Functional Outcome of McKenzie Exercise in Patients with Ankylosing Spondylitis- A Single Center Study in Bangladesh

Abstract

Background: Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton, causing inflammatory back pain and can lead to structural and functional impairments. On average, ankylosing spondylitis (AS) incidence rates range from 0.2% to 1% of the adult population. McKenzie exercise seems to be beneficial for those affected by AS, in particular when it is planned according to the needs of the individual aiming to maintain or improve the level of physical fitness. The prevalence of AS is generally believed to be between 0.1% and 1.4% globally. Aim of the study: The aim of this study was to evaluate the functional outcome of McKenzie exercise in patients with ankylosing spondylitis. Methods: This was a comparative experimental study which was conducted in the Department of Physical Medicine and Rehabilitation, BSMMU, Dhaka, Bangladesh from October 2019 September 2020. The study was approved by Institutional Review Board (IRB) of BSMMU on. A total of 112 patients with ankylosing spondylitis were selected who were divided into two groups. 56 patients were allotted in group A (NSAID group) and another 56 patients were allotted in group B (NSAID with McKenzie exercise). Collected data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The mean VAS score at baseline was 34.44 ±2.78 in group A and 34.03±2.23 in group B, at 4 weeks 28.89±3.67 in group A and 21.23 ±3.57 in group B, at 8 weeks 30.59 ±3.69 in group A and 16.95±3.62 in group B and at 12 weeks 28.08±3.34 in group A and 15.04 ±3.77 in group B. The mean BASFI at baseline was 3.19±0.15 in group A and 3.51±0.18 in group B, at 4 weeks 2.99±0.15 in group A and 2.15±0.05 in group B, at 8 weeks 1.99±0.09 in group A and 1.26±0.22 in group B and at 12 weeks 2.01±0.09 in group A and 1.25±0.2 in group B. The mean BASDAI at baseline was 5.01±0.39 in group A and 4.95±0.4 in group B, at 4 weeks 3.99±0.07 in group A and 3.43±0.09 in group B, at 8 weeks 3.97±0.09 in group A and 3.02±0.07 in group B and at 12 weeks 3.49±0.06 in group A and 1.98±0.09 in group B. The differences of VAS score, BASFI and BASDAI at 4, 8 and 12 weeks were statistically significant (p<0.05) between two groups. Conclusion: Ankylosing spondylitis (AS) causes pain and stiffness to affected joints and the spine and if the disease progresses, it can cause fusion of the joints, which can limit a person’s mobility and flexibility. In analyzing the outcomes of McKenzie exercise in patients with ankylosing spondylitis the differences of VAS score, BASFI and BASDAI at 4, 8 and 12 weeks were found as statistically significant (p<0.05) between NSAID group and NSAID with McKenzie exercise patient groups.