A l’initiative du Groupement d’Isocinétisme Belge et Luxembourgeois

6ème Journée Belge d’ISOCINETISME

Vendredi 14 et samedi 15 mars 2008

INTENSIVE REHABILITATION PROGRAM INANKYLOSING SPONDYLITIS (AS) PATIENTS

B. POORTMANS ¹, P. DUGAILLY ^1,4, V. GANGJI ², S. STEINFELD ⁵, P. SALVIA ⁴, L. TANT ³

1 Physiotherapy,

2 Physical Medecine and Rehabilitation,

3 Rheumatology, Erasmus Hospital,

4 Anatomy (CP 619) and Functional Evaluation Centre, Université Libre de Bruxelles,

5 Rheumatology Hôpital Saint-Jean, Brussels, Belgium

bernard.poortmans@ulb.ac.be

Background:

Rehabilitation programs in AS patients have shown some beneficial effects on pain and mobility in fewer studies (1). However, no treatment protocol is well established at this time. The effects on trunk strength and spinal mobility were never described.

Objectives:

We investigate the effects of a 12 weeks intensive rehabilitation program (IRP) on trunk strength, spinal mobility, pain, disease activity and functionnal questionnaires.

Methods:

12 AS patients (all men, 37 +/-11years, duration of symptoms: 10 +/-6 years) participated to this study. All of them were under specific medical treatment for AS (10 anti- TNFα-blocus, 2 NSAID alone) since at least 1 year and were clinically stable. This treatment was pursued during the IRP. All patients received IRP in addition with their medical treatment. IRP consisted in 2 sessions/week during 12 weeks of 30 minutes manual therapy combined with 30 minutes of trunk muscles strengthening with Tergumed® system.

Before and after IRP, assessments were performed for each patient. Trunk strength assessment consisted in isometric measurement in the sagittal, frontal and horizontal planes (Tergumed® system). Functional parameters such as mobility and motion velocity were computed for cervical and lumbar spine using an electrogoniometer (CA6000). In addition, pain, disease activity and functional questionnaires (BASDAI, BASFI, HAQ) were collected.

Results:

Trunk strength at baseline was statistically significant lower (p<0.001) in AS patients compared to normative data, except for lateral bending. At 12 weeks, trunk strength improved in all patients, so that we didn’t found any statistically significant difference with the normative data. Spinal mobility increased in each plane, but only lateral bending was statistically significant (p<0.01). Pain (VAS), BASDAI and BASFI were statistically significant improved (p<0.05).

Conclusion: IRP improve statistically significantly trunk strength, pain, BASDAI and BASFI. It tends to increase spine mobility.

REFERENCES

1. Dagfinrud H, Tore K. Kvien, Kare B. Hagen. The Cochrane Review of Physiotherapy Interventions for Ankylosing Spondylitis. J Rheumatol 2005; 32: 1899-906.