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Exercise programmes for ankylosing spondylitis
Jean-Philippe Regnaux1, Thomas Davergne, Clémence Palazzo
1Université Rennes, EHESP, F-3500 Rennes, France. ² Université de Paris , Equipe Epi Ageing, Inserm, CRESS- UMR1153, Paris, France.
The Cochrane Database of Systematic Reviews
|October 3, 2019
Summary
Exercise programs for ankylosing spondylitis (AS) show moderate- to low-quality evidence of slight improvements in function and pain. However, the clinical significance of these benefits is uncertain, and effects on spinal mobility and fatigue remain unclear.
Area of Science:
- Rheumatology and Exercise Science
- Clinical Trial Analysis
- Ankylosing Spondylitis Management
Background:
- Ankylosing spondylitis (AS) is a chronic inflammatory condition often managed with exercise programs.
- Exercise is recommended to alleviate pain and maintain or improve functional capacity in AS patients.
- The evidence for the benefits and harms of exercise programs in AS requires systematic evaluation.
Purpose of the Study:
- To systematically assess the benefits and harms of exercise programs for individuals diagnosed with ankylosing spondylitis (AS).
- To synthesize findings from randomized controlled trials (RCTs) comparing exercise interventions with control groups.
Main Methods:
- Conducted a comprehensive search of multiple electronic databases (CENTRAL, Cochrane Library, MEDLINE, EMBASE, CINAHL, PEDro, Scopus) and trial registers up to December 2018.
- Included 14 randomized controlled trials (RCTs) involving 1579 adult participants with AS.
- Compared exercise therapy programs against inactive controls (no intervention, waiting list) or usual care, using standard Cochrane methodology.
Main Results:
- Compared to no intervention, exercise programs showed moderate-quality evidence of slight improvements in physical function (BASFI) and low-quality evidence of pain reduction (VAS), but clinical meaningfulness was debated.
- Compared to usual care, exercise programs demonstrated moderate-quality evidence of slight improvements in physical function (BASFI) and pain (VAS), though not considered clinically meaningful.
- Evidence regarding the impact of exercise on spinal mobility (BASMI) and fatigue was of very low quality, with uncertain effects on adverse events.
Conclusions:
- Exercise programs likely offer slight benefits for function and pain in AS patients compared to no intervention, with moderate-to-low quality evidence.
- Compared to usual care, exercise programs show minimal to no significant improvement in function or pain, with uncertain effects on disease activity.
- The effects of exercise on spinal mobility, fatigue, and the potential for adverse events in AS remain uncertain due to limited and low-quality evidence.
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