title: Outcome of an education and home-based exercise programme for patients with ankylosing spondylitis: a nationwide randomized study.
abstract: OBJECTIVE
  This study aims to assess the impact of a structured education and home exercise programme in daily practice patients with ankylosing spondylitis.
  
  
  METHODS
  A total of 756 patients with ankylosing spondylitis (72% males, mean age 45 years) participated in a 6-month prospective multicentre controlled study, 381 of whom were randomised to an education intervention (a 2-hour informative session about the disease and the implementation of a non-supervised physical activity programme at home) and 375 to standard care (controls). Main outcome measures included Bath Ankylosing Spondylitis Disease Activity and Functional Index (BASDAI, BASFI). Secondary outcome measures were 0-10 cm visual analog scale (VAS) for total pain, nocturnal pain and global disease activity and quality of life (ASQoL), knowledge of disease (self-evaluation ordinal scale) and daily exercise (diary card).
  
  
  RESULTS
  At 6 months, the adjusted mean difference between control and educational groups for BASDAI was 0.32, 95% confidence interval (CI) 0.10-0.54, p=0.005, and for BASFI 0.31, 95%CI 0.12-0.51, p=0.002. Significant differences were found also in VAS for total pain, patient´s global assessment and in ASQoL. Patients in the education group increased their knowledge about the disease and its treatments significantly (p<0.001) and practised more regular exercise than controls (p<0.001).
  
  
  CONCLUSIONS
  A structured education and home exercise programme for patients with ankylosing spondylitis in daily practice was feasible and helped to increase knowledge and exercise. Although statistically significant, the magnitudes of the clinical benefits in terms of disease activity and physical function were poor.
authors.affiliation: Rheumatology Service, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain. crodloz@gobiernodecanarias.org.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodríguez-Lozano
authors.forename: Xavier
authors.initials: X
authors.lastname: Juanola
authors.forename: Juan
authors.initials: J
authors.lastname: Cruz-Martínez
authors.forename: Andrés
authors.initials: A
authors.lastname: Peña-Arrébola
authors.forename: Juan
authors.initials: J
authors.lastname: Mulero
authors.forename: Jordi
authors.initials: J
authors.lastname: Gratacós
authors.forename: Eduardo
authors.initials: E
authors.lastname: Collantes
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010353:Patient Education as Topic; D011446:Prospective Studies; D020127:Recovery of Function; D013030:Spain; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome