Rheumatology Department, Hospital Avicenne, Bobigny, France.
INSERM UMR 1125 Sorbonne Paris Nord, Bobigny, France.
Disabil Rehabil. 2023 Dec;45(24):3989-4000. doi: 10.1080/09638288.2022.2140842. Epub 2022 Nov 11.
This systematic review and meta-analysis of controlled studies aimed to assess the efficacy of different types of exercise programs (EP) on ankylosing spondylitis (AS) activity, function and mobility.
We searched PubMed/Medline, Cochrane Library and Embase databases for reports of controlled trials of patients with AS published up to May 2022. The studies were classified by intervention into categories defined by the 4 exercise domains established by the American College of Sports Medicine and then adopted by the European League Against Rheumatism: aerobic, muscle strength, flexibility, neuromotor performance.
We found a moderate effect of EP as a whole on BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) (-0.60, 95% CI -0.95, -0.25, < 0.001), BASFI (Functional) (-0.63, 95% CI -0.84, -0.42, < 0.0001) and BASMI (Metrology) (-0.52, 95% CI -0.88, -0.15, < 0.01). The effect of "flexibility + muscle strength" EP was large for BASMI, moderate for BASDAI and BASFI. The effect of "flexibility + muscle strength + aerobic" EP was large for BASFI, moderate for BASDAI.
EP, regardless of the specific type of exercise, have a moderate effect on AS activity, function and mobility. EP including flexibility and muscle strength exercises may have a large effect, especially for mobility. Programs including aerobic exercise showed significant efficacy for function.IMPLICATIONS FOR REHABILITATIONIn ankylosing spondylitis (AS), any exercise program (EP), regardless of the type of exercises involved, showed a moderate effect on disease activity, function and spinal mobility.In AS, EP combining flexibility and strength exercises showed the largest effect on spinal mobility and should be encouraged.In AS, EP combining flexibility, muscle strength and aerobic exercises may be particularly effective on patient function.
本系统评价和荟萃分析对对照研究进行了评估，旨在评估不同类型的运动方案（EP）对强直性脊柱炎（AS）活动、功能和运动能力的疗效。
我们检索了 PubMed/Medline、Cochrane 图书馆和 Embase 数据库，以获取截至 2022 年 5 月发表的 AS 患者对照试验的报告。研究根据干预措施分为美国运动医学学院确定的 4 个运动领域的类别，然后被欧洲抗风湿病联盟采用：有氧运动、肌肉力量、柔韧性、神经运动表现。
我们发现 EP 作为一个整体对 BASDAI（巴斯强直性脊柱炎疾病活动指数）（-0.60，95%CI-0.95，-0.25，<0.001）、BASFI（功能性）（-0.63，95%CI-0.84，-0.42，<0.0001）和 BASMI（计量学）（-0.52，95%CI-0.88，-0.15，<0.01）有中等效果。“柔韧性+肌肉力量”EP 对 BASMI 的影响较大，对 BASDAI 和 BASFI 的影响中等。“柔韧性+肌肉力量+有氧运动”EP 对 BASFI 的影响较大，对 BASDAI 的影响中等。
EP 无论运动类型如何，对 AS 的活动、功能和运动能力都有中等效果。包括柔韧性和肌肉力量练习的 EP 可能具有较大的效果，尤其是对运动能力。包括有氧运动的方案对功能显示出显著的疗效。
在强直性脊柱炎（AS）中，任何运动方案（EP），无论所涉及的运动类型如何，对疾病活动、功能和脊柱运动能力都有中等的效果。在 AS 中，结合柔韧性和力量练习的 EP 对脊柱运动能力的影响最大，应予以鼓励。在 AS 中，结合柔韧性、肌肉力量和有氧运动的 EP 可能对患者的功能特别有效。
