The effectiveness of intensive group exercise on patients with ankylosing spondylitis

Objective: To compare, in patients with ankylosing spondylitis (AS), the effectiveness on pain, functional and psychological status of an intensive group exercise programme under the supervision of a physiotherapist and a home physiotherapy programme. Design: Fifty-one patients with AS were randomly allocated into study and control groups. The study was designed as a prospective, double-blind study. Setting: Outpatient department, Istanbul Medical Faculty. Subjects: Patients who consulted with complaints of pain, morning stiffness and restricted range of movement with a confirmed diagnosis of ankylosing spondylitis. Interventions: Before exercise, both groups were given an education programme about AS. For group I patients an intensive exercise programme was organized under the supervision of a physiotherapist for six weeks. Group II patients had to practise exercises individually at home. Main outcome measures: Both groups were evaluated and compared for pain, functional and psychological status before treatment, at the end of treatment and three months after treatment using a visual analogue scale (VAS) for pain, Beck Depression Scale and Bath Ankylosing Spondylitis Functional Index (BASFI). Results: Six patients withdrew, four from group I. Results from the remaining 45 showed more positive changes in the patients undertaking group exercise at six weeks and three months after treatment. Values showed a statistical significant difference in favour of group I. Conclusion: Group exercise in hospital may be more effective than home-based exercises at reducing impairment associated with ankylosing spondylitis.