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The Effect of a Home Based Exercise Intervention Package on Outcome in Ankylosing Spondylitis: A Randomized Controlled Trial

SIOBHAN SWEENEY, GORDON TAYLOR, and ANDREI CALIN

ABSTRACT.

Objective.
Home based self-care is essential for successful management of ankylosing spondylitis (AS). We designed an intervention package aimed at promoting self-care and regular longterm exercise and evaluated its effect on outcome.

Method. Members of our database (n = 4569) were randomly selected and randomized to an intervention group (IG) or a followup control group (CG). The intervention consisted of an exercise/information video, exercise progress chart, patient education booklet, and AS exercise reminder stickers. The outcome measures were function (BASFI), disease activity (BASDAI), global well being (BAS-G), exercise self-efficacy (ESE), arthritis self-efficacy (SES), and quantity of AS mobility/aerobic exercise assessed at baseline and 6 months.

Results. Of the 200 subjects, 155 completed the study (75 IG and 80 CG). Baseline analysis showed no differences between the CG and the IG. At 6 months, analysis revealed no statistically significant between-group differences for the BASFI, BASDAI, and BAS-G, although the p value of 0.08 for function approached significance. Self-efficacy for exercise showed a significant improvement in the IG (p = 0.045). There were no between-group differences for the SES pain and other symptoms subscales. Finally, there was a significant increase in self-reported AS mobility (p < 0.001) and aerobic exercise (p < 0.05) in the IG.

Conclusion. An exercise intervention package designed to promote self-management in AS (1) significantly improves self-efficacy for exercise; (2) significantly improves self-reported levels of exercise; (3) reveals a trend for improvement in function (BASFI). (J Rheumatol 2002;29:763-6)

Key Indexing Terms:

ANKYLOSING SPONDYLITIS
EXERCISE
OUTCOME



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