Is group physical therapy superior to individualized therapy in ankylosing spondylitis? A randomized controlled trial

Abstract

Purpose. To study the effects of adding supervised group physical therapy to unsupervised individualized therapy in ankylosing spondylitis. Methods. One hundred forty‐four patients were randomized to exercises at home, or the same plus weekly group physical therapy for 9 months. Endpoints were spinal mobility, fitness[maximum work capacity by ergometry], functioning (Sickness Impact Profile, Health Assessment Questionnaire for the Spondylar‐thropathies, and Functional Index), and patient's global assessment of change on a 10‐cm visual analogue scale. Results. Thoracolumbar flexion and extension increased by an average of 0.5 cm (9%) after home exercises, and by 0.9 cm (16%) after group therapy. Maximum load in ergometry decreased by 2 W (1%) after home exercises, but increased by 7 W (4%) after group therapy. Global assessment improved by 0.3 (6%)after home exercises, and by 1.7 (34%) after group therapy. These three differenceswere statistically significant. There were no significant differences in chest expansion, cervical rotation, or the self‐assessments of functioning. Conclusions. Group physical therapy proved superior to individualized therapy in improving thoracolumbar mobility and fitness, and had an important effect on global health reported by the patients.