Ankylosing Spondylitis Clinical Trial
Official title:
Comparison of the Benefit Experienced by Patients With Ankylosing Spondylitis, Under Biotherapy, During Management by an Adapted Physical Activity Compared to a Standard Treatment by Kinesitherapy.
The current management of Spondylarthritis Ankylosant (SA), according to the recommendations
of the HAS (High Authority of Health), must be a multidisciplinary global approach
coordinated by the rheumatologist combining a pharmacological aspect (NSAID, analgesics,
biotherapy ...) and not pharmacological (physical treatments, educational approaches, social
measures ...). The therapeutic aim of this management is to achieve a low level of activity
of the disease and a decrease of the repercussion of this one in the daily life of the
patient.
The standard physical treatment currently provided is physiotherapy. This can be prescribed
throughout the disease by the rheumatologist, adapted to the stage of AS and the clinical
condition of the patient. The medical teams note in their daily practice that there may be a
lack of attendance of patients at prescribed physiotherapy sessions. This has been confirmed
in research on certain chronic rheumatic diseases, including AS, for which patients became
less adherent to physical treatments and thus lost the expected benefits, particularly in
terms of the functional impact of AS in the patient's daily life. (BASFI). Various studies
have also shown that combining several physical activities (including aerobic and muscle
building) or / and performing them in groups at a regular frequency (three times a week)
could significantly improve several AS parameters, including BASFI.
From these different findings, we hypothesized that a multidisciplinary treatment combining a
"cardio training" with muscle strengthening, supervised by qualified sports coaches, for a
year, could reduce the impact of SA in the daily life of patients balanced by a biotherapy,
compared to standard physiotherapy. This original care is part of the Adapted Physical
Activity (APA), whose application decree came into force on March 1, 2017 and allows doctors
to prescribe a physical therapy tailored to the needs of the patient. At present, the APA
remains at the expense of the patients in ALD and in some cases, it can be supported,
partially or totally, by the complementary health. APA could therefore be an alternative and
/ or complementary to physiotherapy as a physical therapy in the management of AS, in
addition to pharmacological treatments.
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