Skip to main content
SpringerLink
Log in

Home-based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The importance of exercise and regular physiotherapy in patients with ankylosing spondylitis (AS) under treatment with tumor necrosis factor alpha inhibitors (TNFα inhibitors) was reported in some studies, but the literature on this topic is still scarce. The aim of this study was to assess the effects of home-based exercise therapy on functional capacity, disease activity, spinal mobility, quality of life, emotional state and fatigue in patients with AS receiving TNFα inhibitors. Forty-two AS patients were trained on the disease, and home-based exercise program was demonstrated to all the patients. At baseline and at the end of 10 week, we evaluated Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index, Multidimensional Assessment of Fatigue Scale, Beck Depression Inventory and Short-Form 36. Patients following home-based exercise program five times a week at least 30 min per session (exercise group) were compared with those exercising less than five times a week (control group). At baseline, exercise and control group had similar demographic features. After 10 weeks, all outcome parameters showed statistically significant improvements in exercise group. There were significant differences in all the parameters except social functioning subscale of Short-Form 36 between groups in favor of exercise group at 10th week (P < 0.05). Home-based exercise program is an effective therapy in increasing functional capacity and joint mobility, decreasing disease activity, improving emotional state, fatigue and quality of life for AS patient receiving TNFα inhibitors. We need to find out new ways to provide continuity of AS patients with it.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Forejtová S, Mann H, Stolfa J, Vedral K, Fenclová I, Némethová D (2009) Factors influencing health status and disability of patients with ankylosing spondylitis in the Czech Republic. Clin Rheumatol 27:1005–1013

    Article  Google Scholar 

  2. Karapolat H, Akkoc Y, Sari I, Eyigor S, Akar S, Kirazli Y, Akkoc N (2008) Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: effects on Bath Ankylosing Spondylitis Indices, quality of life and depression. Clin Rheumatol 27:695–700

    Article  PubMed  Google Scholar 

  3. Lim HJ, Lim HS, Lee MS (2005) Relationship between self-efficacy and exercise duration in patients with ankylosing spondylitis. Clin Rheumatol 24:442–443

    Article  PubMed  Google Scholar 

  4. Cakar E, Taskaynatan MA, Dincer U, Kiralp MZ, Durmus O, Ozgül A (2009) Work disability in ankylosing spondylitis: differences among working and work-disabled patients. Clin Rheumatol 28:1309–1314

    Article  PubMed  Google Scholar 

  5. Elyan M, Khan MA (2008) Does physical therapy still have a place in the treatment of ankylosing spondylitis? Curr Opin Rheumatol 20:282–286

    Article  PubMed  Google Scholar 

  6. Zochling J, van der Heijde D, Burgos-Vargas R et al (2006) ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 65:442–452

    Article  PubMed  CAS  Google Scholar 

  7. Dagfinrud H, Kvien TK, Hagen KB (2008) Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev CD002822

  8. Fernández-de-Las-Peñas C, Alonso-Blanco C, Morales-Cabezas M, Miangolarra-Page JC (2005) Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial. Am J Phys Med Rehabil 84:407–419

    Article  PubMed  Google Scholar 

  9. Dubey SG, Leeder J, Gaffney K (2008) Physical therapy in anti-TNF treated patients with ankylosing spondylitis. Rheumatology (Oxford) 47:1100–1101

    Article  CAS  Google Scholar 

  10. Dagfinrud H, Kvien TK, Hagen KB (2005) The Cochrane review of physiotherapy interventions for ankylosing spondylitis. J Rheumatol 32:1899–1906

    PubMed  Google Scholar 

  11. Passalent LA (2011) Physiotherapy for ankylosing spondylitis: evidence and application. Curr Opin Rheumatol 23:142–147

    Article  PubMed  Google Scholar 

  12. Lim HJ, Moon YI, Lee MS (2005) Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis. Rheumatol Int 25:225–229

    Article  PubMed  Google Scholar 

  13. Aytekin E, Caglar NS, Ozgonenel L, Tutun S, Demiryontar DY, Demir SE (2011) Home-based exercise therapy in patients with ankylosing spondylitis: effects on pain, mobility, disease activity, quality of life, and respiratory functions. Clin Rheumatol. doi:10.1007/s10067-011-1791-5

  14. Braun J, van den Berg R, Baraliakos X et al (2011) 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 70:896–904

    Article  PubMed  CAS  Google Scholar 

  15. Uhrin Z, Kuzis S, Ward MM (2000) Exercise and changes in health status in patients with ankylosing spondylitis. Arch Intern Med 160:2969–2975

    Article  PubMed  CAS  Google Scholar 

  16. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21:2286–2291

    PubMed  CAS  Google Scholar 

  17. Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N (2005) A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 25:280–284

    Article  PubMed  Google Scholar 

  18. Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21:2281–2285

    PubMed  CAS  Google Scholar 

  19. Karatepe AG, Akkoc Y, Akar S, Kirazli Y, Akkoc N (2005) The Turkish versions of the Bath Ankylosing Spondylitis and Dougados Functional Indices: reliability and validity. Rheumatol Int 25:612–618

    Article  PubMed  Google Scholar 

  20. Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A (1994) Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 21:1694–1698

    PubMed  CAS  Google Scholar 

  21. Belza BL (1995) Comparison of self-reported fatigue in rheumatoid arthritis and controls. J Rheumatol 22:639–643

    PubMed  CAS  Google Scholar 

  22. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    Article  PubMed  CAS  Google Scholar 

  23. Ware JJ, Sherbourne C (1992) The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  24. Clegg DO (2006) Treatment of ankylosing spondylitis. J Rheumatol Suppl 78:24–31

    PubMed  CAS  Google Scholar 

  25. Durmus D, Alayli G, Cil E, Canturk F (2009) Effects of a home-based exercise program on quality of life, fatigue, and depression in patients with ankylosing spondylitis. Rheumatol Int 29:673–677

    Article  PubMed  Google Scholar 

  26. Karapolat H, Eyigor S, Zoghi M, Akkoc Y, Kirazli Y, Keser G (2009) Are swimming or aerobic exercise better than conventional exercise in ankylosing spondylitis patients? A randomized controlled study. Eur J Phys Rehabil Med 45:449–457

    PubMed  CAS  Google Scholar 

  27. Masiero S, Bonaldo L, Pigatto M, Lo Nigro A, Ramonda R, Punzi L (2011) Rehabilitation Treatment in Patients with Ankylosing Spondylitis Stabilized with Tumor Necrosis Factor Inhibitor Therapy. A Randomized Controlled Trial. J Rheumatol 38:1335–1342

    Article  PubMed  CAS  Google Scholar 

  28. Spadaro A, De Luca T, Massimiani MP, Ceccarelli F, Riccieri V, Valesini G (2008) Occupational therapy in ankylosing spondylitis: Short-term prospective study in patients treated with anti-TNF-alpha drugs. Joint Bone Spine 75:29–33

    Article  PubMed  CAS  Google Scholar 

  29. Lubrano E, D’Angelo S, Parsons WJ, Serino F, Tanzillo AT, Olivieri I, Pappone N (2006) Effects of a combination treatment of an intensive rehabilitation program and etanercept in patients with ankylosing spondylitis: a pilot study. J Rheumatol 33:2029–2034

    PubMed  Google Scholar 

  30. Gunaydin R, Goksel Karatepe A, Cesmeli N, Kaya T (2009) Fatigue in patients with ankylosing spondylitis: relationships with disease-specific variables, depression, and sleep disturbance. Clin Rheumatol 28:1045–1051

    Article  PubMed  Google Scholar 

  31. Missaoui B, Revel M (2006) Fatigue in ankylosing spondylitis. Ann Readapt Med Phys 49(305–308):389–391

    Article  Google Scholar 

  32. Bodur H, Ataman S, Rezvani A et al (2011) Quality of life and related variables in patients with ankylosing spondylitis. Qual Life Res 20:543–549

    Article  PubMed  Google Scholar 

  33. Falkenbach A (2003) Disability motivates patients with ankylosing spondylitis for more frequent physical exercise. Arch Phys Med Rehabil 84:382–383

    Article  PubMed  Google Scholar 

  34. Santos H, Brophy S, Calin A (1998) Exercise in ankylosing spondylitis: how much is optimum? J Rheumatol 25:2156–2160

    PubMed  CAS  Google Scholar 

  35. Barlow JH, Barefoot J (1996) Group education for people with arthritis. Patient Educ Couns 27:257–267

    Article  PubMed  CAS  Google Scholar 

  36. Sundstrom B, Ekergard H, Sundelin G (2002) Exercise habits among patients with ankylosing spondylitis. A questionnaire based survey in the County of Vasterbotten, Sweden. Scand J Rheumatol 31:163–167

    PubMed  Google Scholar 

  37. Durmus D, Alayli G, Uzun O, Tander B, Canturk F, Bek Y, Erkan L (2009) Effects of two exercise interventions on pulmonary functions in the patients with ankylosing spondylitis. Joint Bone Spine 76:150–155

    Article  PubMed  Google Scholar 

  38. Ortancil O, Sarikaya S, Sapmaz P, Basaran A, Ozdolap S (2009) The effect(s) of a six-week home-based exercise program on the respiratory muscle and functional status in ankylosing spondylitis. J Clin Rheumatol 15:68–70

    Article  PubMed  Google Scholar 

  39. Sweeney S, Taylor G, Calin A (2002) The effect of a home based exercise intervention package on outcome in ankylosing spondylitis: a randomized controlled trial. J Rheumatol 29:763–766

    PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Ministry of Health, Gebze Fatih State Hospital, Physical Medicine and Rehabilitation Clinic, Izmit, Turkey

    Semra Yigit

  2. Ministry of Health, Haydarpasa Research and Training Hospital, Physical Medicine and Rehabilitation Clinic, Istanbul, Turkey

    Zerrin Sahin & Deniz Hatun Aytac

  3. Physical Medicine and Rehabilitation Department, Bezmialem Vakif University, Istanbul, Turkey

    Saliha Eroglu Demir

Authors
  1. Semra Yigit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zerrin Sahin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Saliha Eroglu Demir
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deniz Hatun Aytac
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Saliha Eroglu Demir.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yigit, S., Sahin, Z., Demir, S.E. et al. Home-based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors. Rheumatol Int 33, 71–77 (2013). https://doi.org/10.1007/s00296-011-2344-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-2344-6

Keywords

Search

Navigation