Recomendaciones para la prescripción de ejercicio físico en pacientes con espondiloartritis / Recommendations for the prescription of physical exercise for patients with spondyloarthritis

Objetivos: Desarrollar recomendaciones sobre la actividad física y el ejercicio para pacientes con espondiloartritis (EspA) basadas en la opinión de expertos. Métodos: Dos grupos de expertos, uno de fisioterapeutas, rehabilitadores y profesionales de la actividad física y deporte y otro de reumatólogos con interés en EspA, se reunieron para discutir los resultados de grupos focales con pacientes sobre barreras al ejercicio y de una encuesta a reumatólogos sobre ejercicio en EspA. A continuación se redactaron unas recomendaciones preliminares que fueron sometidas a la opinión de los expertos de ambos grupos mediante metodología Delphi a dos rondas. Resultados: Se emitieron 21 recomendaciones que cubren el ejercicio físico, la adaptación al paciente, el modo de dar los mensajes, el manejo del dolor, el tipo de ejercicios indicado y el seguimiento. El grado de acuerdo varía ligeramente entre los grupos de expertos pero en general fue alto. Los ítems discordantes o con poco acuerdo fueron eliminados del consenso. Conclusiones: Se han emitido recomendaciones sobre cuándo y cómo prescribir ejercicio físico y monitorizarlo en pacientes con EspA basadas en la opinión de expertos en espondilitis y en la prescripción de ejercicio. Deberemos confirmar si estas recomendaciones son útiles para la práctica clínica y tienen efecto en los pacientes con EspA atendidos por reumatólogos

Objective: To develop expert-based recommendations on physical activity and exercise for patients with spondyloarthritis (SpA). Methods: Two discussion groups, one of physical therapists, rehabilitation physicians, and professionals of physical activity and sports, and another of rheumatologists interested in SpA, were held to discuss the results of a survey of rheumatologists on exercise and two focus groups with patients on barriers to exercise. Preliminary recommendations were drafted. These were submitted to the opinion of the experts in both groups according to a two round Delphi methodology. Results: Twenty one recommendations covering general aspects of exercise, adaptation to patient, how to deliver messages, pain management, and type of exercise and monitoring were issued. The level of agreement varied slightly between expert groups but it was high overall. Items with poor agreement were removed from the consensus. Conclusions: We present recommendations on when and how to prescribe and monitor exercise in patients with SpA based on the opinion of experts in exercise and in SpA. We must now test whether these recommendations are useful for clinical practice and have an effect on patients with SpA seen by rheumatologists

Recommendations for the prescription of physical exercise for patients with spondyloarthritis. / Recomendaciones para la prescripción de ejercicio físico en pacientes con espondiloartritis.

OBJECTIVE: To develop expert-based recommendations on physical activity and exercise for patients with spondyloarthritis (SpA). METHODS: Two discussion groups, one of physical therapists, rehabilitation physicians, and professionals of physical activity and sports, and another of rheumatologists interested in SpA, were held to discuss the results of a survey of rheumatologists on exercise and two focus groups with patients on barriers to exercise. Preliminary recommendations were drafted. These were submitted to the opinion of the experts in both groups according to a two round Delphi methodology. RESULTS: Twenty one recommendations covering general aspects of exercise, adaptation to patient, how to deliver messages, pain management, and type of exercise and monitoring were issued. The level of agreement varied slightly between expert groups but it was high overall. Items with poor agreement were removed from the consensus. CONCLUSIONS: We present recommendations on when and how to prescribe and monitor exercise in patients with SpA based on the opinion of experts in exercise and in SpA. We must now test whether these recommendations are useful for clinical practice and have an effect on patients with SpA seen by rheumatologists.