SAT0613-HPR EFFECT OF CERVICAL STABILIZATION EXERCISES ON CERVICAL POSITION ERROR IN PATIENTS WITH SPONDYLOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background:Proprioception sense might be deteriorated due to joint related diseases. Different exercise programs were shown beneficial for improving proprioception sense. However, the effect of exercise on cervical position error was not investigated in patients with axial spondyloarthritis (axSpA).Objectives:To investigate the effect of cervical stabilization exercises on cervical position error in patients with axSpA.Methods:Thirty-nine patients with axSpA were randomly allocated into two groups as exercise group (n: 20, 11 males) and control group (n: 19, 12 males). All patients were evaluated regarding to physical characteristics (age, body-mass index), disease activity (Bath Ankylosing Spondylitis Disease Activity Index), functional status (Bath Ankylosing Spondylitis Functional Index), and spinal mobility (Bath Ankylosing Spondylitis Metrology Index). Cervical position error was evaluated in flexion, extension, rotation and lateral flexion directions and was calculated using a special formula (1). All evaluations were performed at baseline and after six weeks. Exercise group performed a progressive home-based cervical stabilization exercise program, while the control group did not receive any exercise intervention. Exercise adherence control and exercise progression was delivered by sending messages and video instructions via a freeware and cross-platform messaging service (WhatsApp Messenger) in a weekly basis.Results:Baseline physical and disease related characteristics were similar between groups (p>0.05, table 1). Exercise group showed significant improvements in all directions related to cervical proprioception following six weeks (p<0.05, Table 2), however, no improvements were observed in the control group (p>0.05, Table 2).Table 1.Comparison of the Groups at BaselineExercise Group (n: 20)Median (IQR 25/75)Control Group (n: 19)Median (IQR 25/75)p*Physical CharacteristicsAge (years)40.5 (36.0/52.5)44.0 (39.0/49.5)0.496Body-Mass Index (kg/m2)27.5 (24.5/30.2)26.8 (23.6/29.3)0.569Disease Related CharacteristicsBASDAI (score)2.0 (1.0/3.3)1.8 (1.3/2.5)0.687BASMI Total (score)2.9 (1.7/4.1)2.3 (1.8/3.1)0.127BASFI (score)1.8 (0.6/2.9)1.2 (1.0/2.2)0.496*Mann-Whitney U Test, IQR 25/75: Interquartile range 25/75, BASDAI: Bath Ankylosing Spondylitis Disease Activity Index, BASMI: Bath Ankylosing Spondylitis Metrology Index, BASFI: Bath Ankylosing Spondylitis Functional Index, p<0.05.Table 2.In-Group Comparison of Cervical Position Sense ErrorBeforeMedian (IQR 25/75)AfterMedian (IQR 25/75)p*Exercise Group (n: 20)Flexion(o)4.9 (2.2/7.0)2.8 (1.7/3.8)0.033Extension(o)4.5 (3.3/6.4)3.1 (1.8/4.8)0.040Right Rotation(o)5.2 (3.0/8.9)3.7 (1.9/4.7)0.006Left Rotation(o)4.3 (2.5/5.0)2.8 (2.2/3.3)0.017Right Lateral Flexion(o)4.9 (3.3/6.8)2.3 (1.8/3.7)0.009Left Lateral Flexion(o)4.3 (2.1/6.7)2.0 (1.5/3.4)0.010Control Group (n: 19)Flexion(o)6.3 (3.5/7.3)5.2 (3.8/7.0)0.856Extension(o)5.5 (4.5/7.3)4.1 (3.3/8.2)0.809Right Rotation(o)6.4 (4.3/9.0)5.5 (3.0/8.5)0.472Left Rotation(o)5.4 (3.5/7.9)5.0 (3.5/7.2)0.778Right Lateral Flexion(o)5.9 (3.6/8.4)4.3 (2.7/7.7)0.717Left Lateral Flexion(o)3.8 (2.4/5.6)4.9 (2.9/5.7)0.904*Wilcoxon Signed Rank Test, IQR 25/75: Interquartile range 25/75,o: degree, p<0.05.Conclusion:A six-week cervical stabilization exercise program is beneficial for impaired cervical proprioception sense in patients with axSpA.