The effect of a home based exercise intervention package on outcome in ankylosing spondylitis: a randomized controlled trial.
OBJECTIVE
Home based self-care is essential for successful management of ankylosing spondylitis (AS). We designed an intervention package aimed at promoting self-care and regular longterm exercise and evaluated its effect on outcome.


METHODS
Members of our database (n = 4569) were randomly selected and randomized to an intervention group (IG) or a followup control group (CG). The intervention consisted of an exercise/information video, exercise progress chart, patient education booklet, and AS exercise reminder stickers. The outcome measures were function (BASFI), disease activity (BASDAI), global well being (BAS-G), exercise self-efficacy (ESE), arthritis self-efficacy (SES), and quantity of AS mobility/aerobic exercise assessed at baseline and 6 months.


RESULTS
Of the 200 subjects, 155 completed the study (75 IG and 80 CG). Baseline analysis showed no differences between the CG and the IG. At 6 months, analysis revealed no statistically significant between-group differences for the BASFI, BASDAI, and BAS-G. although the p value of 0.08 for function approached significance. Self-efficacy for exercise showed a significant improvement in the IG (p = 0.045). There were no between-group differences for the SES pain and other symptoms subscales. Finally, there was a significant increase in self-reported AS mobility (p < 0.001) and aerobic exercise (p < 0.05) in the IG.


CONCLUSIONS
An exercise intervention package designed to promote self-management in AS (1) significantly improves self-efficacy for exercise; (2) significantly improves self-reported levels of exercise; (3) reveals a trend for improvement in function (BASFI).
Sweeney
Siobhan
S
Royal National Hospital for Rheumatic Diseases, Bath, United Kingdom.
Taylor
Gordon
G
Calin
Andrei
A
D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D010353:Patient Education as Topic; D011788:Quality of Life; D011897:Random Allocation; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome