Abstract
Objective
To assess the effectiveness of exercise programs on disease activity and function
in ankylosing spondylitis (AS) by a systematic review and meta-analysis of randomized
controlled trials (RCTs).
Data Sources
Medline via PubMed and Cochrane Library.
Study Selection
Reports of RCTs examining the effectiveness of exercise programs for AS published
up to May 2017.
Data Extraction
Outcomes were evolution of the Bath Ankylosing Spondylitis Disease Activity Index
(BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) after the completion
of exercise programs. Modalities of exercise were compared and the use of biologic
therapy was reported.
Data Synthesis
After screening 190 abstracts, we selected 26 reports for detailed evaluation and
finally investigated 8 trials that assessed a home-based exercise program (2/8), swimming
(1/8), Pilates training (1/8), or supervised exercises (4/8), for a total of 331 patients
with AS. Four trials included patients receiving antitumor necrosis factor therapy.
All trials except one showed a decrease in BASDAI and BASFI with exercise. The weighted
mean difference was −0.90 (95% confidence interval, −1.52 to −0.27; I2=69%; P=.005) for the BASDAI and −0.72 (95% confidence interval, −1.03 to −0.40; I2=0%; P<.00001) for the BASFI in favor of exercise programs.
Conclusions
Despite the small number of patients and the heterogeneity of exercise programs in
the RCTs included in this meta-analysis, its results support the potential of exercise
programs to improve disease activity and body function in AS.
Keywords
List of abbreviations:
AS (ankylosing spondylitis), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), BASFI (Bath Ankylosing Spondylitis Functional Index), CI (confidence interval), RCT (randomized controlled trial), TNF (tumor necrosis factor), WMD (weighted mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 28, 2017
Footnotes
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
