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Effects of physical therapy for the management of patients with ankylosing spondylitis in the biological era

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Abstract

Exercise is considered a fundamental tool for the management of ankylosing spondylitis (AS), in combination with pharmacological therapy that with the advent of biological therapy has improved dramatically the control of signs and symptoms of this challenging disease. Current evidence shows that a specific exercise protocol has not been validated yet. The purpose of this review is to update the most recent evidence (July 2010–November 2013) about physiotherapy in AS, analyzing the possible role and synergistic interactions between exercise and biological drugs. From 117 studies initially considered, only 15 were included in the review. The results support a multimodal approach, including educational sessions, conducted in a group setting, supervised by a physiotherapist and followed by a maintaining home-based regimen. Spa exercise and McKenzie, Heckscher, and Pilates methods seem promising in AS rehabilitation, but their effectiveness should be further investigated in future randomized controlled trials (RCTs). When performed in accordance with the American College of Sports Medicine guidelines, cardiovascular training has been proven safe and effective and should be included in AS rehabilitation protocols. Exercise training plays an important role in the biological era, being now applicable to stabilized patients, leading ultimately to a better management of AS by physiatrists and rheumatologists throughout the world. On the basis of the current evidence, further research should aim to determine which exercise protocols should be recommended.

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Authors and Affiliations

  1. Rehabilitation Unit, Department of Neurosciences, University of Padua, Via Giustiniani 3, 35128, Padua, Italy

    Erika Giannotti, Sabina Trainito & Stefano Masiero

  2. Section of Rehabilitation and Rheumatology, Department of Neurological Sciences, Carlo Poma Hospital, Via Lago Paiolo 10, 46100, Mantua, Italy

    Giovanni Arioli

  3. Unit of Rehabilitation, Spilimbergo and San Vito al Tagliamento Hospital, Pordenone, Italy

    Vincenzo Rucco

Authors
  1. Erika Giannotti
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  2. Sabina Trainito
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  3. Giovanni Arioli
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  4. Vincenzo Rucco
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  5. Stefano Masiero
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Correspondence to Stefano Masiero.

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Giannotti, E., Trainito, S., Arioli, G. et al. Effects of physical therapy for the management of patients with ankylosing spondylitis in the biological era. Clin Rheumatol 33, 1217–1230 (2014). https://doi.org/10.1007/s10067-014-2647-6

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  • DOI: https://doi.org/10.1007/s10067-014-2647-6

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