title: Rehabilitation treatment in patients with ankylosing spondylitis stabilized with tumor necrosis factor inhibitor therapy: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the 2- (T1) and 6-month (T2) followup effects on pain, spine mobility, physical function, and disability outcome of a rehabilitation intervention in patients with ankylosing spondylitis (AS) stabilized with tumor necrosis factor (TNF) inhibitor therapy.
  
  
  METHODS
  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 (T1) and at T2 was based on spinal pain intensity in the previous 4 weeks by self-report visual analog scale (VAS; 100 mm: 0 = no pain, 100 = maximum pain), BASMI, BASFI, BASDAI, and on chest expansion and the active range of motion of the cervical and lumbar spine measured by a pocket goniometer.
  
  
  RESULTS
  The 3 groups were comparable at baseline. On intragroup comparison at T1, 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.
  
  
  CONCLUSIONS
  Combining intensive group exercise with an educational-behavioral program can provide promising results in the management of patients with clinically stabilized AS on TNF inhibitor treatment.
authors: Rehabilitation Unit, Department of Rehabilitation, University of Padua, Padua, Italy. stef.masiero@unipd.it
authors: Stefano
authors: S
authors: Masiero
authors: Lara
authors: L
authors: Bonaldo
authors: Maurizia
authors: M
authors: Pigatto
authors: Alessandro
authors: A
authors: Lo Nigro
authors: Roberta
authors: R
authors: Ramonda
authors: Leonardo
authors: L
authors: Punzi
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001521:Behavior Therapy; D002574:Cervical Vertebrae / Q000503:physiopathology; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010353:Patient Education as Topic; D016059:Range of Motion, Articular / Q000502:physiology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000534:rehabilitation*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha