title: Exercise programs in trials for patients with ankylosing spondylitis: do they really have the potential for effectiveness?
abstract: OBJECTIVE
  To evaluate if exercise programs in trials for patients with ankylosing spondylitis (AS) have the potential for effectiveness.
  
  
  METHODS
  A systematic literature search was performed and randomized trials examining the effectiveness of exercise programs for AS patients were analyzed according to 3 elements: whether the exercise programs were designed according to the American College of Sports Medicine (ACSM) recommendations for developing cardiorespiratory fitness, muscular strength, and flexibility; whether physiologic responses were properly measured; and whether adherence to programs was monitored.
  
  
  RESULTS
  Twelve trials with a total of 826 AS patients were evaluated. Five trials included cardiorespiratory exercise as a part of the exercise programs. One of these met the ACSM recommendations for intensity, duration, frequency, and length of the exercise period. This trial showed the greatest within-group improvement in aerobic capacity (effect size [ES] 2.19). Five trials included muscular strength training, but none measured the physiologic responses nor met the recommendations for improving muscular strength. Eleven trials included flexibility training, but the programs were poorly described overall. Small improvements in spinal mobility (ES range 0.02-0.67) were reported in all trials. Finally, 4 trials reported on participants' adherence to the exercise programs, but only 1 provided sufficient information to evaluate the possible influence of the adherence.
  
  
  CONCLUSIONS
  The quality of interventions in exercise trials for patients with AS can be improved. Future trials should also focus on measuring and reporting physiologic responses and adherence to exercise interventions.
authors: Diakonhjemmet Hospital and University of Oslo, Oslo, Norway. h.s.dagfinrud@medisin.uio.no
authors: Hanne
authors: H
authors: Dagfinrud
authors: Silje
authors: S
authors: Halvorsen
authors: Nina K
authors: NK
authors: Vøllestad
authors: Karin
authors: K
authors: Niedermann
authors: Tore K
authors: TK
authors: Kvien
authors: Kåre B
authors: KB
authors: Hagen
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods / Q000592:standards*; D006801:Humans; D053580:Muscle Strength / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards*; D055070:Resistance Training / Q000379:methods / Q000592:standards; D013167:Spondylitis, Ankylosing / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome