Effect of Cardiovascular Training on Fitness and Perceived Disease Activity in People With Ankylosing Spondylitis

ObjectiveSeveral studies suggest that patients with ankylosing spondylitis (AS) have an increased risk of cardiovascular disease. This study aimed to evaluate the effects of a 12-week, individually monitored, with moderate heart rate level intensity cardiovascular training on cardiovascular fitness and perceived disease activity in AS patients. MethodsPatients diagnosed with AS according to the modified New York criteria were randomized to either cardiovascular training or attention control. The training group performed 3 cardiovascular training units per week. All participants attended 1 weekly usual care flexibility training session. Attention control contained regular discussion groups on coping strategies. Adherence was self-monitored. Assessments were performed at baseline and after the intervention period of 3 months. Physical fitness was the primary end point, measured in watts using a submaximal bicycle test following the physical work capacity 75% protocol. All analyses controlled for sex, age, body mass index, baseline fitness and physical activity levels, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). ResultsOf 106 AS patients enrolled, 40% were women and the mean SD age was 49 +/- 12 years. A total of 74.6% of the training group reported exercising at least 3 times a week. At the 3-month followup, the fitness level in the training group was significantly higher than in the control group (mean +/- SE 90.32W +/- 4.52W versus 109.84W +/- 4.72W; P = 0.001), independent of other covariates. The mean BASDAI total score was 0.31 points lower (P = 0.31) in the training group, reaching significance for the peripheral pain subscore (1.19; P = 0.01) but not for back pain or fatigue. ConclusionCardiovascular training, in addition to flexibility exercise, increased fitness in AS patients and reduced their peripheral pain.