The effect(s) of a six-week home-based exercise program on the respiratory muscle and functional status in ankylosing spondylitis.

BACKGROUND: Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. Involvement of costovertebral and costotransverse joints results in rigidity of the chest wall and inability to expand the chest fully on inspiration. Also significant reduction in exercise capacity in the AS patients was reported.

OBJECTIVES: To determine the effects of a 6-week home-based exercise program on the respiratory muscle and energy cost in AS.

METHODS: Twenty-two AS patients were included. Chest expansion, tragus-wall distance, modified Schober test, maximal inspiratory pressure, maximal expiratory pressure, 6-minute walking distance, physiologic cost index and functional status Bath Ankylosing Spondylitis Functional Index of patients were measured at baseline and repeated at the end of an open 6-week home-based exercise program. Breathing exercises and upper extremity exercises were taught to all the patients. The patients were then asked to practice these exercises at home individually for 6 weeks.

RESULTS: Chest expansion, maximal inspiratory pressure, and maximal expiratory pressure values and Bath Ankylosing Spondylitis Functional Index scores of patients significantly increased after 6 weeks (P < 0.001). Six-minute walking distance and physiologic cost index values did not change at the end of the 6 weeks (P > 0.05).

CONCLUSIONS: A home-based exercise program can have an effect on some measures respiratory muscle and functional status. Greater emphasis should be placed on maintaining cardiorespiratory fitness as well as spinal mobility to encourage patients with AS.