Rheumatology International

, Volume 25, Issue 3, pp 225–229 | Cite as

Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis

  • Hyun-Ja Lim
  • Young-Im Moon
  • Myeong Soo LeeEmail author
Original Article


We investigated the effects of home-based daily exercise on joint mobility, functional capacity, pain, and depression in patients with ankylosing spondylitis (AS). The patients were randomly assigned to a wait-list control group or to an exercise-therapy group. The exercise-therapy group performed a 20-min exercise program once per day for 8 consecutive weeks. After 8 weeks, compared with the control group, the exercise group showed improvements in joint mobility (cervical flexion, extension, shoulder flexion, abduction, hip abduction, and knee flexion), finger–floor distance, and functional capacity. Pain and depression scores were significantly lower after the exercise program in the exercise group than in the control group. These findings indicate that exercise therapy increases joint mobility and functional capacity, and decreases pain and depression in patients with AS. Home-based exercise, which is easily accessible to patients, might be an effective intervention for AS.


Ankylosing spondylitis Home-based Exercise Pain Joint mobility Depression Functional capacity 


  1. 1.
    Rasker JJ, Cosh JA (1987) The natural history of rheumatoid arthritis over 20 years. Clinical symptoms, radiological signs, treatment, mortality and prognostic significance of early features. Clin Rheumatol 6 (Suppl 2):5–11Google Scholar
  2. 2.
    Carette S, Graham D, Little H, Rubenstein J, Rosen P (1983) The natural disease course of ankylosing spondylitis. Arthritis Rheum 26:186–190PubMedGoogle Scholar
  3. 3.
    Gran JT, Husby G (1990) Ankylosing spondylitis in women. Semin Arthritis Rheum 19:303–312CrossRefPubMedGoogle Scholar
  4. 4.
    Hussein A, Stein J, Ehrich JH (1987) C-reactive protein in the assessment of disease activity in juvenile rheumatoid arthritis and juvenile spondyloarthritis. Scand J Rheumatol 16:101–105PubMedGoogle Scholar
  5. 5.
    Hidding A, van der Linden S, de Witte L (1993) Therapeutic effects of individual physical therapy in ankylosing spondylitis related to duration of disease. Clin Rheumatol 12:334–340PubMedGoogle Scholar
  6. 6.
    Jones SD, Koh WH, Steiner A, Garrett SL, Calin A (1996) Fatigue in ankylosing spondylitis: its prevalence and relationship to disease activity, sleep, and other factors. J Rheumatol 23:487–490PubMedGoogle Scholar
  7. 7.
    Basler HD (1993) Group treatment for pain and discomfort. Patient Educ Couns 20:167–175CrossRefPubMedGoogle Scholar
  8. 8.
    Calin A, Edmunds L, Kennedy LG (1993) Fatigue in ankylosing spondylitis–why is it ignored? J Rheumatol 20:991–995PubMedGoogle Scholar
  9. 9.
    Geissner E (1991) Psychological factors of pain control and their effects on pain evoking subjective stress. Z Klin Psychol Psychopathol Psychother 39:46–62PubMedGoogle Scholar
  10. 10.
    Gitman S, Rosenberg M (1992) Exercise is essential. In: Swezey RL (ed) Straight talk on spondylitis. Spondylitis Association of America, Sherman Oaks CA, pp 14–29Google Scholar
  11. 11.
    van Tubergen A, Landewe R, van der Heijde D, Hidding A, Wolter N, Asscher M, Falkenbach A, Genth E, The HG, van der Linden S (2001) Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 45:430–438CrossRefPubMedGoogle Scholar
  12. 12.
    Uhrin Z, Kuzis S, Ward MM (2000) Exercise and changes in health status in patients with ankylosing spondylitis. Arch Intern Med 160:2969–2975CrossRefPubMedGoogle Scholar
  13. 13.
    Gorman JD, Sack KE, Davis JC Jr (2002) Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor alpha. N Engl J Med 346:1349–1356CrossRefPubMedGoogle Scholar
  14. 14.
    Dougados M (2001) Treatment of spondyloarthropathies. Recent advances and prospects in 2001. Joint Bone Spine 68:557–563CrossRefPubMedGoogle Scholar
  15. 15.
    Gall V (1994) Exercise in the spondyloarthropathies. Arthritis Care Res 7:215–220PubMedGoogle Scholar
  16. 16.
    Brandt J, Khariouzov A, Listing J, Haibel H, Sorensen H et al (2003) Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum 48:1667–1675CrossRefPubMedGoogle Scholar
  17. 17.
    Analay Y, Ozcan E, Karan A, Diracoglu D, Aydin R (2003) The effectiveness of intensive group exercise on patients with ankylosing spondylitis. Clin Rehabil 17:631–636CrossRefPubMedGoogle Scholar
  18. 18.
    Santos H, Brophy S, Calin A (1998) Exercise in ankylosing spondylitis: how much is optimum? J Rheumatol 25:2156–2160PubMedGoogle Scholar
  19. 19.
    Kraag G, Stokes B, Groh J, Helewa A, Goldsmith C (1990) The effects of comprehensive home physiotherapy and supervision on patients with ankylosing spondylitis—a randomized controlled trial. J Rheumatol 17:228–233PubMedGoogle Scholar
  20. 20.
    Bakker C, Hidding A, van der Linden S, van Doorslaer E (1994) Cost effectiveness of group physical therapy compared to individualized therapy for ankylosing spondylitis. A randomized controlled trial. J Rheumatol 21:264–268PubMedGoogle Scholar
  21. 21.
    McNeal RL (1990) Aquatic therapy for patients with rheumatic disease. Rheum Dis Clin North Am 18:915–929Google Scholar
  22. 22.
    Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J et al (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21:2281–2285PubMedGoogle Scholar
  23. 23.
    Cline ME (1992) Standardization of the visual analogue scale. Nurs Res 41:378–380PubMedGoogle Scholar
  24. 24.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMedGoogle Scholar
  25. 25.
    Roberts WN, Larson MG, Liang MH, Harrison RA, Barefoot J, Clarke AK (1989) Sensitivity of anthropometric techniques for clinical trials in ankylosing spondylitis. Br J Rheumatol 28:40–45PubMedGoogle Scholar
  26. 26.
    Rasmussen JO, Hansen TM (1989) Physical training for patients with ankylosing spondylitis. Arthritis Care Res 2:25–27PubMedGoogle Scholar
  27. 27.
    Kraag G, Stokes B, Groh J, Helewa A, Goldsmith CH (1994) The effects of comprehensive home physiotherapy and supervision on patients with ankylosing spondylitis—an 8-month followup. J Rheumatol 21:261–263PubMedGoogle Scholar
  28. 28.
    Band DA, Jones SD, Kennedy LG, Garrett SL, Porter J, et al (1997) Which patients with ankylosing spondylitis derive most benefit from an inpatient management program? J Rheumatol 24:2381–2384PubMedGoogle Scholar
  29. 29.
    Diethelm U, Schuler G (1991) Prognosis in ankylosing spondylitis. Schweiz Rundsch Med Prax 80:584–587PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Department of NursingChodang UniversityMuanRepublic of Korea
  2. 2.College of NursingCatholic UniversitySeoulRepublic of Korea
  3. 3.Center for Integrative MedicineInstitute of Medical ScienceWonkwang University, IksanRepublic of Korea

Personalised recommendations