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The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review

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Abstract

The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO2, Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p < 0.05) in patients with AS, although there was no significant difference between two exercise groups. As for pulmonary functions, the specific exercise groups have greater improvements than conventional group in spirometric measurement, chest expansion (p < 0.05). However, there was no significant difference between specific conventional exercise types in 6MWD (p > 0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.

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References

  1. Akkoc N, van der Linden S, Khan MA (2006) Ankylosing spondylitis and symptom-modifying vs disease-modifying therapy. Best Pract Res Clin Rheumatol 20(3):539–557. doi:10.1016/j.berh.2006.03.003

    Article  PubMed  Google Scholar 

  2. Akyol G, Özalevli S, Uçan E (2012) The relationship between pulmonary function and exercise capacity and quality of life in patients with ankylosing spondylitis. Tuberkuloz ve toraks 61(3):227–234

    Article  Google Scholar 

  3. Cho H, Kim T, Kim T-H, Lee S, Lee KH (2013) Spinal mobility, vertebral squaring, pulmonary function, pain, fatigue, and quality of life in patients with ankylosing spondylitis. Ann Rehabil Med 37(5):675–682

    Article  PubMed  PubMed Central  Google Scholar 

  4. Aydemir K, Tok F, Peker F, Safaz I, Taskaynatan MA, Ozgul A (2009) The effects of balneotherapy on disease activity, functional status, pulmonary function and quality of life in patients with ankylosing spondylitis. Acta Reumatol Port 35(5):441–446

    Google Scholar 

  5. Dagfinrud H, Halvorsen S, Vøllestad NK, Niedermann K, Kvien TK, Hagen KB (2011) Exercise programs in trials for patients with ankylosing spondylitis: do they really have the potential for effectiveness? Arthritis Care Res 63(4):597–603

    Article  Google Scholar 

  6. Hsieh LF, Wei JCC, Lee HY, Chuang CC, Jiang JS, Chang KC (2014) Aerobic capacity and its correlates in patients with ankylosing spondylitis. Int J Rheum Dis 19(5):490–499

    Article  PubMed  Google Scholar 

  7. Berdal G, Halvorsen S, van der Heijde D, Mowe M, Dagfinrud H (2012) Restrictive pulmonary function is more prevalent in patients with ankylosing spondylitis than in matched population controls and is associated with impaired spinal mobility: a comparative study. Arthritis Res Ther 14(1):1

    Article  Google Scholar 

  8. Dincer U, Cakar E, Kiralp MZ, Bozkanat E, Kilac H, Dursun H (2007) The pulmonary involvement in rheumatic diseases: pulmonary effects of ankylosing spondylitis and its impact on functionality and quality of life. Tohoku J Exp Med 212(4):423–430

    Article  PubMed  Google Scholar 

  9. Seckin U, Bolukbasi N, Gursel G, Eroz S, Sepici V, Ekim N (2000) Relationship between pulmonary function and exercise tolerance in patients with ankylosing spondylitis. Clin Exp Rheumatol 18(4):503–506

    CAS  PubMed  Google Scholar 

  10. van der Esch M, van’t Hul AJ, Heijmans M, Dekker J (2004) Respiratory muscle performance as a possible determinant of exercise capacity in patients with ankylosing spondylitis. Aust J Physiother 50(1):41–45

    Article  PubMed  Google Scholar 

  11. Smidt N, de Vet HC, Bouter LM, Dekker J (2005) Effectiveness of exercise therapy: a best-evidence summary of systematic reviews. Aust J Physiother 51(2):71–85

    Article  PubMed  Google Scholar 

  12. Wang CY, Chiang PY, Lee HS, Wei JCC (2009) The effectiveness of exercise therapy for ankylosing spondylitis: a review. Int J Rheum Dis 12(3):207–210

    Article  PubMed  Google Scholar 

  13. Millner JR, Barron JS, Beinke KM, Butterworth RH, Chasle BE, Dutton LJ, Lewington MA, Lim EG, Morley TB, O’Reilly JE (2016) Exercise for ankylosing spondylitis: an evidence-based consensus statement. In: Seminars in arthritis and rheumatism, vol 4. Elsevier, pp 411–427

  14. Ozdem YO, Inanici F, Hasçelik Z (2011) Reduced vital capacity leads to exercise intolerance in patients with ankylosing spondylitis. Eur J Phys Rehabil Med 47(3):391–397

    Google Scholar 

  15. O’Dwyer T, O’Shea F, Wilson F (2014) Exercise therapy for spondyloarthritis: a systematic review. Rheumatol Int 34(7):887–902

    Article  PubMed  Google Scholar 

  16. Passalent LA (2011) Physiotherapy for ankylosing spondylitis: evidence and application. Curr Opin Rheumatol 23(2):142–147

    Article  PubMed  Google Scholar 

  17. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269

    Article  PubMed  Google Scholar 

  18. Furlan AD, Pennick V, Bombardier C, van Tulder M (2009) Updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine (Phila Pa 1976) 34(18):1929–1941. doi:10.1097/BRS.0b013e3181b1c99f

    Article  Google Scholar 

  19. Moseley AM, Herbert RD, Sherrington C, Maher CG (2002) Evidence for physiotherapy practice: a survey of the physiotherapy evidence database (PEDro). Aust J Physiother 48(1):43–49

    Article  PubMed  Google Scholar 

  20. Ince G, Sarpel T, Durgun B, Erdogan S (2006) Effects of a multimodal exercise program for people with ankylosing spondylitis. Phys Ther 86(7):924–935

    PubMed  Google Scholar 

  21. Dundar U, Solak O, Toktas H, Demirdal U, Subasi V, Kavuncu V, Evcik D (2014) Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial. Rheumatol Int 34(11):1505–1511

    Article  CAS  PubMed  Google Scholar 

  22. Drăgoi R-G, Amaricai E, Drăgoi M, Popoviciu H, Avram C (2016) Inspiratory muscle training improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study. Clin Rehabil 30(4):340–346

    Article  PubMed  Google Scholar 

  23. Silva EM, Andrade SC, Vilar MJ (2012) Evaluation of the effects of global postural reeducation in patients with ankylosing spondylitis. Rheumatol Int 32(7):2155–2163

    Article  PubMed  Google Scholar 

  24. Durmuş D, Alaylı G, Uzun O, Tander B, Cantürk F, Bek Y, Erkan L (2009) Effects of two exercise interventions on pulmonary functions in the patients with ankylosing spondylitis. Jt Bone Spine 76(2):150–155

    Article  Google Scholar 

  25. White P, Wong W, Fleming T, Gray B (2007) Primary care spirometry: test quality and the feasibility and usefulness of specialist reporting. Br J Gen Pract 57(542):701–705

    PubMed  PubMed Central  Google Scholar 

  26. Bockenhauer SE, Chen H, Julliard KN, Weedon J (2007) Measuring thoracic excursion: reliability of the cloth tape measure technique. J Am Osteopathic Assoc 107(5):191–196

    Google Scholar 

  27. Bellet RN, Adams L, Morris NR (2012) The 6-minute walk test in outpatient cardiac rehabilitation: validity, reliability and responsiveness—a systematic review. Physiotherapy 98(4):277–286

    Article  PubMed  Google Scholar 

  28. Solway S, Brooks D, Lacasse Y, Thomas S (2001) A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest J 119(1):256–270

    Article  CAS  Google Scholar 

  29. Calin A, Garrett S, Whitelock H, Kennedy L, O’hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21(12):2281–2285

    CAS  PubMed  Google Scholar 

  30. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21(12):2286–2291

    CAS  PubMed  Google Scholar 

  31. Péron T, Plassat R (2016) Adolescent idiopathic scoliosis: impact of a physical rehabilitation program performed at home on the exercise capacity. Ann Phys Rehabil Med 59:e36

    Article  Google Scholar 

  32. Durmus D, Alayli G, Cil E, Canturk F (2009) Effects of a home-based exercise program on quality of life, fatigue, and depression in patients with ankylosing spondylitis. Rheumatol Int 29(6):673–677

    Article  PubMed  Google Scholar 

  33. Altan L, Korkmaz N, Dizdar M, Yurtkuran M (2012) Effect of Pilates training on people with ankylosing spondylitis. Rheumatol Int 32(7):2093–2099

    Article  CAS  PubMed  Google Scholar 

  34. Karapolat H, Eyigor S, Zoghi M, Akkoc Y, Kirazli Y, Keser G (2009) Are swimming or aerobic exercise better than conventional exercise in ankylosing spondylitis patients? A randomized controlled study. Eur J Phys Rehabil Med 45(4):449–457

    CAS  PubMed  Google Scholar 

  35. So MW, Heo HM, San Koo B, Kim Y-G, Lee C-K, Yoo B (2012) Efficacy of incentive spirometer exercise on pulmonary functions of patients with ankylosing spondylitis stabilized by tumor necrosis factor inhibitor therapy. J Rheumatol 39(9):1854–1858

    Article  PubMed  Google Scholar 

  36. Koopman WJ, Moreland LW (2001) Arthritis and allied conditions: a textbook of rheumatology. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  37. Paralikar SJ, Kathrotia RG, Pathak NR, Jani MB (2012) Assessment of pulmonary functions in obese adolescent boys. Lung India 29(3):236

    Article  PubMed  PubMed Central  Google Scholar 

  38. Malaguti C, Rondelli RR, de Souza LM, Domingues M, Dal Corso S (2009) Reliability of chest wall mobility and its correlation with pulmonary function in patients with chronic obstructive pulmonary disease. Respir Care 54(12):1703–1711

    PubMed  Google Scholar 

  39. Hill K, Jenkins SC, Hillman DR, Eastwood PR (2004) Dyspnoea in COPD: can inspiratory muscle training help? Aust J Physiother 50(3):169–180

    Article  PubMed  Google Scholar 

  40. Ferreira GE, Barreto RG, Robinson CC, Plentz RD, Silva MF (2016) Global postural reeducation for patients with musculoskeletal conditions: a systematic review of randomized controlled trials. Braz J Phys Ther 20(3):194–205

    Article  PubMed  PubMed Central  Google Scholar 

  41. Alkatan M, Baker JR, Machin DR, Park W, Akkari AS, Pasha EP, Tanaka H (2016) Improved function and reduced pain after swimming and cycling training in patients with osteoarthritis. J Rheumatol 43(3):666–672

    Article  PubMed  Google Scholar 

  42. Fernandes G, Jennings F, Cabral MVN, Buosi ALP, Natour J (2016) Swimming improves pain and functional capacity of patients with fibromyalgia: a randomized controlled trial. Arch Phys Med Rehabil 97(8):1269–1275

    Article  PubMed  Google Scholar 

  43. García RF, Sánchez L, Rodríguez M, Granados GS (2015) Effects of an exercise and relaxation aquatic program in patients with spondyloarthritis: a randomized trial. Med Clín (English Edition) 145(9):380–384

    Article  Google Scholar 

  44. Brophy S, Davies H, Dennis MS, Cooksey R, Husain MJ, Irvine E, Siebert S (2013) Fatigue in ankylosing spondylitis: treatment should focus on pain management. In: Seminars in arthritis and rheumatism, vol 4. Elsevier, pp 361–367

  45. Zochling J, van der Heijde D, Dougados M, Braun J (2006) Current evidence for the management of ankylosing spondylitis: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis. Ann Rheum Dis 65(4):423–432

    Article  CAS  PubMed  Google Scholar 

  46. Anna O (2005) An introduction to clinical Pilates. Athletic therpy today 10(4):19–25

    Article  Google Scholar 

  47. Roşu MO, Ţopa I, Chirieac R, Ancuta C (2014) Effects of Pilates, McKenzie and Heckscher training on disease activity, spinal motility and pulmonary function in patients with ankylosing spondylitis: a randomized controlled trial. Rheumatol Int 34(3):367–372

    Article  PubMed  Google Scholar 

  48. Chan D, Can F (2010) Patients’ adherence/compliance to physical therapy home exercises. Fizyoterapi Rehabilitasyon 21(3):132–139

    Google Scholar 

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Authors and Affiliations

  1. Department of Physiotherapy and Rehabilitation, School of Health Science, Dumlupinar University, Kutahya, Turkey

    Ismail Saracoglu, Gamze Kurt, Eda Ozge Okur, Emrah Afsar, Gulce Kallem Seyyar & Ferruh Taspinar

  2. School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey

    Bilge Basakci Calik

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  1. Ismail Saracoglu
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Correspondence to Ismail Saracoglu.

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Ismail Saracoglu, Gamze Kurt, Eda Ozge Okur, Emrah Afsar, Gulce Kallem Seyyar, Bilge Basakci Calik and Ferruh Taspinar declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Saracoglu, I., Kurt, G., Okur, E.O. et al. The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review. Rheumatol Int 37, 409–421 (2017). https://doi.org/10.1007/s00296-016-3603-3

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