Ankylosing Spondylitis Clinical Trial
Official title:
Effects of Cardiovascular Training on Fitness, Cardiovascular Health, Bone Health and Quality of Life in Individuals With Ankylosing Spondylitis
To test the effects of a cardiovascular training compared to attention control in a group of AS-patients participating in classic spinal mobility exercise groups (randomized controlled trial)
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease, affecting primarily
the spinal column and iliosacral joints. In addition, an increased risk for cardio-vascular
disease and osteoporosis has been described in patients with AS. Patients with AS may suffer
from severe impairment in physical functioning, i.e. spinal stiffness, pain and fatigue,
which reduces their daily activities, and quality of life. As AS mainly affects young
people, work capacity may be reduced, which, together with medical treatment costs, results
in a considerable burden for the society.
Current treatment guidelines for AS (ASAS/EULAR 2006) propose drug treatment, mainly
non-steroidal anti-inflammatory drugs, and in severe cases inhibitors of TNF alpha. In
addition, mobility exercise as the cornerstone of functional training is recommended in all
patients with AS. The efficacy of mobility exercise was confirmed by the third update (2007,
unpublished) of the Cochrane review regarding Physiotherapy in AS. However, the review also
suggested that mobility exercises have no effect on important quality-of life related
outcomes, such as pain, fatigue, or cardiovascular fitness.
Reduced physical activity due to pain, fatigue and reduced cardiovascular fitness may put
patients with AS at increased risk for immobility-induced bone loss and vitamin D deficiency
due to limited outdoor activities. Finally, both inactivity and vitamin D deficiency may
contribute to the elevated risk for cardiovascular disease and osteoporosis in patients with
AS.
Cardiovascular training may increase cardiovascular fitness, reduce pain and fatigue, and
decrease bone loss. The intervention may also enhance vitamin D status by increasing the
amount of physical activity performed outside. Vitamin D has been found to reduce bone loss
and improve cardiovascular health.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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