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Exercise programs in trials for patients with ankylosing spondylitis: Do they really have the potential for effectiveness?
Author(s) -
Dagfinrud Hanne,
Halvorsen Silje,
Vøllestad Nina K.,
Niedermann Karin,
Kvien Tore K.,
Hagen Kåre B.
Publication year - 2011
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20415
Subject(s) - cardiorespiratory fitness , medicine , physical therapy , ankylosing spondylitis , sports medicine , psychological intervention , clinical trial , physical strength , randomized controlled trial , flexibility (engineering) , aerobic exercise , physical medicine and rehabilitation , statistics , mathematics , psychiatry
Objective To evaluate if exercise programs in trials for patients with ankylosing spondylitis (AS) have the potential for effectiveness. Methods 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. Results 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. Conclusion 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.