Background/Purpose: Static and dynamic stretching exercises are applied in Ankylosing Spondylitis (AS) patients to preserve and restore the axial mobility. However, there are no data regarding a specific rehabilitation program including solely stretching in patients with low/moderate disease activity. We, therefore, assessed the efficacy of a stretching program on mobility, functional capacity and disease activity of AS patients.

Methods: Forty sedentary AS patients with low/moderate disease activity according to Ankylosing Spondylitis Disease Activity Scores (ASDAS <2.1) and with stable medication during at least 3 months prior to study entry were included. AS patients were randomly assigned to receive a simple stretching supervised exercise program or no exercise (control group). Exercise group sessions were performed twice a week, for sixteen weeks. This supervised program comprised of 30 minutes of outdoor dynamic and static stretching exercises for the spine and limbs, using only a chair. Mobility, disease activity and functional capacity parameters were evaluated blinded for treatment, at baseline and after 16 weeks.

Results: At study entry patients had mean ± SD age of 47.1±11.5 years, mean disease duration of 17.6±10 years and mean BASMI of 4.7±2.1. All patients were receiving anti-inflammatory drugs and 30% were using anti-TNF therapy. Thirty nine AS patients completed this trial. Patient’s attendance of 14.8±8.3 sessions was registered. Comparing baseline to 16 weeks, the exercise group presented significant improvement in mobility dimensions such as Pavelka’s trunk rotation [1.4 (0.9) vs. 2.2 (1.8) cm, p=0.03], cervical rotation [43.9 (23.5) vs. 53.9 (22.3) degrees, p=0.012], tragus-coronoid distance [12.2 (3.7) vs. 9.3 (2.0) cm, p=0.0001], mento-coronoid distance [13.7 (5.4) vs. 9.6 (2.3) cm, p=0.03], minor intermaleolar distance [0.9 (1.3) vs. 0.2 (0.5) cm, p=0.01] and trunk lateral flexion [7.5 (5.1) vs. 9.5 (5.7) cm, p=0.03]. Exercise group also had improvement in total BASMI (p=0.004). In contrast, comparing control group at baseline vs. 16 weeks, no difference was observed in all mobility parameters assessed and a significant worsening was observed in BASFI (p =0.02), BAS-G (p=0.006) and ASDAS (p=0.03).

Conclusion: Our findings provide novel evidence that a simple stretching program has a significant beneficial mobility effects on AS patients with long disease duration and low/moderate disease activity (ClinicalTrials.gov, number NCT01690273).

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/benefitial-effects-of-a-simple-stretching-exercise-program-for-patients-with-ankylosing-spondylitis-a-randomized-controlled-trial/