Gündüz Gül Yeşim Özge, Bal Ajda, Erdem Ümmü Gül
Department of Physical Medicine and Rehabilitation, Ankara Etlik City Hospital Physical Medicine and Rehabilitation Hospital, Ankara, Türkiye.
Department of Medical Microbiology, Ankara Etlik City Hospital, Ankara, Türkiye.
Arch Rheumatol. 2025 Mar 17;40(1):98-111. doi: 10.46497/ArchRheumatol.2025.10924. eCollection 2025 Mar.
This study aims to examine whether aerobic exercises, in addition to home-based exercise (HBE) program, had anti-inflammatory effects, evaluated by disease activity, acute phase reactants, and cytokine levels in axial spondyloarthropathy (axSpA).
This two parallel-group, unblinded, 12-week, prospective, randomized-controlled trial (RCT) included a total of 54 participants who were followed for axSpa and the patients were equally allocated to the aerobic exercise group or HBE group. The aerobic exercise group included 27 patients (8 males, 19 females, mean age: 43.9±9.0 years; range, 27 to 58 years) and the HBE group included 27 patients (8 males, 19 females, mean age: 42.4±10.5 years; range, 23 to 63 years). The patients were evaluated using the Ankylosing Spondylitis Disease Activity Score (ASDAS), Visual Analog Scale (VAS), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), chest expansion measurement, 6-Min Walk Test, and Ankylosing Spondylitis Quality of Life (ASQoL), Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tumor necrosis factoralpha (TNF-α) and interleukin-17 (IL-17) levels at the beginning of the study and after treatment completion. The HBE group was provided conventional exercise program. The second group ran on the treadmill in addition to their HBE program. Exercise sessions were performed three times a week for a period of 12 weeks.
After treatment, only the aerobic exercise group showed a significant improvement in disease activity (p<0.001). Both HBE and aerobic exercise groups showed a significant improvement in pain levels, functional statement, spinal mobility, chest expansion, functional exercise capacity, and life quality (p<0.001, p<0.001; p<0.001, p<0.001; p=0.03, p<0.001; p=0.008, p<0.001; p=0.004, p<0.001; p<0.001, and p<0.001, respectively). Only the HBE group showed a significant decrease in TNF-α levels and ESR (p=0.015, p=0.014). After treatment, the aerobic exercise group showed more improvement in disease activity, pain levels, functional exercise capacity, and quality of life compared to the HBE group (p<0.001, p=0.005, p<0.001, p=0.038). The change in post-treatment ESR, CRP, TNF-α, and IL-17 levels compared to pre-treatment did not show a statistically significant difference between the HBE and aerobic exercise groups (p>0.05).
Adding aerobic exercise to a conventional exercise program may have an anti-inflammatory effect by reducing disease activity and help to manage disease.
本研究旨在探讨有氧运动除居家锻炼（HBE）计划外，是否具有抗炎作用，通过疾病活动度、急性期反应物以及轴性脊柱关节炎（axSpA）中的细胞因子水平进行评估。
这项两平行组、非盲、为期12周的前瞻性随机对照试验（RCT）共纳入54名axSpA患者，这些患者被平均分配至有氧运动组或HBE组。有氧运动组包括27名患者（8名男性，19名女性，平均年龄：43.9±9.0岁；范围27至58岁），HBE组包括27名患者（8名男性，19名女性，平均年龄：42.4±10.5岁；范围23至63岁）。使用强直性脊柱炎疾病活动评分（ASDAS）、视觉模拟量表（VAS）、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）、胸廓扩张度测量、6分钟步行试验以及强直性脊柱炎生活质量（ASQoL）、红细胞沉降率（ESR）、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）和白细胞介素-17（IL-17）水平在研究开始时和治疗结束后对患者进行评估。HBE组接受常规锻炼计划。第二组除HBE计划外还在跑步机上跑步。锻炼 sessions 每周进行三次，为期12周。
治疗后，仅有氧运动组在疾病活动度方面有显著改善（p<0.001）。HBE组和有氧运动组在疼痛水平、功能状态、脊柱活动度、胸廓扩张度、功能锻炼能力和生活质量方面均有显著改善（分别为p<0.001，p<0.001；p<0.001，p<0.001；p=0.03，p<0.001；p=0.008，p<0.001；p=0.004，p<0.001；p<0.001和p<0.001）。仅HBE组的TNF-α水平和ESR有显著下降（p=0.015，p=0.014）。治疗后，与HBE组相比，有氧运动组在疾病活动度、疼痛水平、功能锻炼能力和生活质量方面改善更明显（p<0.001，p=0.005，p<0.001，p=0.038）。治疗后ESR、CRP、TNF-α和IL-17水平与治疗前相比的变化在HBE组和有氧运动组之间无统计学显著差异（p>0.05）。
在常规锻炼计划中增加有氧运动可能通过降低疾病活动度具有抗炎作用，并有助于控制疾病。
