One-year follow-up of two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial.
OBJECTIVE
To assess the long-term effects on functional and mobility outcomes of two exercise interventions for the management of patients with ankylosing spondylitis.


METHODS
In an extended 12-mo follow-up of a randomized controlled trial, 40 patients who were diagnosed with ankylosing spondylitis according to the modified criteria of New York, allocated to control or experimental groups using a random numbers table, and who performed their respective exercise program at least three times per month, were included in this long-term study. The control group was treated during 15 sessions with a conventional exercise regimen in ankylosing spondylitis, whereas the experimental group received 15 sessions of exercises based on the treatment of the shortened muscle chains following the guidelines described by the Global Posture Reeducation method. These patients were followed up and assessed again 1 yr after entering the study, re-applying the same validated indexes: BASMI (Bath Ankylosing Spondylitis Metrology Index [tragus to wall distance, modified Schober test, cervical rotation, lumbar side flexion, and intermalleolar distance]), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), and BASFI (Bath Ankylosing Spondylitis Functional Index).


RESULTS
The intragroup comparison between follow-up and post-intervention data showed that both groups decrease their clinical and functional measures during the follow-up period. This decrease was only significant for lumbar side flexion and intermalleolar distance measurements, being more significant in the control group (P = 0.001 and P = 0.002, respectively). Intragroup differences between follow-up and pre-intervention assessments revealed that improvements in all mobility measures of the BASMI index and in the BASFI index were partially maintained at the 12-mo follow-up in the experimental group but not in the control group. The intergroup comparison (unpaired t test analysis) between changes on each outcome during the long-term follow-up (post-follow-up; and pre-follow-up) showed no significant differences in the decrease between post-intervention and follow-up data between the study groups. On the other hand, the intergroup comparison between pre-intervention and follow-up data revealed significant differences in almost all mobility measures of the BASMI index (except for cervical rotation) and in the BASFI index, in favor of the experimental group.


CONCLUSIONS
An exercise regimen based on the Global Posture Reeducation method and focusing on specific strengthening and flexibility exercises of the shortened muscle chains offers promising short- and long-term results in the management of patients who have ankylosing spondylitis.
Fernández-de-Las-Peñas
César
C
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Alonso-Blanco
Cristina
C
Alguacil-Diego
Isabel Maria
IM
Miangolarra-Page
Juan Carlos
JC
D000328:Adult; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D026741:Physical Therapy Modalities; D011187:Posture / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D013167:Spondylitis, Ankylosing / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome