Engaging in specific exercises and physical therapy are two strategies for managing ankylosing spondylitis (AS). In this study, we conducted a systematic review and meta-analysis to compare the differences between the outcomes of these strategies. Data from January 2005 to July 2014 was retrieved from the Medline, PubMed, AMED, Embase, and CINAHL databases. Randomized controlled trials were conducted, and the outcomes of these interventions were compared using a meta-analysis. The outcome assessments were classified into the domains of impairment, activity limitations, and participation restrictions for AS according to the International Classification of Functioning model. Eight articles were included in the analysis, and four specific exercises, namely Pilates, aerobic and aquatic exercises, and the Global Postural Reeducation method, were compared with physical therapy. The meta-analysis results revealed that some outcomes of chest expansion and pulmonary function favored the specific exercises. The outcomes of the Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Disease Activity Index, and Bath Ankylosing Spondylitis Functional Index were favored physical therapy. Both interventions exhibited low to moderate effects on impairment, activity limitations, and participation restriction among the patients with AS. However, different outcomes for specific exercises and physical therapy were found; a combination of both interventions is suggested as a clinical program for patients with AS.

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