Physical Therapy Approaches in Ankylosing Spondylitis: A Systematic Review

Abstract

Background: Ankylosing spondylitis (AS) is a chronic, progressive, inflammatory disorder that mainly affects the axial skeleton with aseptic inflammation of synovial tissue, spinal ligaments, intervertebral discs and facet joints. The purpose of this review is to describe the effectiveness of different physical therapy approaches in patients with AS. Method: This review followed PRISMA guidelines. A search was conducted in electronic databases Google Scholar, PubMed, and Cochrane. Publications were included if the study group included patients with a diagnosis of AS according to the classification system described in the New York criteria. Results: A total of 6 clinical trials and 4 reviews were included in this review. One trial (n=1) had no intervention, most studies (n=4) and all the reviews (n=4) compared a variation in type of exercises, such as aerobic exercise, Pilates, swimming, one trial (n=1) was a follow-up evaluation. Conclusions: The results of this review show that different types of treatment programs improve areas related to the physical health of patients with AS such as pain intensity, mobility, functionality, muscle strength, balance, fatigue, anxiety, depression. The most significant improvement in pain across all research data is noted after aquatic therapy. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity and pain in patients with AS.