grades and summarized.

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Results 

Group A showed significant improvements defined as the difference between the 2 measurements (beginning and after 6 months) compared, respectively, with group B and C as resulted at the evaluation of the total range of motion on cervical spine (mean 48.4° ± 27.6 vs -2.5° ± 27.6 and 4.6° ± 30.1; P < .000) and lumbar spine (mean 39.1° ± 27.8 vs 9.4 ± 34.2, 9.4° ± 30.6; P = .007), chest expansion (mean 2.4 ± 1.5 vs 1.1 ± 1.9 and 0.9 ± 1.7; P = .004), BASMI (-1.1 ± -1.2 vs 0.1 ± -1.1 and 0.4 ± 0.5 ; P = .005).

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Conclusions 

The combination of intensive group exercise with an educational-behavioral program can improve spinal mobility in AS patients pharmacologically stabilized with anti-TNFα therapy. Thus, this approach may efficiently complement drug therapy in these patients.