School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey.
Department of Rheumatology, Medical Faculty of Pamukkale University, Denizli, Turkey.
Int J Rheum Dis. 2021 Mar;24(3):445-455. doi: 10.1111/1756-185X.14072. Epub 2021 Feb 28.
The aim of this randomized controlled study was to investigate the effect of soft-tissue mobilization in patients with ankylosing spondylitis (AS).
Twenty-one patients (mean age 44.57 ± 10.40 years) were randomly divided into two groups. There were 13 patients (11 females, 2 males, age 43.69 ± 9.94 years) in the intervention group and 8 patients (5 females, 3 males, age 46.00 ± 11.67 years) in the control group. In the intervention group, soft-tissue mobilization therapy and 20 spinal mobility exercises were applied. The control group received only 20 spinal mobility exercises. The Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Bath AS Metrology Index (BASMI) were used for assessment of disease activity, functional level, and mobility, respectively. Nottingham Health Profile (NHP) for quality of life and Roland Morris Disability Questionnaire (RMDQ) were used to determine disability levels.
We found significant differences between pretreatment and post-treatment scores of BASDAI (P = 0.049); BASFI (P = 0.009; lateral lumbar flexion (P = 0.005), maximal intermalleolar distance (P = 0.001) and total score (P = 0.001) of BASMI; pain subtest (P = 0.036) and total score (P = 0.036) of NHP; and RMDQ score (P = 0.004) in the intervention group. However, in the control group the BASMI score (P = 0.049) was observed to worsen significantly. Delta values were compared and differences in BASFI (P = 0.039), and in lateral lumbar flexion (P = 0.027), maximal intermalleolar distance (P = 0.045) and total score (P = 0.001) of BASMI were significant in favor of intervention group. Only tragus-to-wall distance (P = 0.039) of BASMI was observed to worsen significantly in the control group.
We recommend the use of soft-tissue mobilization in addition to the exercises to treat AS patients.
本随机对照研究旨在探讨软组织松解术对强直性脊柱炎(AS)患者的疗效。
21 例患者(平均年龄 44.57±10.40 岁)随机分为两组。干预组 13 例(11 女 2 男,年龄 43.69±9.94 岁),对照组 8 例(5 女 3 男,年龄 46.00±11.67 岁)。干预组采用软组织松解治疗和 20 项脊柱活动度锻炼。对照组仅接受 20 项脊柱活动度锻炼。采用 Bath AS 疾病活动指数(BASDAI)、Bath AS 功能指数(BASFI)和 Bath AS 度量指数(BASMI)评估疾病活动、功能水平和活动度,诺丁汉健康量表(NHP)和 Roland Morris 残疾问卷(RMDQ)评估生活质量和残疾程度。
我们发现干预组治疗前后 BASDAI(P=0.049)、BASFI(P=0.009;侧腰椎前屈(P=0.005)、最大内外踝间距(P=0.001)和总分(P=0.001)、NHP 疼痛子量表(P=0.036)和总分(P=0.036)、RMDQ 评分(P=0.004)均有显著差异。然而,对照组 BASMI 评分(P=0.049)显著恶化。比较差值,BASFI(P=0.039)、侧腰椎前屈(P=0.027)、最大内外踝间距(P=0.045)和总分(P=0.001)有显著差异,干预组更优。仅对照组 BASMI 的外耳到墙壁距离(P=0.039)显著恶化。
我们建议在 AS 患者的治疗中除运动锻炼外,还应采用软组织松解术。