University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania.
Rheumatol Int. 2014 Mar;34(3):367-72. doi: 10.1007/s00296-013-2869-y. Epub 2013 Sep 26.
The optimal management of ankylosis spondylitis (AS) involves a combination of nonpharmacologic and pharmacologic treatment aiming to maximize health-related quality of life. The primary objective of our study was to demonstrate the benefits of an original multimodal exercise program combining Pilates, McKenzie and Heckscher techniques on pulmonary function in patients with AS, while secondary objectives were to demonstrate the benefits of the same program on function and disease activity. This is a randomized controlled study on ninety-six consecutive patients with AS (axial disease subset), assigned on a 1:1 rationale into two groups based on their participation in the Pilates, McKenzie and Heckscher (group I) or in the classical kinetic program (group II). The exercise program consisted of 50-min sessions performed 3 times weekly for 48 weeks. Standard assessments were done at week 0 and 48 and included pain, modified Schober test (mST) and finger-floor distance (FFD), chest expansion (CE) and vital capacity (VC), as well as disease activity Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional Bath Ankylosing Spondylitis Functional Index (BASFI) and metrology index Bath Ankylosing Spondylitis Metrology Index (BASMI). Groups were comparable at baseline; we demonstrated significant improvement between baseline and after 48 weeks of regular kinetic training for all AS-related parameters in both groups. However, significant improvement was found in pain, lumbar spine motility (mST, FFD), BASFI, BASDAI and BASMI in AS performing the specific multimodal exercise program at the end of study (p = 0.001). Although there were significant improvements in CE in both groups as compared to baseline (group I, p = 0.001; group II, p = 0.002), this parameter increased significantly only in group I (p = 0.001). VC measurements were not significantly changed at the end of the study (group I, p = 0.127; group II, p = 0.997), but we found significant differences within groups (p = 0.011). A multimodal training combining Pilates, McKenzie and Heckscher exercises performed regularly should be included in the routine management of patients with AS for better control of function, disease activity and pulmonary function.
强直性脊柱炎（AS）的最佳治疗方法包括非药物和药物治疗相结合，旨在最大限度地提高与健康相关的生活质量。我们的主要研究目的是证明结合普拉提、麦肯基和赫克歇尔技术的原始综合运动方案对 AS 患者的肺功能的益处，而次要目标是证明相同方案对功能和疾病活动的益处。这是一项针对 96 例连续 AS 患者（轴性疾病亚组）的随机对照研究，根据他们是否参加普拉提、麦肯基和赫克歇尔（I 组）或经典运动方案（II 组），按 1:1 的原则分为两组。运动方案包括每周 3 次、每次 50 分钟的 48 周疗程。在 0 周和 48 周时进行标准评估，包括疼痛、改良 Schober 试验（mST）和指尖-地板距离（FFD）、胸廓扩张（CE）和肺活量（VC），以及疾病活动 Bath 强直性脊柱炎疾病活动指数（BASDAI）、Bath 强直性脊柱炎功能指数（BASFI）和 Bath 强直性脊柱炎计量学指数（BASMI）。两组在基线时具有可比性；我们证明，两组在接受常规运动训练 48 周后，所有与 AS 相关的参数均有显著改善。然而，在研究结束时，接受特定综合运动方案的 AS 患者在疼痛、腰椎活动度（mST、FFD）、BASFI、BASDAI 和 BASMI 方面有显著改善（p=0.001）。与基线相比，两组的 CE 均有显著改善（I 组，p=0.001；II 组，p=0.002），但只有 I 组的 CE 显著增加（p=0.001）。研究结束时，VC 测量值无显著变化（I 组，p=0.127；II 组，p=0.997），但组内有显著差异（p=0.011）。定期进行结合普拉提、麦肯基和赫克歇尔运动的综合训练应纳入 AS 患者的常规治疗，以更好地控制功能、疾病活动和肺功能。
