Ankylosing spondylitis rehabilitation publications and the global productivity: a Web of Science-based bibliometric analysis (2000-2019).

Rehabilitation programs have an important place in the treatment of ankylosing spondylitis (AS), but there is no comprehensive bibliometric research that assesses publications on AS rehabilitation in a holistic way. The aim of this study was to investigate the quantity and quality of articles related to AS rehabilitation and to reveal the features of global productivity in this topic. This bibliometric study was conducted utilizing the Web of Science (WoS) database with the keywords 'ankylosing spondylitis rehabilitation', 'ankylosing spondylitis exercise', 'ankylosing spondylitis physical therapy' and 'ankylosing spondylitis physiotherapy'. The number of articles, citations, and main active countries were determined and trend analyses were performed. A total of 792 articles were reviewed. The articles originated from 51 different countries, 22 of which met the main active country criteria. A significant increase trend was detected in the number of articles between 2000 and 2019 (p < 0.001). The five most productive countries were Germany (n = 111; 14.02%), Turkey (n = 98; 12.37%), the United States (n = 71; 8.96%), the United Kingdom (n = 53; 6.69%) and the Netherlands (n = 53; 6.69%). The highest values in number of articles per million population were calculated in Norway, the Netherlands and Austria, respectively. In the analysis according to GDP, Norway, the Netherlands and Turkey were ranked as the first three. The top three countries for the average citation count were France, Netherlands and Germany. This bibliometric study can be considered as an assessment and summary of worldwide scientific production on AS rehabilitation. The data demonstrate an increasing trend in research productivity since 2000. European countries were seen to be at the forefront both quantitatively and qualitatively in this area.

Effects of exercise programmes on pain, disease activity and function in ankylosing spondylitis: A meta-analysis of randomized controlled trials.

BACKGROUND: To evaluate the effects of exercise programmes on pain, function and disease activity in patients with ankylosing spondylitis (AS). MATERIALS AND METHODS: We searched PubMed, Embase, CNKI and Wanfang from inception to February 2020. Randomized controlled trials comparing exercises with nonexercise interventions in AS patients were applied. Studies that assessed the visual analogue scale (VAS) pain score, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were included. Outcomes of home-based exercise intervention were also reported independently. RESULTS: Ten studies met the inclusion criteria in all, including 534 patients (278 exercise, 256 control). Compared with the nonexercise group, exercise group had statistically significant improvements in pain (weighted mean difference [WMD]: -1.02 [95% CI: -1.50 to -0.55]) (I2 : 31%, P <.0001), BASDAI (WMD: -0.85 [95% CI: -1.09 to -0.61]) (I2 : 20%, P <.00001), and BASFI (WMD: -0.66 [95% CI: -0.95 to -0.38]) (I2 : 0%, P <.00001), but not in CRP and ESR. What's more, home-based exercise programmes had positive impacts on BASFI, BASDAI and pain. CONCLUSIONS: For patients with AS, exercise programmes improve pain, function and disease activity. To confirm the results, more well-designed randomized controlled trials with large number of patients are required.

The effectiveness of aquatic physical therapy intervention on disease activity and function of ankylosing spondylitis patients: a meta-analysis.

This study aimed (i) to complement existing research by focusingon aquatic physical therapy was potentially beneficial to patients with AS; (ii)tosystematically analyze all evidence available in the literature about effectiveness of the aquatic physical therapy intervention on pain and disease activity in AS patients. A systematic search was performed in major electronic databasesto identify studies reporting aquatic physical therapy intervention on pain and disease activity of AS patients. Three independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted, and quantitative analysis was performed with RevMan software (version 5.3).The results were expressed in terms of mean difference(MD) and the corresponding 95% confidence interval.A total of five studies comprising 1,393 participants were included in the study. Meta-analyses showed that aquatic physical therapy interventions significantly reduced the pain scores(SMD=-0.44, 95 % CI:-0.84,-0.04, p=0.03) and BASDAI scores (MD=-0.40, 95% CI:-0.73,-0.06, p=0.02) because of follow up time among these studies; therefore, a subgroup analysis should be conducted for comparison. Aquatic physical therapy can statistically significantly reduce pain and disease activity in patients with AS compared with controls.

Associated factors with adherence to standard exercise therapy and health-related quality of life in Chinese patients with ankylosing spondylitis.

Objectives: The aim of this study is to assess the current situations of standard exercise treatment and predictors of non-standard exercise in Chinese patients with ankylosing spondylitis (AS). An analysis of the effect of standard exercise on health-related quality of life (HR-QoL) was also conducted.Methods: In the cross-sectional study, a total of 259 AS patients were constantly invited to participate in this study and complete the questionnaire under the researchers' supervision in a clinical setting including sociodemographic variables, clinical variables, psychological variables, and HR-QoL. Data were analyzed by Mann-Whitney U test, Chi-square test as well as multivariable analysis of Binary Stepwise Logistic Regression.Results: The data showed that just 20.5% of them could complete the standard exercise. Exercise adherence was associated with employment, educational level, marital status, place of residence, treatment of Tumor Necrosis Factor-α inhibitor, knowledge about exercise, disease duration, clinical variables, and anxiety. The HR-QoL in the group of standard exercise was better than that in the non-standard exercise group. Logistic Regression Analysis showed that lower educational level, less knowledge about benefits of exercise treatment and higher score of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were the independent risk factors of exercise treatment non-adherence.Conclusion: AS patients educated less than 9 years or with higher BASDAI score were more likely not to adhere to standard exercise treatment. Non-adherence to exercise treatment among AS patients is exceedingly common, particularly in patients without knowledge about benefits of exercise treatment. Standard exercise treatment can also improve HR-QoL of AS patients.

Core stability and balance in patients with ankylosing spondylitis.

The main purpose of this study was to compare core stability and balance between ankylosing spondylitis (AS) patients and healthy controls. AS patients diagnosed according to the Modified New York criteria and healthy age- and sex-matched controls were included in the study. Clinical status of AS patients was assessed using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Spinal Mobility Index (BASMI). For evaluation of core stability, static and dynamic core endurance and hip strength were assessed. Trunk flexor and extensor endurance, lateral side bridge tests for static core endurance; modified sit-up test for dynamic core endurance were used. Hip strength was measured with a hand-held dynamometer. Biodex Balance System was used to assess static and dynamic balance. Bilateral standing static and dynamic postural stability, single leg standing postural stability and limits of stability test results were recorded. 64 AS patients (40 male, 24 female) and 64 healthy controls (39 male, 25 female) were assessed. Static and dynamic core endurance test results, hip abductor strength were significantly higher in control group than AS group (p < 0.05). Static postural stability and left leg postural stability test results were significantly better in control group than AS group (p < 0.05). Overall, forward, backward, and right, limits of stability test results were significantly higher in control group (p < 0.05). The results of our study demonstrate that AS has negative effects on core stability and balance. It would be beneficial to add core stability and balance training to AS patients' rehabilitation program.

Effectiveness of Exercise Programs in Ankylosing Spondylitis: A Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: To assess the effectiveness of exercise programs on disease activity and function in ankylosing spondylitis (AS) by a systematic review and meta-analysis of randomized controlled trials (RCTs). DATA SOURCES: Medline via PubMed and Cochrane Library. STUDY SELECTION: Reports of RCTs examining the effectiveness of exercise programs for AS published up to May 2017. DATA EXTRACTION: Outcomes were evolution of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) after the completion of exercise programs. Modalities of exercise were compared and the use of biologic therapy was reported. DATA SYNTHESIS: After screening 190 abstracts, we selected 26 reports for detailed evaluation and finally investigated 8 trials that assessed a home-based exercise program (2/8), swimming (1/8), Pilates training (1/8), or supervised exercises (4/8), for a total of 331 patients with AS. Four trials included patients receiving antitumor necrosis factor therapy. All trials except one showed a decrease in BASDAI and BASFI with exercise. The weighted mean difference was -0.90 (95% confidence interval, -1.52 to -0.27; I2=69%; P=.005) for the BASDAI and -0.72 (95% confidence interval, -1.03 to -0.40; I2=0%; P<.00001) for the BASFI in favor of exercise programs. CONCLUSIONS: Despite the small number of patients and the heterogeneity of exercise programs in the RCTs included in this meta-analysis, its results support the potential of exercise programs to improve disease activity and body function in AS.

Effects of cold mist shower on patients with inflammatory arthritis: a crossover controlled clinical trial.

OBJECTIVES: To evaluate the safety and effects of a new home treatment method, a whole-body cold mist treatment, on patients with chronic inflammatory arthritis. METHOD: Whole-body cold mist shower therapy was given to 121 voluntary patients with chronic inflammatory arthritis in this crossover study during 1-week rehabilitation periods. Pain and sleep quality were assessed by a 10-cm visual analogue scale (VAS). Mental status was assessed by the Depression Scale (DEPS). Body temperature, blood pressure, heart rate, use of occasional pain and sleep medication, and possible side-effects were recorded. RESULTS: The differences in pain (VAS) between treatment and control periods were significant (2.0 vs. 2.4, p = 0.006, paired t-test) in the last measurement, when assessing the pain of the past week as a whole. A trend could be seen of an increasing difference towards the end of the week. The treatment effect was statistically significant [likelihood ratio test (LRT), p < 0.0001] after controlling for period and sequence effects. There was an indication of better sleep quality (VAS) during the treatment period (2.3 vs. 2.7, p = 0.058 paired t-test) when assessing the past week as a whole. The mean DEPS scores showed no difference between the treatment periods (5.5 vs. 5.0, p = 0.1874 paired t-test, at start, and 4.5 vs. 4.1 p = 0.29 paired t-test, at the end). No significant side-effects were recorded. CONCLUSIONS: The new whole-body cold treatment method may offer a safe option for self-treatment of pain at home but further study is needed to determine the clinical significance of the effect after longer use.

The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review.

The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO2, Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p < 0.05) in patients with AS, although there was no significant difference between two exercise groups. As for pulmonary functions, the specific exercise groups have greater improvements than conventional group in spirometric measurement, chest expansion (p < 0.05). However, there was no significant difference between specific conventional exercise types in 6MWD (p > 0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.

The role of land and aquatic exercise in ankylosing spondylitis: a systematic review.

Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility and axial deformity, which lead to diminished quality of life. Its treatment includes not only drugs, but also nonpharmacological therapy. Exercise appears to be a promising modality. The aim of this study is to review the current evidence and evaluate the role of exercise either on land or in water for the management of patients with AS in the biological era. Systematic review of the literature published until November 2016 in Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Thirty-five studies were included for further analysis (30 concerning land exercise and 5 concerning water exercise; combined or not with biological drugs), comprising a total of 2515 patients. Most studies showed a positive effect of exercise on Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, pain, mobility, function and quality of life. The benefit was statistically significant in randomized controlled trials. Results support a multimodal approach, including educational sessions and maintaining home-based program. This study highlights the important role of exercise in management of AS, therefore it should be encouraged and individually prescribed. More studies with good methodological quality are needed to strengthen the results and to define the specific characteristics of exercise programs that determine better results.

The Effectiveness of Structured Group Education on Ankylosing Spondylitis Patients.

BACKGROUND: Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton which can lead to structural and functional impairments. It has a negative impact on the person's daily life activities. Early diagnosis, exercise and patient education are factors playing a major role on prognosis. OBJECTIVE: The purpose of the study was to compare the structured theoretical and exercise educational program with routine clinic educational efforts on the parameters of the disorder over a 3 month follow up. MATERIALS AND METHODS: This randomized, educational intervention study was performed on 41 AS patients. A 5 day structured education and exercise program was applied to the first group of patients (Group 1) in subgroups consisting 4-5 patients each. Patients had group exercises throughout the education program. The second group followed routine clinical care. The effectiveness of the treatment was assessed by Bath ankylosing spondylitis functional (BASFI), Bath ankylosing spondylitis disease activity (BASDAI), Bath ankylosing spondylitis global (BAS-G), Bath ankylosing spondylitis metrology indices (BASMI), chest expansion, short form-36 (SF-36), ankylosing spondylitis quality of life scale (ASQoL) and laboratory parameters in all patients. Patients were evaluated on initiation and after 3 months. RESULTS: Significant improvements in BASFI, BASDAI and BAS-G, chest expansion, SF-36 and ASQoL indices were observed in Group 1 No difference could be found in BASMI and chest expansion. CONCLUSION: A structured educational and exercise intervention had a positive effect on the functional status,disease activity, and general well-being and quality of life. It also, shows that education programs should be within the routine treatment program for AS.

Favorable effect of rehabilitation on balance in ankylosing spondylitis: a quasi-randomized controlled clinical trial.

Balance impairment is a frequent and undertreated manifestation in ankylosing spondylitis, leading to increased risk of falls and lower quality of life. Our aim was to assess supervised training and home-based rehabilitation efficacy on balance improvement in ankylosing spondylitis subjects on biologic agents. This was a single-blinded, quasi-randomized parallel study in a single outpatient Rehabilitation Clinic of a tertiary referral center. Subjects with ankylosing spondylitis on biologic agents were assigned either to supervised training and home-based rehabilitation program (rehabilitation group) plus educational-behavioral therapy, or to educational-behavioral therapy alone (educational groups). The same therapist provided therapy. Outcome measures were assessed at baseline (T0), end of treatment (T1) and at 7-month follow-up (T2). Rheumatologic outcomes were Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index and Bath Ankylosing Spondylitis Disease Activity Index. Balance parameters (anterior-posterior oscillation, latero-lateral oscillation, sway area, sway density and sway path) were evaluated by stabilometry in a condition of open and closed eyes. Forty-six subjects (36 M, 10 F) were enrolled. Demographic data and clinical status at baseline were comparable between the two groups (22 rehabilitation group, 20 educational group). Primary outcome was sway density that improved both at T1 (SDy: open eyes p = 0.003, closed eyes p = 0.004) and at T2 (SDx: open eyes p = 0.0015, closed eyes p = 0.032). A trend toward improvement in the rehabilitation group rather than in the educational group emerged for balance parameters, especially those measured with closed eyes (0.004 < p < 0.048 at T1 and 0.004 < p < 0.036 at T2). Supervised training and home exercise lead to balance improvement in people with ankylosing spondylitis. Eyes-closed trials show a more marked trend toward improvement, and this may suggest a positive effect of rehabilitation on proprioception.

[Interdisciplinary rehabilitation in patients with ankylosing spondylitis]. / Az interdiszciplináris rehabilitáció hatása spondylitis ankylopoeticában szenvedo betegekben.

INTRODUCTION: Complex pulmonary assessment related to respiratory manifestation in patients with ankylosing spondylitis may contribute to adaptation of an appropriate rehabilitation program. AIM: To examine the relationship between lung function, exercise physiological variables and change in quality of life after rehabilitation in patients with ankylosing spondylitis. METHOD: 5 patients in Seyfried's Stage 2 and 11 patients in Stage 3 underwent spinal physiotherapy, ultrasound, massage and paraffin Pack, 15 times each, followed by a high-intensity cycling 3 times a week for 8 weeks. The Bath Ankylosing Spondylitis Disease Activity and Bath Ankylosing Spondylitis Functional Indexes were recorded before and after rehabilitation. Lung function with exercise physiological variables were examined after rehabilitation. RESULTS: Both indexes showed a post-treatment significant improvement compared to the initial scores (p<0.05). These functional indices correlated with lung function at rest and physiological variables during exercise (p<0.05). CONCLUSIONS: Based on this study, it is possible that an initial pulmonary assessment may serve to develop a more effective program for ankylosing spondylitis. Orv. Hetil., 2016, 157(28), 1126-1132.

Physical activity in spondyloarthritis: a systematic review.

Physical activity (PA) is associated with numerous health-related benefits among adults with chronic diseases and the general population. As the benefits are dose-dependent, this review aims to establish the PA levels of adults with spondyloarthritis and to compare these to the general population. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to May 2014 using medical subject headings and keywords. This was supplemented by searching conference abstracts and hand-searching reference lists of included studies. Eligible studies were randomized controlled trials and observational studies of adults with SpA in which free-living PA or energy expenditure levels were measured. Subjects less than 18 years or with juvenile-onset SpA were excluded. Outcomes included objective and self-report measurements. Two reviewers independently screened studies for inclusion and assessed methodological quality using the Cochrane risk of bias tool and the RTI item bank. From the 2,431 records reviewed, nine studies involving 2,972 participants were included. This review focused on qualitative synthesis. Meta-analyses were not undertaken due to differences in study design, measurement tools, and participant characteristics. This heterogeneity, coupled with the risk of bias inherent in the included observational studies, limits the generalizability of findings. Objective measurements suggest PA levels may be lower among adults with spondyloarthritis than in healthy population controls. Self-reported PA and self-reported rates of adherence to PA recommendations varied largely across studies; higher disease activity was associated with lower self-reported PA levels. Physical activity levels may be lower in adults with axial spondyloarthritis, with higher disease activity associated with lower PA levels.

Relationship between cervical sagittal alignment and quality of life in ankylosing spondylitis.

PURPOSE: Little information is available on the relationship between cervical sagittal alignment and health-related quality of life (HRQOL) in ankylosing spondylitis (AS) patients. The aim of this study was to identify relationships between cervical sagittal alignment and HRQOL in AS. METHODS: The study and control groups comprised 102 AS patients (15 women and 87 men) and age- and sex-matched 50 controls, respectively. All underwent anteroposterior and lateral radiographs and completed clinical questionnaires. The radiographic parameters examined were C2-C7 lordosis, C2-C7 sagittal vertical axis (SVA), T1 slope and T1 slope minus C2-C7 lordosis (TS-CL). A visual analogue scale (VAS 0-10) score for neck pain, the neck disability index (NDI), neck pain and disability (NPAD) scale and bath ankylosing spondylitis disease activity index (BASDAI) were administered to evaluate QOL. Statistical analysis was performed to determine the significances of differences between the study and control groups. In addition, correlations between radiological parameters and clinical questionnaires were sought. RESULTS: AS patients and controls were found to be different significantly in terms of C2-C7 SVA, T1 slope, and TS-CL. However, no significant intergroup difference was observed for C2-C7 lordosis (P > 0.05). Correlation analysis revealed significant relationships between radiographic parameters and QOL. Multiple regression analysis was performed to identify predictors of QOL, and the results obtained revealed that C2-C7 SVA significantly predicted VAS, NDI, and NPAD scores and that age predicted NPAD score. CONCLUSIONS: Cervical sagittal parameters were found to be significantly different in AS patients and normal controls. Correlation analysis revealed significant relationships between radiographic parameters and QOL. In particular, C2-C7 SVA was found to be a significant predictor of QOL in AS patient.

Efficacy and safety of adalimumab in Chinese adults with active ankylosing spondylitis: results of a randomised, controlled trial.

BACKGROUND AND OBJECTIVES: Efficacy of adalimumab for ankylosing spondylitis (AS) has been established for Western populations but not in the Chinese population. This study is the first to evaluate the efficacy and safety of adalimumab in Chinese patients with AS. METHODS: Chinese adults with active AS who had an inadequate response or were intolerant to ≥1 non-steroidal anti-inflammatory drugs were randomised to adalimumab 40 mg (N=229) or matching placebo (N=115) subcutaneously every other week (EOW) for 12 weeks, followed by a 12-week open-label adalimumab 40 mg EOW phase. The primary efficacy endpoint was the percentage of patients meeting the Assessment in Spondyloarthritis International Society (ASAS20) response criteria at week 12. The recently developed AS Disease Activity Score (ASDAS), as well as efficacy measures of spinal mobility, disease activity, physical function and quality of life were evaluated. RESULTS: At week 12, adalimumab treatment resulted in a significantly greater percentage of ASAS20 responders than placebo (67.2% versus 30.4%, respectively; p<0.001). Differences in ASAS20 were observed as early as week 2 (42.8% vs 6.1%, respectively; p<0.001). The percentages of patients achieving ASAS40, ASAS 5/6 and ASDAS inactive disease were significantly greater with adalimumab than placebo at week 12 (all p<0.001). Tuberculosis was reported in one patient. No cases of malignancy, lymphoma, demyelinating disease or lupus-like syndrome were reported during the study. CONCLUSIONS: Adalimumab significantly reduced the signs and symptoms, improved physical function and quality of life of Chinese patients with active AS, and was generally safe and well tolerated in this population.

Aspects of validity of the self-administered comorbidity questionnaire in patients with ankylosing spondylitis.

OBJECTIVES: To evaluate criterion and construct validity of the self-administered comorbidity questionnaire (SCQ) in patients with AS. METHODS: The SCQ and indices of disease activity, physical function, health-related quality of life (HRQoL) and work disability were administered to 98 patients with AS. Criterion validity was assessed by the agreement between the SCQ answers and comorbidities identified in medical records. Construct validity was assessed by correlating the SCQ with the Charlson index and MichaudWolfe index; by correlating the SCQ with demographics, physical function, HRQoL and AS-related disease activity; and by exploring the contribution of comorbidity to these outcomes while adjusting for clinical-demographic characteristics. Furthermore, a modified version of the SCQ (mSCQ) was evaluated for the same aspects of validity, after removing rheumatic conditions. RESULTS: Agreement was moderate to perfect for most conditions (k 0.471.00), except for ulcer disease, depression and OA (k 0.140.15). The correlation between the SCQ and Charlson and MichaudWolfe indices was 0.24 and 0.39 respectively, and between the mSCQ and both indices 0.36 and 0.53. Both SCQ and mSCQ correlated weakly to moderately with age, physical function and HRQoL (0.240.45). The SCQ also correlated weakly with disease activity (0.27) while the mSCQ did not (0.17). In multivariable analysis, both SCQ and mSCQ contributed independently to physical function, HRQoL and work disability, while the MichaudWolfe and Charlson indices did not. CONCLUSION: The SCQ is a promising instrument to determine comorbidities and to understand the impact on health outcomes in patients with AS. Excluding rheumatic conditions from the SCQ (mSCQ) improved validity.

Safety and efficacy of golimumab in Chinese patients with active ankylosing spondylitis: 1-year results of a multicentre, randomized, double-blind, placebo-controlled phase III trial.

OBJECTIVE: The aim of this study was to assess the efficacy and safety of golimumab in Chinese patients with active AS. METHODS: Two hundred and thirteen patients were randomized in a 1:1 ratio to receive either s.c. injections of placebo from weeks 0 to 20 followed by golimumab 50 mg from weeks 24 to 48 (group 1, n = 105) or golimumab 50 mg from weeks 0 to 48 (group 2, n = 108), both every 4 weeks. Placebo crossover occurred at week 24, while early escape was at week 16. The primary endpoint was an improvement of at least 20% in the Assessment of SpondyloArthritis international Society (ASAS20) criteria at week 14. Major secondary endpoints included week 24 ASAS20 response and week 14 change scores for BASFI and BASMI. RESULTS: Golimumab treatment elicited significantly better responses than placebo in week 14 ASAS20 response [49.1% (53/108) vs 24.8% (26/105), respectively, P < 0.001], week 24 ASAS20 response (50.0% vs 22.9%, P < 0.001) and mean improvements in BASFI (-1.26 vs 0.11, P < 0.001) and BASMI (-0.42 vs -0.19, P = 0.021) scores at week 14. Additionally, golimumab treatment led to significant improvements in the mental and physical components of health-related quality of life (HRQoL) and sleep problems at week 24, all of which were further improved through week 52. During the 16-week placebo-controlled study period, 31.4% and 30.6% of patients had adverse events (AEs) in groups 1 and 2, respectively; similar AE reporting rates were observed through week 24 (34.3% and 32.0%) and among the golimumab-treated patients through week 56 (41.2%). CONCLUSION: Golimumab significantly reduced clinical symptoms/signs and improved physical function, range of motion and HRQoL in Chinese patients with active AS without unexpected safety concerns. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01248793.

Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.

OBJECTIVE: To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy. DESIGN: Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up. SETTING: Patients' homes. SUBJECTS: A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23). INTERVENTIONS: Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control. MAIN MEASURES: Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer. RESULTS: At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p < 0.05) for all outcomes. At 12-months follow-up, compared with the control and educational-behavioural, the rehabilitation group exhibited significant differences in chest expansion (p = 0.001 and p < 0.001), Bath Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001). CONCLUSION: In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis.

Comparison of Yoga with exercise in ankylosing spondylitis on mobility and functional capacity.

AIM: To compare the effects of Yoga with traditional exercise on the mobility and functional capacity of individuals with ankylosing spondylitis (AS). METHODS: The participants of the study were recruited at the rheumatology department, adhering to the study's inclusion and exclusion criteria. Participants were randomized into two groups (Group A - Yoga, and Group B - exercise).The candidates participated in an 8-week intervention consisting of 3 weekly sessions of either Yoga or Exercise intervention. Outcomes were collected at pre-treatment, at 8 weeks, and at 12 weeks. RESULTS: The within-group comparison showed an improvement in all outcome measures with p < .05 between post-treatment and the follow-up. In the yoga group, there was an improvement in the measures of BASMI (p = .001), BASFI (p = .005), PSQI (p = .021), CE (p = .053) and NPRS (p = .001). Similarly, in the exercise group, there was an improvement in BASMI (p = .002), BASFI (p = .003), PSQI (p = .010), CE (p = .004) and NPRS (p = .001). In the between group comparison at post-treatment, there were no statistically significant differences in BASMI (yoga = 3.0 ± 1.50, exercise = 2.3 ± 1.38), PSQI (yoga = 5.3 ± 1.50, exercise = 4.9 ± 1.17) and NPRS (yoga = 1.3 ± 2.22, exercise = 0.4 ± 0.50) CE (yoga = 4.0 ± 1.18, exercise = 3.4 ± 0.96), BASFI (yoga = 1.8 ± 2.14, exercise = 2.1 ± 1.87). CONCLUSION: The results demonstrated a statistically significant improvement in within-group scores of mobility, functional capacity, sleep quality and pain in AS patients of both intervention programs but there were no significant differences between the groups.