Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis
Department of Nursing, Chodang University, Muan 534-701, Republic of Korea. Rheumatology International
(Impact Factor: 1.52).
05/2005; 25(3):225-9. DOI: 10.1007/s00296-004-0536-z
We investigated the effects of home-based daily exercise on joint mobility, functional capacity, pain, and depression in patients with ankylosing spondylitis (AS). The patients were randomly assigned to a wait-list control group or to an exercise-therapy group. The exercise-therapy group performed a 20-min exercise program once per day for 8 consecutive weeks. After 8 weeks, compared with the control group, the exercise group showed improvements in joint mobility (cervical flexion, extension, shoulder flexion, abduction, hip abduction, and knee flexion), finger-floor distance, and functional capacity. Pain and depression scores were significantly lower after the exercise program in the exercise group than in the control group. These findings indicate that exercise therapy increases joint mobility and functional capacity, and decreases pain and depression in patients with AS. Home-based exercise, which is easily accessible to patients, might be an effective intervention for AS.
Available from: Lin-Fen Hsieh
- "Generally speaking, the compliance with inpatient exercise is highest, followed by supervised outpatient or organized exercise program, and home-based exercise is the lowest. However, in a study by Lim et al., an 8-week home-based exercise program increased joint mobility and functional capacity and decreased pain and depression in patients with AS . In that study, the researchers monitored the patients by telephone every day. "
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ABSTRACT: Home exercise is often recommended for management of patients with ankylosing spondylitis (AS); however, what kind of home exercise is more beneficial for patients with AS has not been determined yet. We aimed to compare the effectiveness of combined home exercise (COMB) and range-of-motion home exercise (ROM) in patients with AS. Nineteen subjects with AS completed either COMB (n = 9) or ROM (n = 10) program. The COMB program included range-of-motion, strengthening, and aerobic exercise while the ROM program consisted of daily range-of-motion exercise only. After exercise instruction, subjects in each group performed home exercise for 3 months. Assessment included cardiopulmonary exercise test, pulmonary function test, spinal mobility measurement, chest expansion, Bath Ankylosing Spondylitis Functional Index (BASFI), and other functional ability and laboratory tests. After exercise, the COMB group showed significant improvement in peak oxygen uptake (12.3%, P = 0.008) and BASFI (P = 0.028), and the changed score between pre- and postexercise data was significantly greater in the COMB group regarding peak oxygen uptake and BASFI. Significant improvement in finger-to-floor distance after 3-month exercise was found only in the COMB group (P = 0.033). This study demonstrates that a combined home exercise is more effective than range-of-motion home exercise alone in aerobic capacity and functional ability.
- "Simultaneously ensuring that pain is being effectively managed may be helpful in reducing anxiety or depression which is pain related. Additionally it may be helpful to reinforce the message that exercise is an effective way of countering both low mood and negative thoughts, whilst simultaneously improving pain and function (Lim et al., 2005). Greater social support and encouragement for exercise in this group of patients may provide motivation, role models and guidance that may be important (Castenada et al., 1998). "
Available from: Nina Vøllestad
- "Legs/trunk NR NR NR 1 9 months NR Analay et al, 2003 (20) Legs/arms/back No external load NR NR 3 6 weeks NR Lim et al, 2005 (21) NR NR NR NR 7 8 weeks NR Fernandez-de-Las-Penas et al, 2005 (22) "
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ABSTRACT: To evaluate if exercise programs in trials for patients with ankylosing spondylitis (AS) have the potential for effectiveness.
A systematic literature search was performed and randomized trials examining the effectiveness of exercise programs for AS patients were analyzed according to 3 elements: whether the exercise programs were designed according to the American College of Sports Medicine (ACSM) recommendations for developing cardiorespiratory fitness, muscular strength, and flexibility; whether physiologic responses were properly measured; and whether adherence to programs was monitored.
Twelve trials with a total of 826 AS patients were evaluated. Five trials included cardiorespiratory exercise as a part of the exercise programs. One of these met the ACSM recommendations for intensity, duration, frequency, and length of the exercise period. This trial showed the greatest within-group improvement in aerobic capacity (effect size [ES] 2.19). Five trials included muscular strength training, but none measured the physiologic responses nor met the recommendations for improving muscular strength. Eleven trials included flexibility training, but the programs were poorly described overall. Small improvements in spinal mobility (ES range 0.02-0.67) were reported in all trials. Finally, 4 trials reported on participants' adherence to the exercise programs, but only 1 provided sufficient information to evaluate the possible influence of the adherence.
The quality of interventions in exercise trials for patients with AS can be improved. Future trials should also focus on measuring and reporting physiologic responses and adherence to exercise interventions.
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