Back condition lessens after adding physical activity
No studies have evaluated this specific type of intervention yet
Ankylosing spondylitis (AS) is a form of arthritis that mainly affects the spine, although other joints throughout the body may also be impacted by it. The condition results from inflammation of the spinal joints, or vertebrae, which can lead to severe, long-lasting pain and discomfort. Due to these symptoms, individuals with AS usually experience a reduction in their physical fitness, work productivity and quality of life. As a result, physical activity is considered a key component of treatment for AS patients. Increased exercise has been found to improve physical function, mobility, and quality of life in those with AS, which is on top of its ability to reduce the risk for heart disease, obesity, cancer, type 2 diabetes, and osteoporosis. But despite these and other benefits of regular exercise, most individuals with AS are not physically active and do not comply well with exercise programs prescribed to them. Getting through to these patients and others with arthritic conditions is a major challenge faced by medical professionals and requires better strategies. One suggestion is to address these individuals with a brief intervention, which includes verbal advice, discussion, and encouragement to make certain changes. Although this type of approach has been researched for treating other conditions, no studies have investigated it on AS patients. Therefore, a powerful study called a randomized-controlled trial (RCT) was conducted to determine if a brief intervention could improve physical activity levels in individuals with AS.
Patients assessed over the span of six months
Patients between the ages of 18-64 diagnosed with AS were invited to the study and screened to determine if they could participate. This process led to 40 AS patients being accepted, who were then randomly assigned to either the brief intervention group or the control group. Participants in the intervention group attended several 30-minute consultations with a physical therapist over three months—the range for number of sessions was 2-6—where the goal was to motivate and support these individuals to engage in a more physical activity. In efforts to accomplish this, each participant was given an information booklet on AS, provided with resources on local physical activity classes and programs, and set individual physical activity goals and a plan to accomplish them with the physical therapist. All participants also scheduled follow-up sessions with the physical therapist at their discretion to track their progress and review their goals as they worked towards them. Participants in the control group did not attend these sessions over this time and were simply instructed to continue with their normal physical activity. All participants were assessed at the start of the study, after the three-month intervention and another three months later using various outcomes for physical activity, fitness, and quality of life.
Brief interventions lead to increased physical activity and better quality of life
On the whole, the brief intervention approach seemed to be effective for increasing physical activity levels and bringing about other benefits in AS patients. After six months, 70% of participants in the intervention group were adhering to the guidelines for aerobic physical activity, which was significantly higher than the adherence rates in the control group. In addition, intervention group participants experienced a moderate improvement on scores for their spinal flexibility, as well as a significant improvement in their quality of life. Finally, the brief intervention approach was well tolerated by participants, who were able to choose and moderate their personal activities according to their personal abilities and goals. This may have increased the chances of them being able to boost their regular activity levels.
Overall, these findings show that using a brief intervention to advise and motivate patients with AS to become more physically active can be effective for accomplishing this task, while also leading to other positive changes. AS patients should, therefore, seek out the services of a physical therapist, who can offer them with this type of intervention and monitor them along the way to help ensure they continue working towards their physical activity goals.
-As reported in the January '17 issue of the Journal of Physiotherapy
January 12, 2018
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