Combining intensive group exercise with an educational-behavioral program can provide promising results in the management of patients with clinically stabilized ankylosing spondylitis (AS) on tumor necrosis factor (TNF) inhibitor treatment, say authors of an article available online April 1 in Journal of Rheumatology.
Sixty-two outpatients (49 men, 13 women, mean age 47.5 ± 10.6 yrs) were randomized to rehabilitation plus an educational-behavioral (n = 20) program, to an educational-behavioral program only (n = 20), or to a control group (n = 22). The educational-behavioral program included 2 educational meetings and 12 rehabilitation exercise sessions (stretching, strengthening, chest and spine/hip joint flexibility exercises), which patients then performed at home. Outcome assessment at the end of rehabilitation training at 2 and 6 months was based on spinal pain intensity in the previous 4 weeks by self-report visual analog scale, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Assessment Index (BASDAI), and on chest expansion and the active range of motion of the cervical and lumbar spine measured by a pocket goniometer.
On intragroup comparison at 2 months, the rehabilitation group showed significant improvement in the BASMI and BASDAI, in chest expansion, and in most spinal active range of motion measurements. BASFI and cervical and lumbar VAS scores improved in both the rehabilitation and educational-behavioral groups. The positive results achieved in the rehabilitation group were maintained at the 6-month followup.