Abstract
BackgroundFrom a health service perspective, society, with its limited resources, needs to be reassured that evidence-based medicine is also effective when carried out in the frame of ordinary clinical practice. The effectiveness of rehabilitation programs in ankylosing spondylitis (AS) has been proven to be effective in clinical trials. However, less is known when this is carried out in clinical practice. The aim of this study was to evaluate the effect of a 2-weeks rehabilitation program on self-reported outcome and physical function in patients with axial spondyloarthritis (ax-SpA) including AS patients carried out in ordinary clinical practice. The program contained of daily water exercises, exercises for flexibility, muscle strength, and cardio-respiratory fitness.ResultsA total of 87 ax-SpA patients (60 men, 27 women), aged ≥ 18 years were identified to have participated in the 2-weeks in-patient rehabilitation program. Mean age was 49 years and disease duration was 14 years. 92.5% were HLA-B27 positive, 62% were current users of non-steroidal anti-inflammatory drugs, and 17% were current users of tumour necrosis factor inhibitors. After 2-weeks, a statistical significant improvement (p < 0.001) was observed for patient-reported outcomes (Bath Ankylosing Spondylitis (BAS) Disease Activity Index 4.3 vs. 3.1, BAS Functional Index 3.1 vs. 2.4) and physical measured outcomes (BAS Metrology Index 3.23 vs. 2.29, Gait Velocity 2.2 vs. 2.6 m/s, timed-stands test 22.5 vs. 16.3 s, finger-floor distance 17.9 vs. 8.9 cm, chest expansion 3.9 vs. 4.6 cm).ConclusionData, from our retrospective case series report, support that patient with ax-SpA benefit from short-term rehabilitation when it is carried out in ordinary clinical care. Data from ordinary clinical care may be important when discussing the effectiveness of a treatment and allocating resources in the health care system.
Highlights
From a health service perspective, society, with its limited resources, needs to be reassured that evidence-based medicine is effective when carried out in the frame of ordinary clinical practice
There is a substantial body of evidence in the literature proving that various spa and exercise programs tested in randomised trials have a beneficial effect in ankylosing spondylitis (AS) patients improving physical function and reducing symptoms of disease [5,6,7,8,9,10,11,12]
In a Cochrane review, the results suggested individual home-based or supervised exercise programs to be better than non-intervention, supervised group physiotherapy to be better than homeexercise, and combined in-patient spa-exercise therapy followed by group physiotherapy to be better than group physiotherapy alone [14]
Summary
From a health service perspective, society, with its limited resources, needs to be reassured that evidence-based medicine is effective when carried out in the frame of ordinary clinical practice. In a Cochrane review, the results suggested individual home-based or supervised exercise programs to be better than non-intervention, supervised group physiotherapy to be better than homeexercise, and combined in-patient spa-exercise therapy followed by group physiotherapy to be better than group physiotherapy alone [14]. This knowledge is reflected in recommendations for management of AS, highlighting that regular exercise and rehabilitation therapy are part of the treatment strategy [3,15]
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