title: The Effect of Comprehensive Musculoskeletal Rehabilitation on Clinical Status of Ankylosing Spondylitis Patients.
abstract: BACKGROUND
  This study aimed to compare the effectiveness of conventional and cryotherapy-based rehabilitation with respect to its impact on selected clinical parameters in AS patients.
  
  
  METHODS
  Fifty working males aged 22-66 years were included in this study. Twenty-five of them underwent cryotherapy-based rehabilitation (cryogenic chamber, local cryotherapy; individual, instrumental, and nonweight-bearing exercises) for 3 weeks. The others received 3 weeks of conventional rehabilitation (magnetic field therapy; electrotherapy; individual and instrumental exercises). The patients were examined at three time points: before rehabilitation, immediately after its completion and at a three-month follow-up visit. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease severity, the Bath Ankylosing Spondylitis Functional Index (BASFI) was used to assess musculoskeletal function and a visual analog scale (VAS) was used to assess pain. A global health index was also employed to assess patients' overall well-being.
  
  
  RESULTS
  Cryotherapy-based rehabilitation improved the following parameters: BASDAI (P<0.001, P<0.001), BASFI (P<0.001, P=0.007), VAS (P<0.007, P=0.001) and global health index (P<0.001, P<0.001) at the second and third assessment, respectively. Conventional rehabilitation improved the BASDAI (P<0.001), VAS (P=0.029), and overall well-being (P<0.030) at the second assessment. Cryotherapy-based rehabilitation was more effective than conventional rehabilitation with respect to BASFI [F(2, 82)=6.571; P=0.004; eta2=0.120] and overall well-being [F(2, 96) =5.018; P=0.008; eta2=0.095)].
  
  
  CONCLUSIONS
  1. Comprehensive rehabilitation in ankylosing spondylitis has a positive effect on patients' clinical status. 2. Rehabilitation involving cryotherapy is more effective in improving musculoskeletal function and overall well-being compared to conventional rehabilitation. 3. Cryotherapy-based rehabilitation significantly reduces the intensity of pain experienced by AS patients and decreases disease activity, with the positive effect maintained at 3 months post rehabilitation.
authors.affiliation: Prof. E. Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Księżopolska-Orłowska
authors.affiliation: Prof. E. Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Pacholec
authors.affiliation: Central Institute for Labour Protection- National Research Institute, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bugajska
authors.affiliation: Prof. E. Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Poland.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sadura-Sieklucka
authors.affiliation: Prof. E. Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kowalik
authors.affiliation: Central Institute for Labour Protection- National Research Institute, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Pawłowska-Cyprysiak
authors.affiliation: Central Institute for Labour Protection- National Research Institute, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Łastowiecka-Moras
mesh_terms: D000328:Adult; D000368:Aged; D017679:Cryotherapy; D004185:Disability Evaluation; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D010147:Pain Measurement; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult