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A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial |
Kjeken I, Bo I, Ronningen A, Spada C, Mowinckel P, Hagen KB, Dagfinrud H |
Journal of Rehabilitation Medicine 2013 Mar;45(3):260-267 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: To evaluate the mean overall effects over a 1-year period of a multidisciplinary in-patient rehabilitation programme for patients with ankylosing spondylitis. DESIGN: Observer-blinded, randomized controlled trial, with assessments made after 4 and 12 months. PATIENTS: Forty-six patients received a 3-week in-patient rehabilitation programme and 49 patients received treatment as usual. METHODS: Primary outcomes were disease activity measured with the Bath Ankylosing Spondylitis Disease Activity Scale (BASDAI), and function measured with the Bath Ankylosing Spondylitis Functional Index (BASFI). Secondary outcomes included well-being, spinal and hip mobility, and health-related quality of life measured with the Medical Outcome Study Short Form-36. Overall treatment effects were estimated with Mixed models repeated measures analyses. RESULTS: Significant overall treatment effects in favour of the rehabilitation group were found in the BASDAI score (mean difference over the 1-year period -10.0, 95% confidence interval -3.7 to -16.3), in well-being (-7.3, 95% confidence interval -1.0 to -14.7), and in the Medical Outcome Study Short Form-36 variables social functioning, role physical, role mental and bodily pain (mean differences ranging from 5.8 (pain) to 10.7 (role physical)). CONCLUSION: A 3-week in-patient rehabilitation programme had positive overall effects on disease activity, pain, function and well-being, and should be considered an important complement to medical disease management in persons with ankylosing spondylitis.
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