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| Is group physical therapy superior to individualized therapy in ankylosing spondylitis? | 
| Hidding A, van der Linden S, Boers M, Gielen X, de Witte L, Kester A, Dijkmans B, Moolenburgh D | 
| Arthritis Care & Research 1993 Sep;6(3):117-125 | 
| clinical trial | 
| 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* | 
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                     PURPOSE: To study the effects of adding supervised group physical therapy to unsupervised individualized therapy in ankylosing spondylitis. METHODS: One hundred forty-four patients were randomized to exercise at home, or the same plus weekly group physical therapy for 9 months. Endpoints were spinal mobility, fitness (maximum work capacity by ergometry), functioning (Sickness Impact Profile, Health Assessment Questionnaire for the Spondylar-thropathies, and Functional Index), and patient's global assessment of change on a 10-cm visual analogue scale. RESULTS: Thoracolumbar flexion and extension increased by an average of 0.5 cm (9%) after home exercises, but increased by 7 W (4%) after group therapy. Global assessment improved by 0.3 (6%) after home exercises, and by 1.7 (34%) after group therapy. These three differences were statistically significant. There were no significant differences in chest expansion, cervical rotation, or the self-assessments of functioning. CONCLUSIONS: Group physical therapy proved superior to individualized therapy in improving thoracolumbar mobility and fitness, and had an important effect on global health reported by the patients.  
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