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Sarac DC, Bayraktar D, Ozer Kaya D, Altug Gucenmez O, Oskay D. The effects of inspiratory muscle training on cardiorespiratory functions in juvenile idiopathic arthritis: A randomized controlled trial. Pediatr Pulmonol 2024; 59:562-573. [PMID: 38038160 DOI: 10.1002/ppul.26783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/16/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Although inspiratory muscle training (IMT) has proven effective in adult rheumatic diseases, its impact on juvenile idiopathic arthritis (JIA) remains unexplored. The present study aimed to investigate the effects of IMT in children with JIA. METHODS Thirty-three children (13-18 years) with JIA were divided into two groups as exercise (n = 17) and control (n = 16). The exercise group performed IMT at home daily for 8 weeks. The initial IMT load was set as 60% of maximal inspiratory pressure (PImax ) and increased by %10 of the initial load every 2 weeks. The control group received no additional intervention. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1 ), FVC/FEV1 , PImax , and maximal expiratory pressure (PEmax ) were evaluated. Peak oxygen consumption (VO2max ), metabolic equivalents (METs), and maximal heart rate were measured with cardiopulmonary exercise test. Functional capacity and quality of life were assessed with 6-min walk distance and Pediatric Quality of Life Inventory 3.0 Arthritis Module. All participants were evaluated at baseline and post-treatment. RESULTS FVC ( ↑ 0.20 (95% CI: 0.07/0.32) liters), FEV1 ( ↑ 0.14 (95% CI: 0.02/0.25) liters), PImax (↑19.11 (95% CI: 9.52/28.71) cmH2 O), PEmax (↑12.41 (95% CI: 3.09/21.72) cmH2 O), VO2peak (↑158.29 (95% CI: 63.85/252.73) ml/min), and METs (↑0.92 (95% CI: 0.34/1.49) [ml/kg/min]) significantly improved only in the exercise group (p < .05). The difference over time in FVC, FEV1 , PImax , VO2peak , and METs were significantly higher in exercise group compared to control group (p < .05). CONCLUSIONS IMT seems to be an effective option for improving respiratory functions and aerobic exercise capacity in JIA.
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Affiliation(s)
- Devrim Can Sarac
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkiye
| | - Deniz Bayraktar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkiye
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkiye
| | - Ozge Altug Gucenmez
- Clinic of Pediatric Rheumatology, University of Health Sciences Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, Izmir, Turkiye
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkiye
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Bağlan Yentür S, Saraç DC, Sari F, Tore G, Bilici Salman R, Akif Öztürk M, Oskay D. The effects of Pilates training on respiratory muscle strength in patients with ankylosing spondylitis. Physiother Theory Pract 2024; 40:31-41. [PMID: 35938234 DOI: 10.1080/09593985.2022.2109540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/26/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Reduction in flexibility and mobility are important factors that lead to impairments in quality of life, reduction of exercise tolerance, and a decreased pulmonary capacity with the progression of Ankylosing Spondylitis (AS). AIM The purpose of this study was to investigate the effects of Pilates exercises on mobility, quality of life, and respiratory muscle strength in patients with AS. METHODS Forty patients with AS were randomly divided into two groups as Pilates group and the control group. The Pilates group performed Pilates exercises in supervised group sessions and the control group performed conventional exercises at home three days a week for eight weeks. The main outcome measure was respiratory muscle strength. Secondary outcome measures were forced vital capacity (FVC), forced expiratory volume in one second (FEV1) FEV1/FVC ratio, chest expansion, Bath indices (BASDAI, BASMI), Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and six-minute walk test (6MWT). All participants were assessed by a blind assessor at baseline and the end of eight weeks. RESULTS Thirty-six AS patients (n = 19 in the Pilates group, n = 17 in the control group) completed the study. Respiratory muscle strength, FEV1/FVC, chest expansion, BASDAI, BASMI, ASQoL, and 6MWT significantly improved at the 8th week (p < .05) in the Pilates group, while inspiratory muscle strength, FEV1/FVC, chest expansion, and 6MWT showed significant improvements in the control group at 8th week compared to baseline (p < .05). No significant between-group differences were observed when the change over time values were compared (Δ). CONCLUSION Both Pilates and home exercises seem to be effective for improving respiratory parameters and functional status in patients with AS. Pilates exercises without using any equipment and additional exercises is found to be useful for improving respiratory functions and disease-related symptoms.
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Affiliation(s)
- Songül Bağlan Yentür
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Firat University, Üniversite Avenue, Firat University Central Offices, Merkez/Elazig, Turkey
| | - Devrim Can Saraç
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Balatcik/Izmir, Turkey
| | - Fulden Sari
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Gizem Tore
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Reyhan Bilici Salman
- Faculty of Medicine, Division of Rheumatology, Gazi University, Yenimahalle, Turkey
| | - Mehmet Akif Öztürk
- Faculty of Medicine, Division of Rheumatology, Gazi University, Yenimahalle, Turkey
| | - Deran Oskay
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
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Soufivand P, Gandomi F, Assar S, Abbasi H, Salimi M, Ezati M, Pournazari M, Shahsavari S. The effect of a six-week Aqua Pilates and Aqua Stretch intervention on pain, function, and quality of life in patients affected by ankylosing spondylitis: A rater-blind randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:355-367. [PMID: 37980643 DOI: 10.3233/bmr-230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND There has been a dearth of research into the benefits of water-based workouts for ankylosing spondylitis (AS) patients. OBJECTIVE This study aimed to compare the effect of Aqua Stretch and Aqua Pilates in improving quality of life (QOL), function, and pain in AS patients. METHODS This study was conducted on 40 patients, who were randomly assigned to the Aqua Pilates, Aqua Stretch, and control groups. The experimental groups attended interventions for six-week. QOL, pain intensity, function, and fatigue were measured before and after treatments. RESULTS Except for the chest expanding, all variables in the Aqua Stretch group changed significantly after six weeks (p< 0.05). QOL (p= 0.002), 6MWT (p= 0.016), and Schober flexion (p= 0.011) showed changes, while BASDAI (p= 0.0001), VAS (p= 0.0001), fatigue (p= 0.0001), and Schober extension (p= 0.028) showed significant decreases. Except for chest expansion and Schober extension, which did not alter significantly after six-week of Aqua Pilates (p> 0.05), all other variables did. There was an increasing trend in 6MWT and Schober flexion (p= 0.021) and a decreasing trend in BASDAI (p= 0.002), VAS (p= 0.0001) and fatigue (p= 0.002). Except for QOL (p= 0.016), no statistically significant differences were found between the groups. CONCLUSION All variables had a significant change after six-week Aqua Stretch, except for the chest expanding. Chest expanding and Schober extension were the variables which had no significant change after six-week Aqua Pilates. With the exception of QOL, no statistically significant differences were found between the groups. Aqua Stretch had the greatest effect on the VAS, as measured by the minimum clinically relevant differences (MCID). Moreover, in Aqua Stretch alone, there was a notable impact on fatigue, QOL, and the BASDAI.
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Affiliation(s)
- Parviz Soufivand
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzaneh Gandomi
- Sport Injuries and Corrective Exercises Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran
| | - Shirin Assar
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Homayoun Abbasi
- Sports Management Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran
| | - Mehran Salimi
- Health and Sport Medicine Department, Sport Sciences Faculty, Tehran University, Tehran, Iran
| | - Mozhgan Ezati
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehran Pournazari
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soodeh Shahsavari
- Health Information Technology Department, Faculty of Allied Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
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The Role of Core Stability and Core Muscles in Ankylosing Spondylitis: A Review of Functional and Clinical Importance. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1123915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Purpose: Physiotherapy and exercise training are one of the cornerstones in the treatment of patients with ankylosing spondylitis (AS). However, although the effects of exercise programs and their superiority over each other have still not been determined, research on this subject is continuing in the literature day by day. Due to the pathophysiology of AS, the spine is one of the most affected areas of the musculoskeletal system. Therefore, stabilization of the lumbopelvic region and the spine, which is the reference point for the core muscles, is important for the treatment and management of this disease.
In this review, the involvement of core muscles and core stability in patients with AS and the literature on core training programs will be discussed.
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Iguchi N, Mano T, Iwasa N, Ozaki M, Yamada N, Kikutsuji N, Kido A, Sugie K. Thoracic Excursion Is a Biomarker for Evaluating Respiratory Function in Amyotrophic Lateral Sclerosis. Front Neurol 2022; 13:853469. [PMID: 35401409 PMCID: PMC8984343 DOI: 10.3389/fneur.2022.853469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo evaluate the usefulness of thoracic excursion as a biomarker in patients with amyotrophic lateral sclerosis (ALS).MethodsWe measured the forced the vital capacity (FVC), thoracic excursion, baseline-to-peak diaphragmatic compound muscle action potential (DCMAP) amplitude, diaphragm thickness at full inspiration (DTfi), Medical Research Council (MRC) sum score for muscle strength, and arterial partial pressures of oxygen and carbon dioxide and administered the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) and modified Medical Research Council (mMRC) Dyspnea Scale. The test–retest reliability of thoracic excursion was determined.Results and ConclusionsThirty-four patients with ALS and 26 age- and sex-matched healthy participants were enrolled. Thoracic excursion measurement had excellent test–retest reliability (intraclass coefficient: 0.974). Thoracic excursion was more strongly correlated with FVC (r = 0.678, p < 0.001) than DCMAP amplitude (r = 0.501, p = 0.003) and DTfi (r = 0.597, p < 0.001). It was also correlated with ALSFRS-R score (r = 0.610, p < 0.001), MRC sum score (r = 0.470, p = 0.005), and mMRC Dyspnea Scale score (r = −0.446, p = 0.008) and was the most sensitive parameter for assessing dyspnea and FVC. Thoracic excursion decreased as FVC declined in the early and late stages, there were no differences in DCMAP amplitude and DTfi between the early and late stages, and ALSFRS-R score and MRC sum score decreased only in the late stage. Thoracic excursion was well correlated with respiratory function and is useful for predicting respiratory and general dysfunction in patients with ALS regardless of stage.
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Affiliation(s)
- Naohiko Iguchi
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Tomoo Mano
- Department of Neurology, Nara Medical University, Kashihara, Japan
- Department of Rehabilitation Medicine, Nara Medical University, Kashihara, Japan
- *Correspondence: Tomoo Mano
| | - Naoki Iwasa
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Maki Ozaki
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Nanami Yamada
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Naoya Kikutsuji
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Akira Kido
- Department of Rehabilitation Medicine, Nara Medical University, Kashihara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, Kashihara, Japan
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Nolte K, van Rensburg DCJ, Fletcher L. Effects of a 6-month exercise programme on disease activity, physical and functional parameters in patients with ankylosing spondylitis: Randomised controlled trial. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1546. [PMID: 34230900 PMCID: PMC8252160 DOI: 10.4102/sajp.v77i1.1546] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/19/2021] [Indexed: 11/01/2022] Open
Abstract
Background Exercise forms an important component in the management of ankylosing spondylitis (AS). The objective of our study was to determine the effects of a 6-month swimming, land-based stretching, strengthening and breathing exercise intervention in AS patients. Methods/design A total of 29 (14 females, 15 males) patients diagnosed with AS according to the Modified New York Criteria participated in our study. Participants were randomly assigned to an exercise group (ASE) (16 participants) and a control group (ASC) (13 participants). Erythrocyte sedimentation rate and C-reactive protein (CRP); anthropometric measurements; pulmonary function; aerobic capacity; balance; Bath AS Metrology Index; Bath AS Disease Activity Index and the Bath AS Functional Index were assessed. Discussion Erythrocyte sedimentation rate and CRP did not change notably within or between the groups from pre- to post-intervention. The between group analyses of the physical assessments favoured the ASE with observable improvements in chest expansion (p = 0.002), forced expiration volume (p = 0.012), absolute (p = 0.017) and relative (p = 0.003) maximal oxygen consumption, absolute (p = 0.028) and relative (p = 0.001) physical work capacity. Within the ASE, there is statistical evidence of improvements in 11 of the 19 physical variables. Within the ASC, five of the physical variables deteriorated substantially (p between 0.004 and 0.037) and only balance overall stability on the right improved (p = 0.016). The three functional assessments in the ASE improved (p < 0.007) compared with the ASC post-intervention. A 6-month combined exercise programme may improve physical and functional capacity of AS patients. Conclusion A multimodal exercise intervention may be useful in the management of ankylosing spondylitis. Clinical implications An unsupervised well -explained exercise programme combining swimming, land-based strengthening and stretching exercises and breathing exercises may be an option for patients with ankylosing spondylitis. Trial registration Registration not undertaken at the time of writing.
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Affiliation(s)
- Kim Nolte
- Department of Physiology, Division of Biokinetics and Sport Science, Faculty of Health Sciences, School of Medicine, University of Pretoria, Pretoria, South Africa
| | | | - Lizelle Fletcher
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
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Lim JM, Cho OH. Effects of Home-and-Workplace Combined Exercise for Patients with Ankylosing Spondylitis. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:181-188. [PMID: 33741506 DOI: 10.1016/j.anr.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/22/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the effects of home-and-workplace combined exercise on physical function, depression, and work-related disability in patients with ankylosing spondylitis. METHODS This study adopted a non-randomized quasi-experimental design. Fifty-two patients were recruited: home-and-workplace combined exercise (n = 17), home exercise (n = 18), and control group (n = 17). RESULTS The home-and-workplace combined exercise group showed improvement in spinal mobility and pulmonary function and significantly lower absenteeism and overwork impact than the home-exercise group and control group. The home-and-workplace combined exercise and home exercise groups showed a higher level of activity improvement than the control group. CONCLUSION home-and-workplace combined exercise can be recommended to patients with ankylosing spondylitis to enhance their physical function, including spinal mobility and pulmonary function, and reduce work-related disability.
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Affiliation(s)
- Jong Mi Lim
- Department of Nursing, Shinsung University, Dangjin, Republic of Korea.
| | - Ok-Hee Cho
- Department of Nursing, College of Nursing and Health, Kongju National University, Gongju, Republic of Korea.
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Reyes-Cordero G, Enríquez-Sosa F, Gomez-Ruiz C, Gonzalez-Diaz V, Castillo-Ortiz JD, Duran-Barragán S, Duran-Ortiz JS, Espinosa-Morales R, Gamez-Nava JI, Gonzalez-Lopez L, Julian-Martínez B, Mendoza-Fuentes A, Ramos-Remus C, Pacheco-Tena C, Burgos-Vargas R. Recommendations of the Mexican College of Rheumatology for the Management of Spondyloarthritis. REUMATOLOGIA CLINICA 2021; 17:37-45. [PMID: 31285162 DOI: 10.1016/j.reuma.2019.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 03/31/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To update the recommendations for the management of patients with Spondyloarthritis (SpA) in the Mexican population, and identify which variables could influence patient management. MATERIAL AND METHODS A group of 15 experts in SpA translated, analyzed and modified the recommendations of the Mexican College of Rheumatology (CMR) and the International Society for the Assessment of Spondyloarthritis (ASAS)/European League Against Rheumatism (EULAR) 2016 group through a systematic review of the literature by two external reviewers during the period from 2015 to 2018 using the grade of recommendation, Oxford levels of evidence, percentage of concordance (Delphi). RESULTS Compared to previous recommendations, there were no significant changes from the year 2015. However, we modified the five fundamental principles and reduced the number of recommendations to ten by incorporating the first item in the text and combining five recommendations into two and adding a further recommendation. We confirmed the tendency to use glucocorticoids for patients with inflammatory activity and scarce access to biologicals. We identified the sociodemographic and clinical characteristics of patients with SpA and their influence on the application of the recommendations. CONCLUSIONS The ten recommendations of the CMR and the analysis of the characteristics of the Mexican patients with SpA focussed on step therapy, including pharmacological and non-pharmacological therapies, in a spectrum from easily accessible to high-tech substances available to a small percentage of the population.
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Affiliation(s)
- Greta Reyes-Cordero
- Hospital Ángeles Chihuahua, Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - Favio Enríquez-Sosa
- Hospital Regional «General Ignacio Zaragoza», ISSSTE, Ciudad de México, México
| | | | - Verónica Gonzalez-Diaz
- Antiguo Hospital Civil de Guadalajara «Fray Antonio Alcalde», Guadalajara, Jalisco, México
| | | | - Sergio Duran-Barragán
- Clínica de Investigación en Reumatología y Obesidad S.C. Instituto de Investigación en Reumatología y del Sistema Musculoesquelético, Departamento de Clínicas Médicas, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - J Santos Duran-Ortiz
- Servicio de Reumatología, Hospital General de Zona N.(o) 1, Instituto Mexicano del Seguro Social, Tepic, Nayarit, México
| | - Rolando Espinosa-Morales
- Servicio de Reumatología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Jorge I Gamez-Nava
- Unidad de Investigación Biomédica 02, UMAE, Hospital de Especialidades Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco, México; Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Laura Gonzalez-Lopez
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Bernardo Julian-Martínez
- Servicio de Reumatología, Hospital General de Zona N.(o) 1, Instituto Mexicano del Seguro Social Delegación Hidalgo, Pachuca, Hidalgo, México
| | | | - Cesar Ramos-Remus
- Unidad de Investigación en Enfermedades Crónico-Degenerativas, Guadalajara, Jalisco, México
| | - Cesar Pacheco-Tena
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - Ruben Burgos-Vargas
- Hospital General de México «Dr. Eduardo Liceaga», Universidad Nacional Autónoma de México, Ciudad de México, México.
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Mustur D. Positive effects of a four-week rehabilitation spa program on quality of life in patients with ankylosing spondylitis. ACTA FACULTATIS MEDICAE NAISSENSIS 2021. [DOI: 10.5937/afmnai38-33135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
This is an open uncontrolled study about the positive effects of a four-week rehabilitation spa program on the quality of life of 74 patients with ankylosing spondylitis. We assessed the following health status parameters on admission and discharge from the Institute Igalo, Montenegro: BASFI, BASDAI, ASDAS-CRP, ASAS 20 improvement criteria and SF-36 questionnaire. It was a "test-retest study". All the patients had six days of spa physical therapy per week during the four-week rehabilitation program, which made 24 therapy days in total. Therapy sets included the exercise program in gym and pool with mineral water, breathing exercises, massage therapy, balneotherapy (mud packs of baths, mineral and pearl baths, underwater massages), electrotherapy, sonotherapy, as well as thalassotherapy. Physiotherapy was prescribed by physician individually according to general health status and eventual contraindications. In all the observed parameters, statistical analysis showed that there was a highly significant improvement (p < 0.01). After four weeks of spa rehabilitation, ASAS 20 improvement index was achieved in 74.3% of patients with ankylosing spondylitis. Conclusions were that four weeks of complex spa physical therapy program in Institute Igalo led to a significant improvement of assessed parameters of disease activity, functional status and in domains of quality of life.
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The efficiency of inspiratory muscle training in patients with ankylosing spondylitis. Rheumatol Int 2018; 38:1713-1720. [DOI: 10.1007/s00296-018-4093-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 06/19/2018] [Indexed: 12/25/2022]
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de Alvarenga GM, Charkovski SA, dos Santos LK, da Silva MAB, Tomaz GO, Gamba HR. The influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women: A randomized controlled trial. Clinics (Sao Paulo) 2018; 73:e356. [PMID: 29924184 PMCID: PMC5996441 DOI: 10.6061/clinics/2018/e356] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/05/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Aging is progressive, and its effects on the respiratory system include changes in the composition of the connective tissues of the lung that influence thoracic and lung compliance. The Powerbreathe® K5 is a device used for inspiratory muscle training with resistance adapted to the level of the inspiratory muscles to be trained. The Pilates method promotes muscle rebalancing exercises that emphasize the powerhouse. The aim of this study was to evaluate the influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women. METHODS The participants were aged sixty years or older, were active women with no recent fractures, and were not gait device users. They were randomly divided into a Pilates with inspiratory training group (n=11), a Pilates group (n=11) and a control group (n=9). Spirometry, manovacuometry, a six-minute walk test, an abdominal curl-up test, and pulmonary variables were assessed before and after twenty intervention sessions. RESULTS The intervention led to an increase in maximal inspiratory muscle strength and pressure and power pulmonary variables (p<0.0001), maximal expiratory muscle strength (p<0.0014), six-minute walk test performance (p<0.01), and abdominal curl-up test performance (p<0.00001). The control group showed no differences in the analyzed variables (p>0.05). CONCLUSION The results of this study suggest inspiratory muscle training associated with the Pilates method provides an improvement in the lung function and physical conditioning of elderly patients.
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Affiliation(s)
- Guilherme Medeiros de Alvarenga
- Programa de Pos-Graduacao em Engenharia Eletrica e Informatica Industrial, Universidade Tecnologica Federal do Parana, Curitiba, PR, BR
- Departamento de Fisioterapia, Universidade Positivo, Curitiba, PR, BR
- *Corresponding author. E-mail:
| | | | | | | | | | - Humberto Remigio Gamba
- Programa de Pos-Graduacao em Engenharia Eletrica e Informatica Industrial, Universidade Tecnologica Federal do Parana, Curitiba, PR, BR
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Zão A, Cantista P. The role of land and aquatic exercise in ankylosing spondylitis: a systematic review. Rheumatol Int 2017; 37:1979-1990. [PMID: 28983663 DOI: 10.1007/s00296-017-3829-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022]
Abstract
Ankylosing spondylitis (AS) is a chronic and inflammatory rheumatic disease, characterized by pain and structural and functional impairments, such as reduced mobility and axial deformity, which lead to diminished quality of life. Its treatment includes not only drugs, but also nonpharmacological therapy. Exercise appears to be a promising modality. The aim of this study is to review the current evidence and evaluate the role of exercise either on land or in water for the management of patients with AS in the biological era. Systematic review of the literature published until November 2016 in Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Thirty-five studies were included for further analysis (30 concerning land exercise and 5 concerning water exercise; combined or not with biological drugs), comprising a total of 2515 patients. Most studies showed a positive effect of exercise on Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, pain, mobility, function and quality of life. The benefit was statistically significant in randomized controlled trials. Results support a multimodal approach, including educational sessions and maintaining home-based program. This study highlights the important role of exercise in management of AS, therefore it should be encouraged and individually prescribed. More studies with good methodological quality are needed to strengthen the results and to define the specific characteristics of exercise programs that determine better results.
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Affiliation(s)
- Ana Zão
- PRM Department, Centro Hospitalar Universitário do Porto/Hospital de Santo António, Largo do Prof. Abel Salazar, 4099-001, Porto, Portugal.
| | - Pedro Cantista
- PRM Department, Centro Hospitalar Universitário do Porto/Hospital de Santo António, Largo do Prof. Abel Salazar, 4099-001, Porto, Portugal
- University of Porto-Instituto de Ciências Biomédicas Abel Salazar, Rua Jorge de Viterbo Ferreira 228, 4050-343, Porto, Portugal
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Wong ML, Anderson RG, Garcia K, Housmann EM, McHale E, Goldberger GS, Cahalin LP. The effect of inspiratory muscle training on respiratory variables in a patient with ankylosing spondylitis: A case report. Physiother Theory Pract 2017; 33:805-814. [PMID: 28715240 DOI: 10.1080/09593985.2017.1346023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ankylosing Spondylitis (AS) presents with both musculoskeletal and cardiorespiratory pathophysiological manifestations. Inspiratory muscle training (IMT) may be a useful intervention to address deficits in respiratory and functional status. CASE DESCRIPTION A 25-year-old male with AS initially sought treatment for low back and right hip pain, but 7 weeks of IMT was also provided due to abnormal respiratory performance. OUTCOMES At baseline, the patient presented with a resting respiratory rate (RR) of 14.5 breaths/minute, tidal volume (TV) of 0.76 L, minute ventilation (VE) of 10.87 L/min, and end tidal CO2 (PetCO2) of 30.56 mmHg. Baseline exercise test results revealed a VO2max of 44 ml/kg/min and VE to CO2 output (VE/VCO2) slope of 30. Baseline MIP, SMIP, and MEP were 54 cm H2O, 507 PTU, and 87 cm H2O, respectively, and increased to 176 cm H2O, 807 PTU, and 151 cm H2O, respectively, after IMT. The VO2max increased to 51 ml/kg/min with decreases in the VE/VCO2 slope (29), resting RR (12 breaths/minute), resting TV (0.52 L), and resting VE (6.83 L/min) after IMT. Improvements during postural challenges were also observed. DISCUSSION This case demonstrates the clinical utility of respiratory gas analysis and respiratory performance measures to identify functional deficits and manage a patient with AS. The improvements in respiratory performance at rest, during postural challenges, and during maximal exercise after a relatively short period of IMT highlights the role IMT may have to improve functional status in patients with AS. Further investigation of IMT in patients with AS is warranted.
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Affiliation(s)
- Marlon L Wong
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Rachael G Anderson
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Kelsey Garcia
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Elissa M Housmann
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Erin McHale
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Gregory S Goldberger
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Lawrence P Cahalin
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
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Regel A, Sepriano A, Baraliakos X, van der Heijde D, Braun J, Landewé R, Van den Bosch F, Falzon L, Ramiro S. Efficacy and safety of non-pharmacological and non-biological pharmacological treatment: a systematic literature review informing the 2016 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis. RMD Open 2017; 3:e000397. [PMID: 28176966 PMCID: PMC5278330 DOI: 10.1136/rmdopen-2016-000397] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/22/2016] [Accepted: 01/03/2017] [Indexed: 12/21/2022] Open
Abstract
To assess the efficacy and safety of non-biological therapies in patients with axial spondyloarthritis (axSpA) to inform the update of the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of axSpA. A systematic literature review (2009–2016) of all non-pharmacological treatments, non-biological drugs (except targeted synthetic disease-modifying antirheumatic drugs (DMARDs)) and surgical therapies was performed. Randomised controlled trials (RCTs) and clinical controlled trials were assessed for efficacy and safety, while observational studies with a comparator were assessed for safety. All relevant efficacy and safety outcomes were included. Study heterogeneity precluded data pooling. If possible, Cohen's effect size was calculated for non-pharmacological treatments. In total, 45 papers and 2 abstracts were included. Studies on non-pharmacological treatments were very heterogeneous but overall confirmed a benefit for regular exercises, with small improvements in disease activity, function and spinal mobility. New studies on non-steroidal anti-inflammatory drugs (NSAIDs) confirmed their efficacy and new safety signals were not found. NSAIDs used continuously compared with on-demand did not reduce the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) mean change over 2 years in patients with ankylosing spondylitis with normal C reactive protein (CRP; ≤5 mg/L) (1 ‘negative’ RCT (0.9 vs 0.8; p=0.62)), while for patients with high CRP, conflicting results were found (1 ‘positive’ RCT (0.2 vs 1.7; p=0.003), 1 ‘negative’ RCT (1.68 vs 0.96; p=0.28)). No new trials were found for conventional synthetic DMARDs (csDMARDs). Short-term high-dose systemic glucocorticoids showed limited efficacy. Regular exercises may improve several outcomes. Efficacy and safety of NSAIDs in axSpA are confirmed. Glucocorticoids are not proven to be effective in axSpA and new data on csDMARDs are lacking.
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Affiliation(s)
- Andrea Regel
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum , Herne , Germany
| | - Alexandre Sepriano
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - Désirée van der Heijde
- Department of Rheumatology , Leiden University Medical Center , Leiden , The Netherlands
| | - Jürgen Braun
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum , Herne , Germany
| | - Robert Landewé
- Department of Clinical Immunology & Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Zuyderland Medical Center, Heerlen, The Netherlands
| | | | - Louise Falzon
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center , New York, New York , USA
| | - Sofia Ramiro
- Department of Rheumatology , Leiden University Medical Center , Leiden , The Netherlands
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Saracoglu I, Kurt G, Okur EO, Afsar E, Seyyar GK, Calik BB, Taspinar F. The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review. Rheumatol Int 2016; 37:409-421. [PMID: 27837263 DOI: 10.1007/s00296-016-3603-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/04/2016] [Indexed: 01/12/2023]
Abstract
The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO2, Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p < 0.05) in patients with AS, although there was no significant difference between two exercise groups. As for pulmonary functions, the specific exercise groups have greater improvements than conventional group in spirometric measurement, chest expansion (p < 0.05). However, there was no significant difference between specific conventional exercise types in 6MWD (p > 0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.
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Affiliation(s)
- Ismail Saracoglu
- Department of Physiotherapy and Rehabilitation, School of Health Science, Dumlupinar University, Kutahya, Turkey.
| | - Gamze Kurt
- Department of Physiotherapy and Rehabilitation, School of Health Science, Dumlupinar University, Kutahya, Turkey
| | - Eda Ozge Okur
- Department of Physiotherapy and Rehabilitation, School of Health Science, Dumlupinar University, Kutahya, Turkey
| | - Emrah Afsar
- Department of Physiotherapy and Rehabilitation, School of Health Science, Dumlupinar University, Kutahya, Turkey
| | - Gulce Kallem Seyyar
- Department of Physiotherapy and Rehabilitation, School of Health Science, Dumlupinar University, Kutahya, Turkey
| | - Bilge Basakci Calik
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Ferruh Taspinar
- Department of Physiotherapy and Rehabilitation, School of Health Science, Dumlupinar University, Kutahya, Turkey
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Park HK, Kim YJ, Kim TH. The role of visual feedback in respiratory muscle activation and pulmonary function. J Phys Ther Sci 2015; 27:2883-6. [PMID: 26504317 PMCID: PMC4616118 DOI: 10.1589/jpts.27.2883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/15/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] It is well known that visual feedback is an important factor contributing to
balance and postural control. Nevertheless, there has been little discussion about the
effects of visual feedback on pulmonary function. This study was conducted to investigate
the role of visual feedback on respiratory muscle activation and pulmonary function.
[Subjects and Methods] The subjects were 37 healthy adults who consented to participate in
this study. The study measured the muscular activation of the trunk and pulmonary function
according to the absence or presence of visual feedback. [Results] The results revealed
significant changes in muscular activation and pulmonary function with the use of visual
feedback. [Conclusion] These findings suggest that visual feedback may play a role in
increasing respiratory muscle activity and pulmonary function.
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Affiliation(s)
- Han-Kyu Park
- Department of Physical Therapy, Graduate School of Rehabilitation Science, Daegu University, Republic of Korea
| | - Yeong-Ju Kim
- Department of Physical Therapy, Graduate School of Clinical Pharmacy and Health, Kyungsung University, Republic of Korea
| | - Tae-Ho Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
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