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Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

Institutional price:	$684.00
Issues per year:	4

2006, Volume18

98 pages

DOI: 10.1615/CritRevPhysRehabilMed.v18.i1

Issue price - $169.00

Exercise and Ankylosing Spondylitis—Which Exercises Are Appropriate? A Critical Review

Cesar Fernandez-de-las-Penas, PT
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid; Escuela de Osteopatía de Madrid, Madrid, Spain 28807

Cristina Alonso-Blanco, PT
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain

Ana M. Aguila-Maturana, MD, PhD
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain

Ana Isabel-de-la-Llave-Rincon, PT
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain

Alberto Molero-Sanchez, MD
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain

Juan C. Miangolarra-Page, MD, PhD
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain

ABSTRACT

Ankylosing Spondylitis (AS) is a chronic rheumatic disorder involving the axial skeleton that progressively limits spinal mobility. Exercises are considered as basic therapy to increase the functional capacity and quality of life in these patients. Today, there are different exercise programs for AS; however, not all of these exercises are specific for patients with this disease. Although an analysis of the peer-reviewed literature shows that exercise is effective in the management of AS patients, adequate, well-designed follow-up studies are still required due to the heterogeneous follow-up periods of the published trials. The main question that clinicians need to address is: Which exercises are more appropriate for patients with AS? In the present article we discuss a scientific justification for the employment of global and functional approaches for the management of these patients. With that aim, we examine the principles of the Global Posture Re-education (GPR) method, a rehabilitation method based on the concept of muscle chains. With this concept in mind, physical therapists can analyze, from a functional and global viewpoint, which exercises would be more appropriate for the management of patients with AS. Moreover, we also discuss the protocol that we employ in our clinic, based on the concept of muscle chains, which has been analyzed in a randomized controlled trial published by our research group.