title: The effects of combined spa therapy and rehabilitation on patients with ankylosing spondylitis being treated with TNF inhibitors.
abstract: Despite advances in pharmacological therapy, physical treatment continues to be important in the management of ankylosing spondylitis (AS). The objective of the present study was to evaluate the effects and tolerability of combined spa therapy and rehabilitation in a group of AS patients being treated with TNF inhibitors. Thirty AS patients attending the Rheumatology Unit of the University of Padova being treated with TNF inhibitors for at least 3 months were randomized and assessed by an investigator independent from the spa staff: 15 were prescribed 10 sessions of spa therapy (mud packs and thermal baths) and rehabilitation (exercises in a thermal pool) and the other 15 were considered controls. The patients in both groups had been receiving anti-TNF agents for at least three months. The outcome measures utilized were BASFI, BASDAI, BASMI, VAS for back pain and HAQ. The evaluations were performed in all patients at the entry to the study, at the end of the spa treatment, and after 3 and 6 months. Most of the evaluation indices were significantly improved at the end of the spa treatment, as well as at the 3 and 6 months follow-up assessments. No significant alterations in the evaluation indices were found in the control group. Combined spa therapy and rehabilitation caused a clear, long-term clinical improvement in AS patients being treated with TNF inhibitors. Thermal treatment was found to be well tolerated and none of the patients had disease relapse.
authors.affiliation: Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ciprian
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lo Nigro
authors.forename: Michela
authors.initials: M
authors.lastname: Rizzo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gava
authors.forename: Roberta
authors.initials: R
authors.lastname: Ramonda
authors.forename: Leonardo
authors.initials: L
authors.lastname: Punzi
authors.forename: Franco
authors.initials: F
authors.lastname: Cozzi
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001416:Back Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001452:Balneology; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D000068800:Etanercept; D005081:Exercise Therapy; D005260:Female; D006304:Health Status; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D009094:Mud Therapy; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D020127:Recovery of Function; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D029002:Steam Bath; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept