title: Efficacy of rehabilitation for patients with ankylosing spondylitis: comparison of a four-week rehabilitation programme in a Mediterranean and a Norwegian setting.
abstract: OBJECTIVE
  To investigate the sustained effect of a rehabilitation programme for patients with ankylosing spondylitis, and to compare the effect of this intervention given in a Mediterranean vs a Norwegian setting.
  
  
  METHODS
  A total of 107 patients with ankylosing spondylitis applying for rehabilitation were randomized to a 4-week inpatient rehabilitation programme in a Mediterranean country or in Norway. The participants were evaluated clinically before and after the rehabilitation period (week 0 and 4) and in week 16. The ASsessments in Ankylosing Spondylitis working group's Improvement Criteria (ASAS-IC), and tests of spinal mobility and physical capacity were used to measure treatment response.
  
  
  RESULTS
  An ASAS20 improvement was still present at week 16 in 50% of the patients treated in a Mediterranean and 23% in a Norwegian centre (p = 0.006). The tests of spinal mobility, physical capacity, and almost all patient's assessments of health status (ASAS-IC components) were still improved at week 16 after therapy in both climatic settings. While the improvements in physical capacity were comparable, the spinal mobility and ASAS-IC components improved more, and improvements were sustained longer, after rehabilitation in a Mediterranean setting.
  
  
  CONCLUSIONS
  Patients with ankylosing spondylitis benefit from a 4-week rehabilitation programme in Norway, but even more so from a similar programme in a Mediterranean setting.
authors.affiliation: Section for Climate Therapy, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, PO Box 4950 Nydalen, 0424 Oslo, Norway. ystrumse@ous-hf.no
authors.forename: Yndis A
authors.initials: YA
authors.lastname: Staalesen Strumse
authors.forename: Bjørn-Yngvar
authors.initials: BY
authors.lastname: Nordvåg
authors.forename: Johan K
authors.initials: JK
authors.lastname: Stanghelle
authors.forename: Mona
authors.initials: M
authors.lastname: Røisland
authors.forename: Anne
authors.initials: A
authors.lastname: Winther
authors.forename: Pär-Arne
authors.initials: PA
authors.lastname: Pajunen
authors.forename: Torhild
authors.initials: T
authors.lastname: Garen
authors.forename: Berit
authors.initials: B
authors.lastname: Flatø
mesh_terms: D000328:Adult; D000368:Aged; D002980:Climate; D013790:Climatotherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054548:Montenegro; D009664:Norway; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D013167:Spondylitis, Ankylosing / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey