Özbaş Günay M, Bal S, Bayram KB, Harman Koçyiğit H, Gürgan A, Meryem Özbaş Günay, Serpil Bal, Korhan Barış Bayram, Ece Harman, Elif Ebru Dalgıç, Hikmet Koçyiğit, Alev Gürgan

The Effect of Breathing and Posture Exercise on the Clinical, Functional Status and Disease Related Quality of Life in Patients with Ankylosing Spondylitis

Objectives: The aim of this study was to investigate the effects of breathing and posture exercises on pain, functional status as well as respiratory function and health related quality of life in patients with Ankylosing Spondylitis (AS). Materials and Methods: Forty patients with AS were included in the study. Pain levels were recorded by Visual Analog Scale (VAS). Disease activity levels were determined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional status was determined by Bath Ankylosing Spondylitis Functional Index (BASFI) and spinal measurements were determined by the Bath Ankylosing Spondylitis Metrology Index (BASMI) criteria. Ankylosing Spondylitis Quality of Life (ASQol) was used as the disease-related quality of life scale. Pulmonary functions were tested with the Zan spirometry device. The first group was given a home exercise program including breathing and posture exercises and the second group was given a program with only posture exercises. However, the control group was not given a home exercise program. Patients in all groups were evaluated again after three months. Results: The VAS, BASDAI, BASFI, BASMI, chest expansion, pulmonary function test results and ASQol values showed a significant improvement in the group with breathing and posture exercises. There was no significant change in the control group. Chest expansion, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1)/FVC ratio in the first group had improved more significantly than group 2 and the control group. Also, BASFI, BASMI, BASDAI, ASQol, VAS scores in group 1 had improved more significantly when compared to group 2 and the control group. Conclusion: Breathing exercises show a positive effect on the pain level, clinical status and respiratory function and provides improved functional status and quality of life in patients with AS.

Keywords:

Ankylosing Spondylitis, Exercise, Respiratory Function,

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Kabasakal Y. Ankylosing Spondylitis Clinical Findings and Diagnosis. Turkey Int J Med Sci 2007; 3(25): 20-29.
Erdem CZ, Erdem LO, Tor M: Respiratory System Involvement in Ankylosing Spondylitis: Radiologic Approach. Respiratory Journal 2005; 6(1): 73-6.
Casserly IP, Fenlon HM, Breatnach E, Sant SM. Lung Findings on high- resolution computed tomography in idiopathic ankylosing spondylitis- correlation with clinical findings, pulmonary function testing and plain radiography. Br J Rheumatol 1997; 36: 677-82.
Fraser RS, Pare JAP, Fraser RG, Pare PD. Disease of the diaphragm and chest wall. In: Fraser RS, Pare JAP, Fraser RG, Pare PD, eds. Synopsis of Disease of the Chest, 2nd ed. Philadelphia, Saunders; 1994: 943-65.
Fernandez-de-Las-Penas C, Alonso-Blanco C, Alguacil-Diego IM,
Miangolarra Page J-Cet: One-year follow-up of two exercise interventions for
the management of Patients with ankylosing spondylitis: A randomized
controlled trial. Am J Phys Med Rehabil 2006; 85: 559-67.
Durmus D, Alayli G, Uzun O, Tander B, Canturk F, Bek Y, Erkan L: Effects of two exercise interventions on pulmonary functions in the patients with ankylosing spondylitis. Joint Bone Spine 2009; 76: 150-5.
Fernández-de-Las-Peñas C, Alonso-Blanco Miangolarra-Page JC. A randomized controlled trial of two exercise interventions for the management of patients with ankylosing spondylitis. Am J Phys Med Rehabil 2005; 84: 407-19. C, Morales-Cabezas M,
Fisher LR, Cawley MID, Holgate ST: Relation between chest expansion, pulmonary function and exercise tolerance in patients with ankylosing spondylitis. Ann Rheum Dis 1990; 49; 921-5.
Wagner J. Pulmonary function laboratory management and procedure manual. New York, American Society of Thorasic, 1998.
Vanderschueren D, Decramer M, Van den Daele P, Dequeker J. Transrespiratory pulmonary function and maximal pressures in ankylosing spondylitis. Ann Rheum Dis 1989; 48(8): 632-5.
Landfill L, Misheetik G. Ankylosing spondylitis. Baris I, ed. Pulmonary disease. New York: Trust Publications, 1995; 282-91.
Kelley WN, Harris ED, Ruddy S, Sledge CB. Textbook of Rheumatology. Fifth edition. United States of America: WB Saunders Company, 1997; 969- 82.
Schumacher HR. Primer on the rheumatic diseases. Ninth edition. Atlanta: Arthritis Foundation, 1988; 142-7.
Altin R, Ozdolap S, Savranlar A, Sarikaya S, Tor M, Kart L, Ozdemir H. Comparison of early and late pleuropulmonary findings of ankylosing spondylitis by high-resolution computed tomography and effects on patient's daily life. Clin Rheumatol 2005; 24(1): 22-8.
Elya M, Khan MA. Style does have a place in physical therapy treatment of ankylosing spondylitis? Current Opinion in Rheum. 2008; 20 (3): 282-6.
Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in AS: the Bath ankylosing spondylitis Disease Activity Index. J Rheumatol 1994; 21: 2286-91.
Kraag G, Stokes B, Grohe J, Helewa A, Goldsmith C. The effects of the comprehensive home phsyotherapy and supervision on patients with ankylosing spondylitis. A randomized controlled trial. The Journal of Rheum. 1990; 17(2): 228-33.
Sweeney S, Taylor G, Calin A. The effect of a home-based exercise intervention package on outcome in ankylosing spondylitis: A randomized controlled trial. The Journal of Rheumatol. 2002; 29(4): 763-6.
Lim HJ, Moon YI, Lee MS. Effects of home-based daily exercise on joint mobility, daily activity, pain and depression in patients with ankylosing spondylitis. Rheumatol Int. 2005; 25: 225-9.
Uhrin Z, Kuzis S, Ward MM. Exercise and changes in the health status of patients with ankylosing spondylitis. Arch Intern Med 2000; 160(19): 2969- 75.
Santos H, Brophy S, Calin A. Exercise in ankylosing spondylitis: How much is optimal? The Journal of Rheumatology 1998; 25(11): 2156-60.
Karatepe AG, Akkoc Y, Akar S, Kirazli Y, Akkoc N. The Turkish versions of the Bath ankylosing spondylitis and Dougados Functional Indices: reliability and validity. Rheumatol Int 2005; 25: 612-8.
Karapolat H, Akkoc Y, Sari I. Comparison of group-based exercise versus exercise homebased in patients with ankylosing spondylitis: Effect of Bath ankylosing spondylitis Indices, quality of life and depression. Clin Rheumatol 2008 Jun; 27(6): 695-700.
Bostan EE, Borman P, Bodur H, Barca N. Patients with functional disability and quality of life in ankylosing spondylitis. Rheumatol Int 2003; 23: 121-6.
Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, McKenna SP, Tennant A, van der Heijde D, Chamberlain MA. Development of the ASQoL: A quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 2003; 62(1): 20-6.