Effectiveness of Physical Therapy In Ankylosing Spondylitis: A Randomized Controlled Study

Öz

Objective: To evaluate the effects of physical therapy on pain, disease activity, functional and emotional status and quality of life in patients with ankylosing spondylitis (AS). Material and Method: The study included 31 patients diagnosed with AS. The physical therapy group received 15 sessions of physical therapy (hotpack, ultrasound, TENS and hydrotherapy) exercise and the control group received only a home exercise program. All patients were evaluated with a Visual Analog Scale (VAS) for pain, the Bath Ankylosing Spondylitis Functional Index (BASFI) for functional status, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for disease activity and Bath Ankylosing Spondylitis Metrology Index (BASMI) for spinal mobility measurements before therapy, then after 2 and 6 weeks. The Beck Depression Inventory (BDI) and Short Form 36 (SF-36) were completed by all patients at baseline and after 6 weeks. Results: With the exception of lateral flexion, tragus wall distance measurements for spinal mobility and BDI scores, significant improvements were determined in all the other parameters in the physical therapy group in the second week (p<0.05). In the 6th week, this improvement was not maintained for intermalleolar distance, cheek manubrium distance, cervical rotation, finger floor distance and BASFI. Significant improvements were determined in the mental capacity and social function subgroups of SF-36 at 6 weeks compared to baseline (p<0.05). Significant improvements were determined in the 2nd and 6th weeks in respect of VAS at rest and the general health subgroup of SF-36 in the physical therapy group compared to the control group. Conclusion: Physical therapy may have benefical effects on pain, spinal mobility and quality of life in patients with AS.

Anahtar Kelimeler

• ankylosing spondylitis
• physical therapy
• exercise
• hydrotherapy

Ankilozan Spondilitte Fizik Tedavinin Etkinliği: Randomize Kontrollü Bir Çalışma

Öz

Amaç: Ankilozan spondilitli hastalarda fizik tedavinin ağrı, fonksiyon, hastalık aktivitesi, emosyonel durum ve yaşam kalitesi üzerine etkisini değerlendirmek. Materyal ve Metod: Çalışmaya Selçuk Üniversitesi Meram Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı Kliniğinde takip edilen, AS tanısı konulan 31 hasta alındı. Hastaların rutin fizik muayene, kas-iskelet sistemi muayenesi ve nörolojik muayenesi yapıldı. Hastalar randomize olarak fizik tedavi grubu ve kontrol grubu olarak ikiye ayrıldı. Fizik tedavi grubuna 15 seans fizik tedavi (sıcak paket, ultrason, TENS, hidroterapi), egzersiz ve medikal tedavi verildi. Kontrol grubuna sadece ev egzersiz programı ve medikal tedavi verildi. Her iki gruba da tedavi öncesi, 2. ve 6. haftalarda ağrı için vizüel analog skala (VAS) gece ve istirahat, fonksiyon için Ankilozan Spondilit Fonksiyon İndeksi (BASFİ), hastalık aktivitesi için Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAİ), spinal mobilite için modifiye schober, el parmak zemin mesafesi, lateral fleksiyon, servikal rotasyon, intermalleolar mesafe, tragus duvar mesafesi ve Ankilozan Spondilit Metroloji İndeksi (BASMİ), göğüs eksansiyonu, çene manubrium mesafesi ölçüldü. Tedavi öncesi ve 6. hafta Beck depresyon ölçeği ve SF-36 formu dolduruldu. Bulgular: Fizik tedavi grubunda spinal mobilite ölçümlerinden lateral fleksiyon, tragus duvar mesafesi ve beck depresyon ölçeği dışındaki tüm parametrelerde 2. haftada anlamlı düzelme saptadık (p<0,05). Bu düzelme, 6. haftada intermalleolar mesafe, el parmak zemin mesafesi, çene manubrium, servikal rotasyon ve BASFİ dışındaki tüm parametrelerde devam etti. Tedavi grubunda SF-36’nın sosyal fonksiyon ve mental kapasite alt grubunda tedavi öncesi ve 6. hafta arasında anlamlı düzelme saptadık (p<0,05). Gruplar arasında VAS (istirahat) 2. hafta ve 6. hafta ve SF-36’nın genel sağlık alt grubunda tedavi grubunda anlamlı düzelme vardı. Sonuç: Fizik tedavi AS’li hastalarda ağrı, spinal mobilite ve yaşam kalitesi üzerine etkilidir.

Anahtar Kelimeler

• ankilozan spondilit
• fizik tedavi
• egzersiz
• hidroterapi

Kaynakça

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