Exercise Improves Outcomes in Ankylosing Spondylitis

Alice Goodman

June 20, 2013

MADRID, Spain — Working with an exercise ball significantly improved muscle strength and ability to walk in patients with ankylosing spondylitis (AS), did not worsen disease activity, and increased well-being, according to a new study.

"Although exercise is recommended for AS patients, its benefits have not been clearly defined, and patients can be reluctant to try it," said lead investigator Marcelo de Souza, PT, MSc, from the Federal University of Sao Paolo in Brazil, in a press release

His colleague, Fabio Jennings, MD, also from the University of Sao Paolo, presented the study results here at the European League Against Rheumatism Congress 2013.

All 60 patients had received at least 3 months of standard drug treatment before study enrollment and continued their medication during the study. Thirty patients were randomized to an exercise program with the exercise ball and 30 were randomized to no prescribed exercise and served as the control group.

At baseline, clinical and demographic characteristics were similar in the 2 groups.

Patients in the exercise group performed 8 exercises with free weights using an exercise ball twice a week in 40-minute sessions for 16 weeks. Weight loads were reassessed and increased every 4 weeks.

The improvement in muscle strength from baseline to 16 weeks was significant in patients in the exercise group, compared with the control group, for abdominal exercises (= .003), rowing exercises (= .02), squats (= .01), triceps exercises (= .021), and reverse fly exercises (= .02). Improvement was also significant for the 6-minute walk test (= .005).

I am optimistic about our patients continuing with their exercise program because they were able to see how much benefit they had.

Using the exercise ball did not lead to a worsening of disease activity, measured with the Bath Ankylosing Spondylitis Disease Activity Index. No difference in spinal mobility was seen between the 2 groups.

Patients in the exercise group expressed significantly greater treatment satisfaction than those in the control group (< .001). Both groups reported similar quality of life on the SF-36 Health Survey.

The researchers plan to follow the patients assigned to the exercise group to see if they continue with the exercise routine now that the study is completed. In a previous study of a cardiovascular workout in AS patients, about 60% to 70% of patients continued to work out after the study ended, Dr. Jennings noted.

"I am optimistic about our patients continuing with their exercise program because they were able to see how much benefit they had," he said.

Dr. Jennings said he hopes to report follow-up results at next year's meeting.

"We are always looking for effective interventions for patients with AS," said session cochair Karen Niedermann, MD, from University Children's Hospital in Basel, Switzerland. "We already know that strenuous exercise is very important. This study not only confirms that, it provides more evidence that exercises that increase flexibility are helpful to these patients."

Dr. de Souza, Dr. Jennings, and Dr. Niedermann have disclosed no relevant financial relationships.

European League Against Rheumatism (EULAR) Congress 2013: Abstract OP0096-HPR. Presented June 13, 2013.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.