Exercise in ankylosing spondylitis: how much is optimum?
OBJECTIVE
To evaluate how much exercise patients with ankylosing spondylitis perform on a regular basis, to analyze demographic and clinical variables that might influence adherence to exercise, and to determine the effect of exercise on disease activity and function.


METHODS
We analyzed 4282 patients who completed a self-administered questionnaire regarding physical exercise. To determine the relationship between exercise, demographic data, and clinical variables, patients who exercise 2 to 4 hours and 10 or more hours per week were compared to nonexercising controls matched for age, sex, and disease duration.


RESULTS
Most of the patients reported 2 to 4 hours of exercise or no exercise. The group who performed moderate exercise had improved function and lower disease activity (p < 0.001, p < 0.015, respectively). The group who performed intensive exercise had improved function, but no difference in disease activity was found (p=0.033, p=0.394, respectively). Adherence to a regular exercise regime is associated with rheumatologist followup, beliefs in the benefits of exercise, and a higher education level.


CONCLUSIONS
This study suggests there is an optimum duration for exercise performed over a weekly period. Consistency, rather than quantity, is of most importance. Individuals most likely to follow this regime attend a rheumatologist, believe that exercise is of benefit, and are in the higher education category. Those who are less educated and followed by general practitioners should be targeted.
Santos
H
H
Epidemiology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK.
Brophy
S
S
Calin
A
A
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D004493:Education; D015444:Exercise; D006801:Humans; D008875:Middle Aged; D012219:Rheumatology / Q000379:methods; D013167:Spondylitis, Ankylosing / Q000188:drug therapy / Q000503:physiopathology*; D013997:Time Factors