title: Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.
abstract: OBJECTIVE
  To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy.
  
  
  METHODS
  Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up.
  
  
  METHODS
  Patients' homes.
  
  
  METHODS
  A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23).
  
  
  METHODS
  Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control.
  
  
  METHODS
  Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer.
  
  
  RESULTS
  At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p < 0.05) for all outcomes. At 12-months follow-up, compared with the control and educational-behavioural, the rehabilitation group exhibited significant differences in chest expansion (p = 0.001 and p < 0.001), Bath Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001).
  
  
  CONCLUSIONS
  In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Padua, Padua, Italy stef.masiero@unipd.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masiero
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Padua, Padua, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Poli
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Padua, Padua, Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Bonaldo
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Padua, Padua, Italy.
authors.forename: Maurizia
authors.initials: M
authors.lastname: Pigatto
authors.affiliation: Department of Rheumatology, University of Padua, Padua, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ramonda
authors.affiliation: Department of Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
authors.affiliation: Department of Rheumatology, University of Padua, Padua, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Punzi
authors.affiliation: Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D013167:Spondylitis, Ankylosing / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation*; D018709:Statistics, Nonparametric; D000079424:Tumor Necrosis Factor Inhibitors; D048069:Tumor Necrosis Factors / Q000627:therapeutic use
chemical_list: D000079424:Tumor Necrosis Factor Inhibitors; D048069:Tumor Necrosis Factors
keywords: Activity Index; Ankylosing spondylitis; Functional Index; Metrology Index