SELF- AND MANUAL MOBILIZATION IMPROVES SPINE MOBILITY IN MEN WITH ANKYLOSING SPONDYLITIS – A RANDOMIZED STUDY

Aims: To evaluate effects of physiotherapeutic intervention in terms of self- and manual mobilization on chest expansion, vital capacity, posture, spine mobility and experienced consequences of the disease in patients with ankylosing spondylitis.

Design: A prospective, randomized controlled study.

Methods: Thirty-two men, aged between 23 and 60 years, with ankylosing spondylitis were randomized to active or no treatment for eight weeks. Physiotherapeutic intervention included individualized self- and manual mobilization for 1 hour twice a week and individually adjusted home exercises. Two blinded investigators made the assessments of chest expansion, posture and spinal mobility before and after the treatment period. The patient filled in three and the physiotherapist one of the four Bath Ankylosing Spondylitis scales (BAS scales).

Results: In the treatment group, chest expansion increased at the level of processus xiphoideus (P<0.01), with no difference in vital capacity compared with the control group. The posture improved in the cervical (C7–wall distance) (P<0.001) and thoracic spine (P<0.05). Thoracic and lumbar spine flexion improved (P<0.01), as did sagittal range of motion (P<0.001 and P<0.01, respectively). The Bath Ankylosing Spondylitis Metrology Index (BASMI) improved significantly (P<0.001) in the treatment group compared with the control group. Other BAS scales showed no significant differences. Improvements in posture, mobility and BASMI were still present at four-month follow-up.

Conclusion: This study shows that eight weeks of self- and manual mobilization treatment improved chest expansion, posture and spine mobility in patients with ankylosing spondylitis.

El grupo de intervención mostró mejoras significativas en la expansión torácica, postura cervical y torácica, así como en la flexión y rango de movimiento tanto de la columna torácica como lumbar. El índice BASMI, que evalúa movilidad global, también mejoró significativamente respecto al grupo control (p < 0.001). En cambio, no se observaron mejoras significativas en los índices BAS de actividad de la enfermedad, funcionalidad o percepción global del paciente. A los

Los resultados respaldan el uso de programas de movilización combinada –manual y autodirigida–como componente clave en el tratamiento no farmacológico de la espondilitis anquilosante. La integración de este tipo de tratamiento en fases precoces de la enfermedad puede contribuir al mantenimiento funcional y a la prevención de deformidades a largo plazo.

Este ensayo clínico aleatorizado evalúa el impacto de una intervención fisioterapéutica combinada–movilización manual y autoejercicios– en varones con espondilitis anquilosante.