The Effect of Comprehensive Musculoskeletal Rehabilitation on Clinical Status of Ankylosing Spondylitis Patients

Ortop Traumatol Rehabil. Jan-Feb 2016;18(1):41-52. doi: 10.5604/15093492.1198853.

Abstract

Background: This study aimed to compare the effectiveness of conventional and cryotherapy-based rehabilitation with respect to its impact on selected clinical parameters in AS patients.

Material and methods: Fifty working males aged 22-66 years were included in this study. Twenty-five of them underwent cryotherapy-based rehabilitation (cryogenic chamber, local cryotherapy; individual, instrumental, and nonweight-bearing exercises) for 3 weeks. The others received 3 weeks of conventional rehabilitation (magnetic field therapy; electrotherapy; individual and instrumental exercises). The patients were examined at three time points: before rehabilitation, immediately after its completion and at a three-month follow-up visit. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease severity, the Bath Ankylosing Spondylitis Functional Index (BASFI) was used to assess musculoskeletal function and a visual analog scale (VAS) was used to assess pain. A global health index was also employed to assess patients' overall well-being.

Results: Cryotherapy-based rehabilitation improved the following parameters: BASDAI (P<0.001, P<0.001), BASFI (P<0.001, P=0.007), VAS (P<0.007, P=0.001) and global health index (P<0.001, P<0.001) at the second and third assessment, respectively. Conventional rehabilitation improved the BASDAI (P<0.001), VAS (P=0.029), and overall well-being (P<0.030) at the second assessment. Cryotherapy-based rehabilitation was more effective than conventional rehabilitation with respect to BASFI [F(2, 82)=6.571; P=0.004; eta2=0.120] and overall well-being [F(2, 96) =5.018; P=0.008; eta2=0.095)].

Conclusions: 1. Comprehensive rehabilitation in ankylosing spondylitis has a positive effect on patients' clinical status. 2. Rehabilitation involving cryotherapy is more effective in improving musculoskeletal function and overall well-being compared to conventional rehabilitation. 3. Cryotherapy-based rehabilitation significantly reduces the intensity of pain experienced by AS patients and decreases disease activity, with the positive effect maintained at 3 months post rehabilitation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cryotherapy*
  • Disability Evaluation*
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations*
  • Pain Measurement*
  • Reproducibility of Results
  • Severity of Illness Index*
  • Spondylitis, Ankylosing / diagnosis*
  • Spondylitis, Ankylosing / rehabilitation*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult