The Cochrane review of physiotherapy interventions for ankylosing spondylitis.
OBJECTIVE
To update the Cochrane review on the effectiveness of physiotherapy interventions in the management of ankylosing spondylitis (AS).


METHODS
All randomized studies available in systematic searches (electronic databases, contact with authors, reference lists) up to February 2004 were included. Two reviewers independently selected trials for inclusion, assessed the validity of included trials, and extracted data. Investigators were contacted to obtain missing information.


RESULTS
Six trials with a total of 561 participants were included. Two trials compared individualized home exercise programs with no intervention. Low quality evidence for effects in favor of the home exercise program was found in physical function and spinal mobility [absolute benefit 10.3 cm on fingertip to floor distance; relative percentage difference (RPD) 37%)]. Further, the trials showed low quality evidence for no group differences in pain. Three trials compared supervised group physiotherapy with an individualized home exercise program. Moderate quality evidence for effectiveness was found in patient global assessment and spinal mobility in favor of the supervised group. The trials showed moderate quality evidence for no differences in pain intensity between the groups. One trial compared a 3-week inpatient spa-exercise therapy followed by weekly outpatient group physiotherapy with weekly outpatient group physiotherapy alone. Moderate quality evidence was found for effects in pain (absolute benefit 0.9 cm on visual analog scale; RPD 19%), physical function (absolute benefit 1 cm; RPD 24%), and patient global assessment (absolute benefit 1.3 cm; RPD 27%), in favor of the combined spa-exercise therapy.


CONCLUSIONS
The current best available evidence suggests that physiotherapy is beneficial for people with AS. However, it is still not clear which treatment protocol should be recommended in the management of AS.
Dagfinrud
Hanne
H
Section for Health Science, University of Oslo, PO Box 1153, Blindern, 0316 Oslo, Norway. h.s.dagfinrud@medisin.uio.no
Kvien
Tore K
TK
Hagen
Kåre B
KB
D000553:Ambulatory Care; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D012648:Self Care; D013167:Spondylitis, Ankylosing / Q000628:therapy*