title: Evaluation of physiotherapy in a prospective cohort of early axial spondyloarthritis. Data from the DESIR cohort.
abstract: OBJECTIVE
  To evaluate the effect of physiotherapy on functional limitation in an observational cohort of early axial spondyloarthritis.
  
  
  METHODS
  
  
  
  METHODS
  prospective population-based cohort study.
  
  
  METHODS
  708 patients with early axial spondyloarthritis between 2007 and 2010 naive of TNF blockers.
  
  
  METHODS
  early physiotherapy defined by at least eight supervised sessions of physical therapy during the first six months.
  
  
  METHODS
  the primary outcome was functional improvement defined by a relative improvement of at least 20% in BASFI at six months. Secondary outcomes were improvement in BASFI at one and two years and ASAS20 response criteria at six months.
  
  
  METHODS
  a propensity score of having physiotherapy was developed and multivariate analysis using propensity score weighting were used to assess the effect of physiotherapy on outcome.
  
  
  RESULTS
  Overall, 166 (24%) patients had physiotherapy during the first six months. After using propensity score weighting, there was no functional improvement on the primary outcome in patients treated with early physical therapy (relative risk [IC95%]: 1.15 [0.91-1.45]). No differences were observed on secondary outcomes (relative risk [IC95%]: 0.94 [0.80-1.11]).
  
  
  CONCLUSIONS
  It seems there is no functional benefit for patients with early spondyloarthritis to be treated early by physiotherapy in daily practice, even though the efficacy of physiotherapy has been shown in several randomized controlled studies.
authors.affiliation: Department of Physical Medicine and Rehabilitation, AP-HP, Paris Descartes University, Cochin Hospital, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Escalas
authors.affiliation: Inserm U1153 and IFR Handicap, Cochin Hospital, 75014 Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Dalichampt
authors.affiliation: Inserm U1153, Clinical epidemiology and biostatistics, Department of Rheumatology, Cochin Hospital, AP-HP, Paris Descartes University, PRES Sorbonne Paris-Cité, 75014 Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: Department of Physical Medicine and Rehabilitation, AP-HP, Paris Descartes University, Cochin Hospital, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Inserm U1153 and IFR Handicap, Cochin Hospital, 75014 Paris, France. Electronic address: serge.poiraudeau@cch.aphp.fr.
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D025241:Spondylarthritis / Q000628:therapy*
keywords: Axial spondyloarthritis; Physical therapy; Treatment and epidemiology