PRM Department, Centro Hospitalar Universitário do Porto/Hospital de Santo António, Largo do Prof. Abel Salazar, 4099-001, Porto, Portugal.
University of Porto-Instituto de Ciências Biomédicas Abel Salazar, Rua Jorge de Viterbo Ferreira 228, 4050-343, Porto, Portugal.
Rheumatol Int. 2017 Dec;37(12):1979-1990. doi: 10.1007/s00296-017-3829-8. Epub 2017 Oct 5.
Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility and axial deformity, which lead to diminished quality of life. Its treatment includes not only drugs, but also nonpharmacological therapy. Exercise appears to be a promising modality. The aim of this study is to review the current evidence and evaluate the role of exercise either on land or in water for the management of patients with AS in the biological era. Systematic review of the literature published until November 2016 in Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Thirty-five studies were included for further analysis (30 concerning land exercise and 5 concerning water exercise; combined or not with biological drugs), comprising a total of 2515 patients. Most studies showed a positive effect of exercise on Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, pain, mobility, function and quality of life. The benefit was statistically significant in randomized controlled trials. Results support a multimodal approach, including educational sessions and maintaining home-based program. This study highlights the important role of exercise in management of AS, therefore it should be encouraged and individually prescribed. More studies with good methodological quality are needed to strengthen the results and to define the specific characteristics of exercise programs that determine better results.
强直性脊柱炎（AS）是一种慢性炎症性风湿性疾病，其特征为疼痛和结构及功能损伤，如活动度降低和脊柱畸形，导致生活质量下降。其治疗不仅包括药物治疗，还包括非药物治疗。运动似乎是一种很有前途的治疗方法。本研究旨在回顾目前的证据，并评估在生物时代对 AS 患者进行陆地或水上运动管理的作用。系统回顾截至 2016 年 11 月在 Medline、Embase、Cochrane 图书馆、Web of Science 和 Scopus 数据库中发表的文献。有 35 项研究被纳入进一步分析（30 项涉及陆地运动，5 项涉及水上运动；与生物药物联合或不联合），共纳入 2515 例患者。大多数研究表明运动对 Bath 强直性脊柱炎疾病活动指数、Bath 强直性脊柱炎功能指数、疼痛、活动度、功能和生活质量有积极影响。随机对照试验的结果具有统计学意义。结果支持多模式方法，包括教育课程和维持家庭为基础的方案。本研究强调了运动在 AS 管理中的重要作用，因此应鼓励并个体化制定运动方案。需要更多具有良好方法学质量的研究来加强结果，并确定决定更好结果的运动方案的具体特征。
