Eppeland Siv Grødal, Diamantopoulos Andreas P, Soldal Dag Magnar, Haugeberg Glenn
BMC Res Notes. 2013 May 7;6:185. doi: 10.1186/1756-0500-6-185.
From 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.
A 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).
Data, 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.
从卫生服务的角度来看,社会资源有限,需要确信循证医学在普通临床实践框架内实施时也是有效的。强直性脊柱炎(AS)康复项目的有效性已在临床试验中得到证实。然而,在临床实践中实施时,了解的情况较少。本研究的目的是评估在普通临床实践中为包括AS患者在内的轴性脊柱关节炎(ax-SpA)患者开展的为期2周的康复项目对自我报告结局和身体功能的影响。该项目包括每日水上运动、柔韧性练习、肌肉力量练习和心肺适能练习。
共确定87例年龄≥18岁的ax-SpA患者(60例男性,27例女性)参与了为期2周的住院康复项目。平均年龄为49岁,病程为14年。92.5%的患者HLA-B27呈阳性,62%的患者目前使用非甾体抗炎药,17%的患者目前使用肿瘤坏死因子抑制剂。2周后,患者报告的结局(巴斯强直性脊柱炎(BAS)疾病活动指数从4.3降至3.1,BAS功能指数从3.1降至2.4)和身体测量结局(BAS计量指数从3.23降至2.29,步速从2.2米/秒增至2.6米/秒,定时起立试验从22.5秒降至16.3秒,手指-地面距离从17.9厘米降至8.9厘米,胸廓活动度从3.9厘米增至4.6厘米)均有统计学意义的改善(p<0.001)。
我们的回顾性病例系列报告数据支持,ax-SpA患者在普通临床护理中接受短期康复治疗会受益。在讨论治疗效果和在医疗保健系统中分配资源时,来自普通临床护理的数据可能很重要。