Şen Ece Nur, Sarıtaş Fatih, Öztürk Özgül
Institute of Health Sciences, Physiotherapy and Rehabilitation, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Türkiye.
Department of Rheumatology, Haydarpaşa Numune Research and Training Hospital, University of Health Sciences, Istanbul, Türkiye.
Ir J Med Sci. 2025 Feb;194(1):137-146. doi: 10.1007/s11845-024-03846-8. Epub 2024 Nov 26.
Exercise is a key component of axial spondyloarthritis (axSpA) management. As telerehabilitation has become a viable solution for delivering remote care, the effectiveness of core stability exercises via this method remains under-researched.
To compare the effects of telerehabilitation-based synchronous versus asynchronous core stability exercises on core muscle endurance, spinal mobility, disease activity, physical function, and quality of life in patients with axSpA.
Forty-four patients with axSpA were randomly assigned to a synchronous exercise group (n = 22, 14 females) performing real-time exercises supervised by a physiotherapist, or an asynchronous group (n = 22, 10 females) following pre-recorded exercise videos. Core endurance tests, Bath Ankylosing Spondylitis Disease Activity (BASDAI), Bath Ankylosing Spondylitis Functional (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life Scale (ASQoL), and functional mobility tests (timed-up-and-go and chair stand tests) were used to assess outcomes. Perceived change was evaluated at post-treatment using the 5-point Global Rating of Change (GRoC) scale.
The synchronous group demonstrated greater changes in core endurance, BASMI, BASDAI, ASQoL, BASFI, and functional mobility tests (p < 0.05) compared to asynchronous group. Asynchronous group displayed improvement only in core endurance, ASQoL, chair stand test, and some BASMI parameters (p < 0.05). Notably, 100% of participants in the synchronous group reported their condition as improved, compared to 50% in the asynchronous group shown by GRoC.
Supervised core stability exercises delivered by using a synchronous telerehabilitation program may provide better outcomes compared to unsupervised video-based exercise program.
This study is prospectively registered at Clinicaltrials.gov (NCT06000072).
运动是轴性脊柱关节炎（axSpA）管理的关键组成部分。随着远程康复已成为提供远程护理的可行解决方案，通过这种方法进行核心稳定性训练的有效性仍未得到充分研究。
比较基于远程康复的同步与异步核心稳定性训练对axSpA患者核心肌肉耐力、脊柱活动度、疾病活动度、身体功能和生活质量的影响。
44例axSpA患者被随机分配到同步运动组（n = 22，14名女性），在物理治疗师的监督下进行实时训练，或异步组（n = 22，10名女性），按照预先录制的运动视频进行训练。使用核心耐力测试、巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）、巴斯强直性脊柱炎测量指数（BASMI）、强直性脊柱炎生活质量量表（ASQoL）和功能活动测试（计时起立行走测试和椅子站立测试）来评估结果。使用5点整体变化评分（GRoC）量表在治疗后评估感知变化。
与异步组相比，同步组在核心耐力、BASMI、BASDAI、ASQoL、BASFI和功能活动测试方面表现出更大的变化（p < 0.05）。异步组仅在核心耐力、ASQoL、椅子站立测试和一些BASMI参数方面有所改善（p < 0.05）。值得注意的是，同步组100%的参与者报告其病情有所改善，而GRoC显示异步组为50%。
与无监督的基于视频的运动计划相比，使用同步远程康复计划进行监督的核心稳定性训练可能会提供更好的效果。
本研究已在Clinicaltrials.gov（NCT06000072）进行前瞻性注册。
