Sharing Knowledge About Ankylosing Spondylitis
July 11, 2018 at 11:00 AM
As a Physiotherapist who has a special interest in treating patients with Ankylosing Spondylitis (AS), I am very passionate about what I do. As few Physiotherapists have had the exposure or experience treating people with inflammatory arthritis as I have, I feel that the knowledge I have gained should be shared. I take great pleasure in helping practitioners understand how to suspect this disease as well as how to best manage their patient’s treatment. I also find it very rewarding seeing the relief on patients’ faces when they can sense my experience and that I can ‘talk the talk’ of AS.
A couple of weeks ago I was invited to speak to a number of New Zealand Rheumatology Nurses on exercise management with AS, in hopes of imparting them with the knowledge to spark a change in their client management.
Based around research I was involved with two years ago, my talk compiled 10 exercise guidelines for people with AS. The recommendations are summarised below*.
Recommendation 1: Assessment
Individual exercise prescription should be informed by a thorough and reproducible assessment.
Recommendation 2: Monitoring
Sufficient monitoring and feedback should be provided on an individual basis, to achieve confidence and competence with exercise, and to inform changing needs for exercise prescription.
Recommendation 3: Safety
Throughout all aspects of exercise prescription, especially for those with more severe or later disease, the physical changes of AS must be considered.
Recommendation 4: Disease Management
Individuals receiving anti-TNFα therapy should continue with regular exercise prescription as it confers an additional benefit to anti-TNFα therapy alone
Recommendation 5: AS-Specific Exercise – Mobility
Individual exercise prescription with an emphasis on spinal mobility is paramount for best management of AS. Maintaining mobility of peripheral joints is also essential.
Recommendation 6: AS-Specific Exercise – Other
Stretching, strengthening, cardiopulmonary and functional fitness are important components to include in a balanced exercise programme.
Recommendation 7: Physical Activity
Regular physical activity should be encouraged to promote general health, well-being and functional outcomes.
Recommendation 8: Dosage
Exercise frequency, intensity, duration and type must be tailored to the person’s assessment findings, goals and lifestyle.
Recommendation 9: Adherence
It is important to assess adherence with regular exercise, encourage motivation and promote ongoing self-management.
Recommendation 10: Exercise Setting
Priority should be given to patient preference in exercise choice, to enhance adherence and optimize positive outcomes.
While there certainly needs to be further research in this area to maximize best outcomes for people with AS and inflammatory arthritis back pain, I have found these recommendations to be of help when prescribing exercise for my clients with AS.
The full article from which these recommendations were summarized can be found here: https://www.sciencedirect.com/science/article/pii/S0049017215002012
Rachael is a qualified Rheumatology and Back Pain Physiotherapist. Her particular interest is with clients who have lower back pain that is not resolving, helping these clients get to a diagnosis and then guiding them with appropriate treatment.