Sunday, 23 November 2014

As it Is - Back to Action at the Houses of Parliament

As It Is - Back to Action at the Houses of Parliament

In the last decade, great advance has been made in treatment of ankylosing spondylitis (AS). This has been focused on therapies such as the biologics eg. Anti-TNF. One of the cornerstones in treatment of AS remain exercise and physiotherapy. This spans the treatment pathway for AS as recommended by ASAS/EULAR.

Studies have shown that exercise in AS improves function (Passalent, 2011) (van Tubergen & Hidding, 2002). A Cochrane review suggest that an individual home-based or supervised exercise program is better than no intervention (Dagfinrud, Kvien, & Hagen, 2005). Supervised group physiotherapy is better than home exercises and that combined inpatient spa-exercise therapy followed by group physiotherapy is better than group physiotherapy alone. The benefit of group therapy may be due to both the motivation and opportunity for exercise that it provides. Both these factors are important in improving function is AS (Brophy et al., 2013). In a small study, high intensity exercise improved disease activity and reduced cardiovascular risk factors in patients with active axial SpA (Sveaas et al., 2014).

The evidence from the many studies have form the recommendations for the management of AS (Zochling, van der Heijde, Burgos-Vargas, et al., 2006). Exercise and physiotherapy forms the non-pharmacological treatments for AS  (Zochling, van der Heijde, Dougados, & Braun, 2006).

As it is, I was back at the Houses of Parliament on November 18th November 2014, to highlight the need for better access to physiotherapy for patients with AS. The event organized by NASS was hosted by Huw Irranca-Davies MP.

With the team from Portsmouth, L-R: Roger, me and physiotherapists Emma, Claire and Ronnie

With the NASS Team, Hedley Hamilton, Laura G and Laura R

With Debbie Cook, Director of  NASS

With Gillian Eames, Sebastian, Paul Curry and wife. Paul shared his story of AS.

A survey in 2013 by NASS showed that 60% of people in UK with AS do not have regular access to  physiotherapy. The evidence supports the role of physiotherapy and exercise as key to managing the condition. Physiotherapy remains one of the cornerstones of treatment for AS and is provided by 90 physiotherapy branches. Improved access to the right care for patients with AS including physiotherapy will ensure that patient remain physically active and in work where possible.



Views are my own. These are opinions, not specific medical advice and cannot replace the need to see your physician for review of your individual medical condition.


Brophy, S., Cooksey, R., Davies, H., Dennis, M. S., Zhou, S.-M., & Siebert, S. (2013). The effect of physical activity and motivation on function in ankylosing spondylitis: a cohort study. Seminars in Arthritis and Rheumatism, 42(6), 619–26. doi:10.1016/j.semarthrit.2012.09.007

Dagfinrud, H., Kvien, T. K., & Hagen, K. B. (2005). The cochrane review of physiotherapy interventions for ankylosing spondylitis. Journal of Rheumatology. doi:10.1002/14651858.CD002822.pub3

Passalent, L. A. (2011). Physiotherapy for ankylosing spondylitis: evidence and application. Current Opinion in Rheumatology, 23, 142–147. doi:10.1097/BOR.0b013e328342273a

Sveaas, S. H., Berg, I. J., Provan, S. A., Semb, A. G., Hagen, K. B., Vøllestad, N., … Dagfinrud, H. (2014). Efficacy of high intensity exercise on disease activity and cardiovascular risk in active axial spondyloarthritis: a randomized controlled pilot study. PloS One, 9(9), e108688. doi:10.1371/journal.pone.0108688

Van Tubergen, A., & Hidding, A. (2002). Spa and exercise treatment in ankylosing spondylitis: fact or fancy? Best Practice & Research. Clinical Rheumatology, 16, 653–666. doi:10.1016/S1521-6942(02)90240-8

Zochling, J., van der Heijde, D., Burgos-Vargas, R., Collantes, E., Davis, J. C., Dijkmans, B., … Braun, J. (2006). ASAS/EULAR recommendations for the management of ankylosing spondylitis. Annals of the Rheumatic Diseases, 65(4), 442–52. doi:10.1136/ard.2005.041137

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. Annals of the Rheumatic Diseases, 65(4), 423–32. doi:10.1136/ard.2005.041129

No comments:

Post a Comment