Masiero Stefano, Poli Patrizia, Bonaldo Lara, Pigatto Maurizia, Ramonda Roberta, Lubrano Ennio, Punzi Leonardo, Maffulli Nicola
Department of Physical Medicine and Rehabilitation, University of Padua, Padua, Italy
Department of Physical Medicine and Rehabilitation, University of Padua, Padua, Italy.
Clin Rehabil. 2014 Jun;28(6):562-72. doi: 10.1177/0269215513512214. Epub 2013 Nov 27.
To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy.
Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up.
Patients' homes.
A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23).
Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control.
Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer.
At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p < 0.05) for all outcomes. At 12-months follow-up, compared with the control and educational-behavioural, the rehabilitation group exhibited significant differences in chest expansion (p = 0.001 and p < 0.001), Bath Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001).
In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis.
评估在使用肿瘤坏死因子抑制剂治疗病情稳定的强直性脊柱炎患者中，为期12个月的监督训练及家庭康复对疼痛、活动能力和身体功能结局的影响。
为期12个月随访的对照临床试验（顺序确定分配）。
患者家中。
总共69名受试者被分配到一个康复计划（康复组，n = 22）、一个教育行为计划（教育组，n = 24）或两个计划都不参与（对照组，n = 23）。
康复计划包括监督训练和家庭锻炼（伸展、强化、有氧运动、胸部以及脊柱/髋关节灵活性锻炼）；教育行为计划包括关于强直性脊柱炎、疼痛和压力机制以及控制的信息。
脊柱疼痛强度、巴斯强直性脊柱炎测量指数、巴斯强直性脊柱炎功能指数、巴斯强直性脊柱炎疾病活动指数、胸部扩张度，以及使用袖珍测角仪测量的颈椎和腰椎活动范围。
在基线时，三组呈现出可比的人口统计学特征和基础评估。康复组从基线到12个月的组内变化在所有结局方面均产生了具有统计学意义的改善（p < 0.05）。在12个月随访时，与对照组和教育行为组相比，康复组在胸部扩张度（p = 0.001和p < 0.001）、巴斯强直性脊柱炎疾病活动指数（p = 0.012和p = 0.050）以及一些测角测量结果方面存在显著差异，如颈椎旋转（p = 0.007和p = 0.014）、胸腰椎旋转（p = 0.009和p = 0.050）以及颈椎总活动度（p = 0.009和p = 0.001）。
与教育行为计划或不干预相比，监督训练和家庭锻炼改善了强直性脊柱炎患者的长期结局。
