Title:Physiotherapy for Ankylosing Spondylitis: Systematic Review and a Proposed Rehabilitation Protocol
VOLUME: 13 ISSUE: 2
Author(s):Deepak Sharan* and Joshua S. Rajkumar
Affiliation:Department of Orthopaedics and Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Centre, Bangalore, Department of Orthopaedics and Rehabilitation, Department of Physiotherapy, RECOUP Neuromusculoskeletal Rehabilitation Centre, Bangalore
Keywords:Ankylosing spondylitis, physiotherapy, rehabilitation protocol, chronic inflammatory, rehabilitation.
Abstract:Ankylosing Spondylitis (AS) is a chronic inflammatory disease with gradual onset, largely
affecting the axial skeleton. As leads to varying degrees of restricted spinal mobility, pain and loss of
functional capacity. Rehabilitation, especially physiotherapy and exercises, are considered integral
components of its management. Various rehabilitation modalities are available for the benefit of
individuals with AS, but a sequenced protocol has not been reported. A scientific review was performed
using the following search engines: MEDLINE (Pubmed), COCHRANE Library and Physiotherapy
Evidence Database (PEDro). Studies, which had at least one of the groups receiving rehabilitation,
and the major outcomes studied including pain, stiffness, mobility (spine and chest wall) and
physical function (disease activity, ADL, QOL and global function) were selected. A total of 28 studies
were shortlisted for the review which included a total of 1926 subjects with AS. The review of
literature showed that individuals with AS had beneficial effects from exercise programmes compared
to no exercise. Patient education, active involvement and motivation of individuals with AS
played an important role in the overall treatment outcomes. Based on the review, a four-phase sequenced
rehabilitation protocol has been laid down for the benefit of individuals with AS.