National Advisory Unit for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Br J Sports Med. 2020 Mar;54(5):292-297. doi: 10.1136/bjsports-2018-099943. Epub 2019 Feb 11.
Exercise is considered important in the management of patients with rheumatic diseases, but the effect of high intensity exercises on disease activity is unknown.
To investigate the effectiveness of high intensity exercises on disease activity in patients with axial spondyloarthritis (axSpA).
Assessor blinded multicentre randomised controlled trial. 100 patients (aged from their 20s to their 60s) with axSpA were randomly assigned to an exercise group or to a no-intervention control group. The exercise group performed cardiorespiratory and muscular strength exercises at high intensity over 3 months. The control group received standard care and was instructed to maintain their usual physical activity level. Primary outcome was disease activity measured with the Ankylosing Spondylitis (AS) Disease Activity Scale (ASDAS, higher score=worst) and the Bath AS Disease Activity Index (BASDAI, 0-10, 10=worst). Secondary outcomes were inflammatory markers, physical function and cardiovascular (CV)-health. There was patient involvement in the design and reporting of this study.
97 of the 100 (97%) randomised patients completed the measurements after the intervention. There was a significant treatment effect of the intervention on the primary outcome (ASDAS: -0.6 [-0.8 to -0.3], p<0.001 and BASDAI: -1.2 [-1.8 to -0.7], p<0.001). Significant treatment effects were also seen for inflammation, physical function and CV-health.
High intensity exercises reduced disease symptoms (pain, fatigue, stiffness) and also inflammation in patients with axSpA. It improves patients' function and CV health. This debunks concerns that high intensity exercise might exacerbate disease activity in patients with axSpA.
NCT02356874.
运动被认为是风湿性疾病患者管理的重要组成部分，但高强度运动对疾病活动的影响尚不清楚。
研究高强度运动对强直性脊柱炎（axSpA）患者疾病活动的影响。
评估员设盲的多中心随机对照试验。100 例（年龄 20 多岁至 60 多岁）axSpA 患者被随机分配到运动组或无干预对照组。运动组在 3 个月内进行心肺和肌肉力量的高强度运动。对照组接受标准护理，并被指示保持其日常身体活动水平。主要结局是使用强直性脊柱炎疾病活动度评分（ASDAS，评分越高表示病情越差）和 Bath 强直性脊柱炎疾病活动指数（BASDAI，0-10，10 表示病情最差）来衡量疾病活动度。次要结局包括炎症标志物、身体功能和心血管（CV）健康。本研究的设计和报告均有患者参与。
100 例随机患者中有 97 例（97%）在干预后完成了测量。干预对主要结局有显著的治疗效果（ASDAS：-0.6[-0.8 至-0.3]，p<0.001；BASDAI：-1.2[-1.8 至-0.7]，p<0.001）。炎症、身体功能和 CV 健康也有显著的治疗效果。
高强度运动可减轻 axSpA 患者的疾病症状（疼痛、疲劳、僵硬）和炎症，改善患者的功能和 CV 健康。这消除了人们对高强度运动可能会加重 axSpA 患者疾病活动的担忧。
NCT02356874。
