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.
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| With the team from Portsmouth, L-R: Roger, me and physiotherapists Emma, Claire and Ronnie |
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| With the NASS Team, Hedley Hamilton, Laura G and Laura R |
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| With Debbie Cook, Director of NASS |
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| 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.
#AS_It_Is
@synovialjoints
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.
References
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
