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Aerobic exercise for axial spondyloarthritis ‐ its effects on disease activity and function as compared to standard physiotherapy: A systematic review and meta‐analysis
Author(s) -
Verhoeven Frank,
Guillot Xavier,
Prati Clément,
Mougin Fabienne,
Tordi Nicolas,
Demougeot Céline,
Wendling Daniel
Publication year - 2019
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13385
Subject(s) - basfi , basdai , medicine , aerobic exercise , physical therapy , ankylosing spondylitis , erythrocyte sedimentation rate , vo2 max , spondylitis , randomized controlled trial , meta analysis , metabolic equivalent , disease , heart rate , physical activity , blood pressure , psoriatic arthritis
Aim To evaluate the impact of an aerobic fitness program on disease activity, defined by the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) and on C‐reactive protein ( CRP ), erythrocyte sedimentation rate ( ESR ) and the Bath Ankylosing Spondylitis Functional Index ( BASFI ) in case of axial spondyloarthritis. Methods A systematic review of the literature, following the Prisma recommendations, was performed by two reviewers on the PubMed and Embase databases. Controlled trials assessing the efficacy of aerobic exercises compared to physiotherapy on axial spondyloarthritis disease activity were included. The diagnosis of axial spondyloarthritis was meeting the New York criteria and/or the Assessment in Axial Spondyloarthritis International Working Group criteria. Aerobic fitness was defined as an exercise performed at 50%‐90% of the maximal heart rate or between 50% and 80% oxygen consumption ( VO 2 ) peak. Results Five hundred and twenty abstracts were identified and 93 abstracts were analyzed. Eight studies met the selection criteria and 6 were finally included in this study because of the presence of a control group. Both groups were similar in terms of age, sex ratio, disease duration. Aerobic exercise provided a positive impact on the BASDAI in the intervention group (148 patients) (weighted mean difference [ WMD ]: −0.52 [95% CI : −0.9 to −0.13]) ( I 2 : 10.3%, P = 0.35). However, when compared to a control group (152 patients), the improvement of BASDAI didn't reach significance ( WMD : −0.25 [95% CI : −0.83 to 0.32]) ( I 2 : 0%, P = 0.41). Aerobic exercise did not improve BASFI , CRP or ESR . Conclusion Aerobic exercise did not provide beneficial effects either on disease activity or on physical function and biological parameters when compared to a control group in axial spondyloarthritis.