Erythrocyte sedimentation rate, C-reactive protein level, and serum amyloid a protein for patient selection and monitoring of anti-tumor necrosis factor treatment in ankylosing spondylitis. Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: effects on Bath Ankylosing Spondylitis Indices, quality of life and depression Efficacy of High Intensity Exercise on Disease Activity and Cardiovascular Risk in Active Axial Spondyloarthritis: A Randomized Controlled Pilot Study Establishment of the minimum clinically important difference for the bath ankylosing spondylitis indices: a prospective study. Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor α inhibitors The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial. Effects of Aerobic Training in Patients with Ankylosing Spondylitis Effects of two exercise interventions on pulmonary functions in the patients with ankylosing spondylitis. Prediction of a major clinical response (BASDAI 50) to tumour necrosis factor alpha blockers in ankylosing spondylitis. Outcome of an education and home-based exercise programme for patients with ankylosing spondylitis: a nationwide randomized study. Occupational therapy in ankylosing spondylitis: Short-term prospective study in patients treated with anti-TNF-alpha drugs. Stanger bath therapy for ankylosing spondylitis: illusion or reality? MRI in predicting a major clinical response to anti-tumour necrosis factor treatment in ankylosing spondylitis. The effect of a home based exercise intervention package on outcome in ankylosing spondylitis: a randomized controlled trial. Effects of Pilates, McKenzie and Heckscher training on disease activity, spinal motility and pulmonary function in patients with ankylosing spondylitis: a randomized controlled trial Changes of clinical response and bone biochemical markers in patients with ankylosing spondylitis taking etanercept. A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial.
OBJECTIVE To study the usefulness of erythrocyte sedimentation rate ( ESR ) , C-reactive protein ( CRP ) , and serum amyloid A ( SAA ) for response prediction and monitoring of anti-tumor necrosis factor ( anti-TNF ) treatment in ankylosing spondylitis ( AS ) patients . METHODS Patients were included consecutively before starting etanercept or infliximab treatment .  ASsessment in Ankylosing Spondylitis ( ASAS ) response , defined as a 50 % improvement or an absolute improvement of 2 points of the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ; 0 - 10 scale ) , was assessed at 3 months . Inflammatory markers and the BASDAI were collected at baseline and 1 and 3 months . Longitudinal data analysis was performed to compare associations between inflammatory markers and the BASDAI over time by calculating st and ardized betas . Predictive values of baseline levels of inflammatory markers for ASAS response were calculated . RESULTS In total , 155 patients were included , of whom , after 3 months of treatment , 70 % in the etanercept cohort and 71 % in the infliximab cohort responded . All markers , notably SAA , decreased significantly ( P < 0.0001 ) . St and ardized betas were 0.49 for ESR , 0.43 for CRP , and 0.39 for SAA . Normal baseline levels of CRP and SAA were significantly associated with nonresponse . A combination of elevated CRP and SAA levels at baseline revealed the highest predictive value ( 81 % ) for ASAS response . CONCLUSION ESR , CRP , and SAA were significantly associated with the BASDAI over 3 months , and the association with ESR was the strongest . Elevated baseline CRP and SAA levels revealed the highest predictive value for response . Together , this study demonstrates that inflammatory markers , and notably CRP and SAA , may facilitate patient selection and monitoring of efficacy of anti-TNF treatment in AS , and could be added to response criteria The objective of this non-r and omised controlled trial was to evaluate the impact of group-based exercise programme and a home-based exercise programme on Bath Ankylosing Spondylitis Indices , depression and quality of life in patients with ankylosing spondylitis ( AS ) . Approximately 41 patients in a rehabilitation unit were divided into two groups , either group- or home-based exercise programme . Exercise sessions were performed three times a week for a period of 6 weeks . The patients were compared before and after the rehabilitation programme , with respect to Bath Ankylosing Spondylitis Functional Index ( BASFI ) , Bath Ankylosing Spondylitis Disease Assessment Index ( BASDAI ) , Bath Ankylosing Spondylitis Metrology Index ( BASMI ) , Beck Depression Inventory ( BDI ) and The Nottingham Health Profile ( NHP ) . A statistically significant improvement was observed on BASDAI , BASMI and energy , pain , reaction of emotional and sleep subscores of NHP in both exercise groups after the exercise programme ( p < 0.05 ) . No statistically significant changes were detected in BASFI , BDI and social and mobility subscores of NHP in both exercise groups ( p > 0.05 ) . No statistically significant differences were found between the two exercise programmes ( p > 0.05 ) . Group and home-based exercise programmes are efficient in improving symptoms and mobility and had an important effect on quality of life in patients with AS . Home-based exercise programme , as it is cheaper , more easily performed and efficient , may be preferable for the management programme in AS Background Physical therapy is recommended for the management of axial spondyloarthritis ( axSpA ) and flexibility exercises have traditionally been the main focus . Cardiovascular ( CV ) diseases are considered as a major health concern in axSpA and there is strong evidence that endurance and strength exercise protects against CV diseases . Therefore , the aim of this study was to investigate the efficacy of high intensity endurance and strength exercise on disease activity and CV health in patients with active axSpA. Methods In a single blinded r and omized controlled pilot study the exercise group ( EG ) performed 12 weeks of endurance and strength exercise while the control group ( CG ) received treatment as usual . The primary outcome was the Ankylosing Spondylitis ( AS ) Disease Activity Score ( ASDAS ) . Secondary outcomes included patient reported disease activity ( Bath AS Disease Activity Index [ BASDAI ] ) , physical function ( Bath AS Functional Index [ BASFI ] ) , and CV risk factors measured by arterial stiffness ( Augmentation Index [ Alx ] ) and Pulse Wave Velocity [ PWV ] ) , cardiorespiratory fitness ( VO2 peak ) and body composition . ANCOVA on the post intervention values with baseline values as covariates was used to assess group differences , and Mann Whitney U-test was used for outcomes with skewed residuals . Results Twenty-eight patients were included and 24 ( EG , n = 10 , CG , n = 14 ) completed the study . A mean treatment effect of −0.7 ( 95%CI : −1.4 , 0.1 ) was seen in ASDAS score . Treatment effects were also observed in secondary outcomes ( mean group difference [ 95%CI ] ) : BASDAI : −2.0 ( −3.6 , −0.4 ) , BASFI : −1.4 ( −2.6 , −0.3 ) , arterial stiffness ( estimated median group differences [ 95 % CI ] ) : AIx ( % ) : −5.3 ( −11.0 , −0.5 ) , and for PVW ( m/s ) : −0.3 ( −0.7 , 0.0 ) , VO2 peak ( ml/kg/min ) ( mean group difference [ 95%CI ] : 3.7 ( 2.1 , 5.2 ) and trunk fat ( % ) : −1.8 ( −3.0 , −0.6 ) . No adverse events occurred . Conclusion High intensity exercise  improved disease activity and reduced CV risk factors in patients with active axSpA. These effects will be further explored in a larger trial . Trial Registration Clinical Trials.gov OBJECTIVE The minimum clinical ly important difference ( MCID ) is the minimum level of change of an outcome measure that is considered to be clinical ly relevant . This prospect i ve study was conducted to establish the minimum level of change in the Bath Ankylosing Spondylitis ( BAS ) indices that is meaningful for both the patient and the clinician . METHODS The BAS question naires [ i.e. , Bath Ankylosing Spondylitis Functional Index ( BASFI ) ; Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) ; and Bath Ankylosing Spondylitis patient Global score ( BAS-G ) ] were administered to 125 patients with ankylosing spondylitis ( AS ) at baseline and at the end of a 2-week intensive physiotherapy program . Together with the final assessment , a global vali date d rating scale was used to examine each domain . Receiver operating characteristic ( ROC ) curves were plotted to determine the BAS change score that most accurately classified patients with respect to a clinical ly meaningful change . This analysis was repeated to investigate whether the estimate of change was dependent upon the patients ' baseline scores . RESULTS According to analyses of ROC curves , the MCID are 7 mm or 17.5 % for BASFI : sensitivity = 0.60/specificity = 0.85 ; 10 mm or 22.5 % for BASDAI : sensitivity = 0.65/specificity = 0.82 ; and 15 mm or 27.5 % for BAS-G : sensitivity = 0.61/specificity = 0.74 . MCID values were independent of the patients ' baseline scores ( p = 0.09 to 0.72 ) by regression analysis . CONCLUSION This prospect i ve study gives MCID values for BASFI , BASDAI , and BAS-G that allow translation from the BAS indices to readily understood values for both patients and clinicians Objectives To investigate construct validity and responsiveness of the novel ankylosing spondylitis ( AS ) disease activity score ( ASDAS ) in patients with spondyloarthritis ( SpA ) . Methods In a 46-week prospect i ve longitudinal multicentre study of 60 patients with SpA ( 80 % men , median age 40 years ( range 21–62 ) ) treated with tumour necrosis factor α ( TNFα ) inhibitors ( infliximab , n=41 ; etanercept , n=13 ; adalimumab , n=6 ) , the responsiveness of ASDAS , conventional clinical measures of disease activity and treatment response and the Berlin MRI sacroiliac joint ( SIJ ) and lumbar spine inflammation scores were compared . Results After 22 weeks , 58.3 % of the patients were clinical responders ( 50 % or 20 mm reduction in the Bath AS Disease Activity Index ( BASDAI ) ) . At baseline , clinical responders had significantly higher median ( range ) ASDAS than non-responders ( 4.15 ( 1.98–6.04 ) vs 2.99 ( 2.05–6.19 ) , p=0.008 ) . Changes in ASDAS correlated with changes in clinical measures of disease activity ( including BASDAI ( ρ=0.76 ) and C-reactive protein ( CRP ) ( 0.79 ) ) , MRI SIJ inflammation ( 0.46 ) and MRI total inflammation scores ( 0.34 ) . Patients with  higher BASDAI or Assessment of SpondyloArthritis International Society ( ASAS ) responses obtained more profound reductions in ASDAS . ASDAS had the highest responsiveness with an effect size of 2.04 and a st and ardised response mean of 1.45 , whereas BASDAI ( effect size 1.86 ; st and ardised response mean 1.36 ) and CRP ( effect size 0.63 ; st and ardised response mean 0.70 ) were less responsive . Linear regression showed that a change in BASDAI of 20 mm or 50 % corresponded to a change in ASDAS of 1.38 and 1.95 , respectively . Conclusion ASDAS demonstrates construct validity and high responsiveness during treatment with TNFα inhibitors in patients with SpA. The proposed thresholds for disease activity and treatment response need further validation . Trial registration number NCT00133315 BACKGROUND Exergames are a well-known type of game based on a virtual avatar 's body movements . This hightech approach promotes an active lifestyle . OBJECTIVES The aim of this r and omized controlled trial was to evaluate the effects of exergames on pain , disease activity , functional capacity and quality of life in patients with ankylosing spondylitis ( AS ) . MATERIAL AND METHODS The study involved 60 patients , who were r and omized into either the exergame group ( EG ) or the control group ( CG ) . The EG patients engaged in exergaming , and CG patients did not engage in any exercises . The exergaming sessions were performed five times a week for eight weeks ( 40 sessions in total ) . The patients were assessed before and after the eight-week program on a visual analog scale ( VAS ) , the Bath Ankylosing Spondylitis Functional Index ( BASFI ) , the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) and the Ankylosing Spondylitis Quality of Life ( ASQOL ) question naire . RESULTS A statistically significant improvement was observed in VAS , BASFI , BASDAI and ASQoL scores in the EG group after completion of the exercise program ( p < 0.05 ) . CONCLUSIONS This study is a first step in investigating the possibilities of using an exergame platform to help patients with spondyloarthropathies to adopt a more physically active lifestyle . The results of this study suggest that exergames increase physical activity and decrease the pain scores in AS patients and also could , therefore , be feasible and safe Objective . To evaluate the effects of aerobic exercise in patients with ankylosing spondylitis ( AS ) . Methods . Seventy patients classified with AS by the modified New York criteria were included . The patients were r and omly assigned into 2 groups . The intervention group ( IG ) performed 50 min of walking followed by stretching exercises 3 times a week for 12 weeks . The control group ( CG ) performed only stretching exercises . The outcome measurements were the Bath indexes [ Bath AS Functional Index ( BASFI ) , Bath AS Disease Activity Index ( BASDAI ) , and Bath AS Metrology Index ( BASMI ) ] , Health Assessment Question naire for the Spondyloarthropathies ( HAQ-S ) , AS Disease Activity Score ( ASDAS ) , the 6-min walk test ( 6MWT ) , chest expansion , and the Medical Outcomes Study Short Form-36 . Aerobic capacity was assessed by ergospirometry on a treadmill . Routine laboratory techniques were used in determining lipid levels . Assessment s were performed immediately before r and omization and after 6 , 12 , and 24 weeks . Results . Thirty-five patients were r and omized to the IG and 35 to the CG . There was significant improvement in the BASFI , HAQ-S , BASMI , BASDAI , and ASDAS in both groups ( p < 0.05 ) , but did not differ between groups . There was a significant increase in the walking distance in the 6MWT in the IG compared with CG ( p < 0.001 ) . The IG showed significant improvement in cardiopulmonary capacity compared with CG . Cholesterol and triglyceride levels did not change in either group . Conclusion . In patients with AS , aerobic training improved walking distance and aerobic capacity . Aerobic training did not provide additional benefits in functional capacity , mobility , disease activity , quality of life , and lipid levels when compared with stretching exercises alone OBJECTIVE The aim of this study was to evaluate the impact of two different home-based daily exercise programs on pulmonary functions in the patients with ankylosing spondylitis ( AS ) . METHODS Fifty-one patients with AS were distributed into three groups . Group 1 ( n=19 ) was given a conventional exercise regimen . Group 2 ( n=19 ) received exercises based on the Global Posture Reeducation ( GPR ) method . Group 3 ( n=13 ) was accepted as the control group . Patients were assessed according to pain , functional capacity ( The Bath Ankylosing Spondylitis Functional Index - BASFI ) , disease activity ( The Bath Ankylosing Spondylitis Disease Activity Index - BASDAI ) , chest expansion , pulmonary function parameters , and 6-min walk distance ( 6MWD ) test . RESULTS Although there were significant improvements for BASDAI and BASFI scores in all groups , significant improvements in the VAS pain , chest expansion , pulmonary function parameters and 6MWD test were observed in the exercise groups . The improvements in pain , functional capacity , disease activity , chest expansion , pulmonary function parameters and 6MWD test were better in the exercise groups than in the control group . The GPR method result ed in greater improvements than the conventional exercise program in specific pulmonary function parameters like forced vital capacity , forced expiratory volume in 1s , and peak expiratory flow parameters . CONCLUSION Both exercises are efficient in improving pulmonary functions . Since the improvements in pulmonary function tests were greater in the patients who performed the exercise according to GPR method , motivated patients should be encouraged to perform this exercise program BACKGROUND TNFalpha blockers have been shown to be highly efficacious in patients with active ankylosing spondylitis ( AS ) . OBJECTIVE To identify parameters predicting the clinical response to TNF blockers in AS . METHODS Patients with active AS participated in two placebo controlled , r and omised trials conducted in Germany with infliximab ( n = 69 ) and etanercept ( n = 30 ) , respectively . For inclusion in either trial patients had to have high disease activity ( BASDAI > or=4 ) and a spinal pain score ( numerical rating scale 0 - 10 ) > or=4 despite treatment with NSAIDs . A major clinical response was defined as a 50 % improvement of the initial BASDAI ( BASDAI 50 ) after 12 weeks ' treatment with active drug . Logistic regression likelihood ratio tests ( univariate and multivariate ) , Student 's t test , and chi(2 ) tests were performed . RESULTS Univariate analysis showed the following to be predictors of a major response ( BASDAI 50 ) to treatment : shorter disease duration ( p = 0.003 ) ; lower BASFI ( p = 0.007 ) ; younger age ( p = 0.009 ) ; raised ESR ( p = 0.033 ) ; raised CRP ( p = 0.035 ) . After adjustment for disease duration , BASFI , ESR , and CRP , but not age , remained significantly associated . After adjustment for disease duration and for BASFI , ESR , CRP , and in addition , a higher BASDAI were significantly associated with response . The best multivariate model built by stepwise regression contained the covariables disease duration , BASFI , BASDAI , and CRP . CONCLUSION A shorter disease duration , younger age , and a lower BASFI are predictors of a major clinical response to TNF blockers in active AS . Raised CRP and a higher BASDAI may also be valuable predictors . These data need to be confirmed in further studies OBJECTIVES This study aims to assess the impact of a structured education and home exercise programme in daily practice patients with ankylosing spondylitis . METHODS A total of 756 patients with ankylosing spondylitis ( 72 % males , mean age 45 years ) participated in a 6-month prospect i ve multicentre controlled study , 381 of whom were r and omised to an education intervention ( a 2-hour informative session about the disease and the implementation of a non-supervised physical activity programme at home ) and 375 to st and ard care ( controls ) . Main outcome measures included Bath Ankylosing Spondylitis Disease Activity and Functional Index ( BASDAI , BASFI ) . Secondary outcome measures were 0 - 10 cm visual analog scale ( VAS ) for total pain , nocturnal pain and global disease activity and quality of life ( ASQoL ) , knowledge of disease ( self-evaluation ordinal scale ) and daily exercise ( diary card ) . RESULTS At 6 months , the adjusted mean difference between control and educational groups for BASDAI was 0.32 , 95 % confidence interval ( CI ) 0.10 - 0.54 , p=0.005 , and for BASFI 0.31 , 95%CI 0.12 - 0.51 , p=0.002 . Significant differences were found also in VAS for total pain , patient´s global assessment and in ASQoL. Patients in the education group increased their knowledge about the disease and its treatments significantly ( p<0.001 ) and practised more regular exercise than controls ( p<0.001 ) . CONCLUSIONS A structured education and home exercise programme for patients with ankylosing spondylitis in daily practice was feasible and helped to increase knowledge and exercise . Although statistically significant , the magnitudes of the clinical benefits in terms of disease activity and physical function were poor OBJECTIVE To assess the effect of occupational therapy ( OT ) on functional status in ankylosing spondylitis ( AS ) patients treated with anti-TNF-alpha drugs  in a short-term open controlled prospect i ve study . METHODS Twenty-seven AS subjects treated with anti-TNF-alpha drugs  , were allocated to OT ( n=14 ) or control ( n=13 ) group . At the study entry and at the 16th week we evaluated the following outcome parameters including BASFI , BASDAI , BASMI , Short-Form Health Survey ( SF-36 ) , pain , erythrocyte sedimentation rate ( ESR ) , C-reactive protein CRP ) and the adherence reported using self management methods , related to joint protection and energy conservation . RESULTS At baseline , OT and control group had similar demographic and clinical features . After 16 weeks , we found that the changes from baseline of BASFI ( p<0.05 ) , BASDAI ( p<0.02 ) , SF-36 CMS ( p<0.02 ) and pain ( p<0.02 ) score improved more significantly in OT group than in control group , where the scores remained invariable . After 16 weeks from baseline , the OT group reported a significantly more frequent use of self management methods , related to joint protection and energy conservation , than the control group . CONCLUSION Our controlled study indicates that a combination treatment with anti-TNFalpha agents and OT was beneficial for patients with AS , with synergistic effects on pain , function and disability . Thus OT intervention could be also considered when the disease is stable and well controlled with drugs because it may represent a further tool to improve the health status of patients We compared the short-term effects of Stanger bath therapy and conventional exercises on spinal mobility , functional capacity , disease activity , and quality of life with conventional exercise alone in ankylosing spondylitis ( AS ) patients . A total of 58 patients with a diagnosis of AS according to the modified New York criteria were included in this r and omized prospect i ve study . The patients were divided into two groups . Patients in group I ( n = 30 ) received Stanger bath therapy and an exercise program . Group II ( n = 28 ) patients were given the same exercise program but did not receive Stanger bath therapy . Patients were evaluated before ( T0 ) and at the end of the treatments ( T1 ) . Evaluation parameters were the Bath AS Metrology Index ( BASMI ) , Bath AS Functional Index ( BASFI ) , Bath AS Disease Activity Index ( BASDAI ) , and AS Quality of Life ( ASQoL ) . In both patient groups , a significant improvement was determined in all clinical outcomes between T0 and T1 except for BASMI in group II . Comparison of the groups showed significantly superior results in group I parameters of BASMI , BASFI , BASDAI , and ASQoL.  Stanger bath therapy showed beneficial effects in spinal mobility , functional capacity , disease activity , and quality of life in AS patients immediately after the treatment period . We recommend Stanger bath therapy for AS patients in the short-term , but further research is imperative to assess whether improvement is sustained over a long-term follow-up OBJECTIVE To evaluate the role of MRI in predicting a Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) improvement of at least 50 % ( BASDAI 50 ) upon anti-tumour necrosis factor ( TNF ) therapy of active ankylosing spondylitis ( AS ) . METHODS  MRIs from patients with active AS who participated in r and omised controlled trials were analysed with respect to presence and extent of active inflammatory lesions as detected in the spine ( n = 46 ) , sacroiliac ( SI ) joints ( n = 42 ) and both sites ( n = 26 ) . Univariate and multivariate logistic regression analyses were applied to evaluate MRI and clinical data in predicting a BASDAI 50 response . RESULTS The Berlin MRI spine score ( odds ratio ( OR ) 1.16 , 95 % CI 1.02 to 1.33 ) and disease duration ( OR 0.9 , 95 % CI 0.63 to 0.97 ) were statistically significant predictors of a BASDAI 50 response using regression analysis while there was only a trend for C-reactive protein ( CRP ) . The likelihood ratio ( LR ) for achievement of BASDAI 50 was increased in patients with a Berlin MRI spine score > /=11 ( LR 6.7 ) , disease duration < 10 years ( LR 4.2 ) and CRP > /=40 mg/litre ( LR 3.4 ) . All patients with two or three of these predictors improved clinical ly ( as assessed by BASDAI ) by at least 45 % . Disease duration > 20 years , normal CRP and no active inflammatory lesion in the spine were highly predictive of not achieving BASDAI 50 . A trend was only found for the MRI score of SI joints to be predictive . CONCLUSIONS Widespread inflammation in the spine as detected by MRI contributes to predicting a BASDAI 50 response in active patients with AS treated with anti-TNF agents OBJECTIVE Home based self-care is essential for successful management of ankylosing spondylitis ( AS ) . We design ed an intervention package aim ed at promoting self-care and regular longterm exercise and evaluated its effect on outcome . METHOD Members of our data base ( n = 4569 ) were r and omly selected and r and omized to an intervention group ( IG ) or a followup control group ( CG ) . The intervention consisted of an exercise/information video , exercise progress chart , patient education booklet , and AS exercise reminder stickers . The outcome measures were function ( BASFI ) , disease activity ( BASDAI ) , global well being ( BAS-G ) , exercise self-efficacy ( ESE ) , arthritis self-efficacy ( SES ) , and quantity of AS mobility/aerobic exercise assessed at baseline and 6 months . RESULTS Of the 200 subjects , 155 completed the study ( 75 IG and 80 CG ) . Baseline analysis showed no differences between the CG and the IG . At 6 months , analysis revealed no statistically significant between-group differences for the BASFI , BASDAI , and BAS-G. although the p value of 0.08 for function approached significance . Self-efficacy for exercise showed a significant improvement in the IG ( p = 0.045 ) . There were no between-group differences for the SES pain and other symptoms subscales . Finally , there was a significant increase in self-reported AS mobility ( p < 0.001 ) and aerobic exercise ( p < 0.05 ) in the IG . CONCLUSION An exercise intervention package design ed to promote self-management in AS ( 1 ) significantly improves self-efficacy for exercise ; ( 2 ) significantly improves self-reported levels of exercise ; ( 3 ) reveals a trend for improvement in function ( BASFI ) The optimal management of ankylosis spondylitis ( AS ) involves a combination of nonpharmacologic and pharmacologic treatment aim ing to maximize health-related quality of life . The primary objective of our study was to demonstrate the benefits of an original multimodal exercise program combining Pilates , McKenzie and Heckscher techniques on pulmonary function in patients with AS , while secondary objectives were to demonstrate the benefits of the same program on function and disease activity . This is a r and omized controlled study on ninety-six consecutive patients with AS ( axial disease subset ) , assigned on a 1:1 rationale into two groups based on their participation in the Pilates , McKenzie and Heckscher ( group I ) or in the classical kinetic program ( group II ) . The exercise program consisted of 50-min sessions performed 3 times weekly for 48 weeks . St and ard assessment s were done at week 0 and 48 and included pain , modified Schober test ( mST ) and finger – floor distance ( FFD ) , chest expansion ( CE ) and vital capacity ( VC ) , as well as disease activity Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) , functional Bath Ankylosing Spondylitis Functional Index ( BASFI ) and metrology index Bath Ankylosing Spondylitis Metrology Index ( BASMI ) . Groups were comparable at baseline ; we demonstrated significant improvement between baseline and after 48 weeks of regular kinetic training for all AS-related parameters in both groups . However , significant improvement was found in pain , lumbar spine motility ( mST , FFD ) , BASFI , BASDAI and BASMI in AS performing the specific multimodal exercise program at the end of study ( p = 0.001 ) . Although there were significant improvements in CE in both groups as compared to baseline ( group I , p = 0.001 ; group II , p = 0.002 ) , this parameter increased significantly only in group I ( p = 0.001 ) . VC measurements were not significantly changed at the end of the study ( group I , p = 0.127 ; group II , p = 0.997 ) , but we found significant differences within groups ( p = 0.011 ) . A multimodal training combining Pilates , McKenzie and Heckscher exercises performed regularly should be included in the routine management of patients with AS for better control of function , disease activity and pulmonary function OBJECTIVE Tumor necrosis factor-alpha has a prominent role in the inflammatory process and bone resorption in patients with ankylosing spondylitis ( AS ) . We evaluated the markers of clinical efficacy and bone biochemical changes in Korean patients with AS treated with etanercept therapy .  METHODS Serum sample s from 26 patients receiving etanercept for refractory AS were obtained at baseline and 12 weeks after treatment . Clinical measures and serum levels of transforming growth factor-Beta ( TGF-Beta ) , matrix metalloproteinase-3 ( MMP-3 ) , macrophage-colony stimulating factor ( M-CSF ) , bone-specific alkaline phosphatase ( BALP ) , osteocalcin , C-telopeptide ( CTX ) , receptor activator of nuclear factor-kB lig and ( RANKL ) , and osteoprotegerin ( OPG ) were measured at each timepoint . RESULTS Significant improvement of the Bath AS Disease Activity Index ( BASDAI ) and Functional Index ( BASFI ) was achieved after 12 weeks ( p < 0.001 ) . ASsessment s in Ankylosing Spondylitis Working Group ( ASAS ) 20 criteria were achieved by 22 patients ( 84.6 % ) after 12 weeks ' treatment . ASAS 50 and 70 were achieved by 10 ( 38.5 % ) and 7 patients ( 26.9 % ) . Serum levels of BALP and osteocalcin were significantly increased after 12 weeks of treatment ( p < 0.05 ) . Serum levels of CTX were not changed after treatment . Serum levels of TGF-Beta , MMP-3 , and M-CSF were significantly decreased after 12 weeks of treatment ( p < 0.05 ) . Serum levels of OPG and RANKL were not changed . Change of MMP-3 had a high correlation coefficient with changes of C-reactive protein ( CRP ) and erythrocyte sedimentation rate ( ESR ) upon etanercept treatment ( CRP , r = 0.446 , p = 0.022 ; ESR , r = 0.449 , p = 0.021 ) . CONCLUSION In patients with AS , etanercept therapy may be effective for reducing disease activity and improving bone biochemical markers . MMP-3 may be a useful biomarker for monitoring etanercept therapy OBJECTIVE To evaluate the mean overall effects over a 1-year period of a multidisciplinary in-patient rehabilitation programme for patients with ankylosing spondylitis . DESIGN Observer-blinded , r and omized controlled trial , with assessment s made after 4 and 12 months . PATIENTS Forty-six patients received a 3-week in-patient rehabilitation programme and 49 patients received treatment as usual .  METHODS Primary outcomes were disease activity measured with the Bath Ankylosing Spondylitis Disease Activity Scale ( BASDAI ) , and function measured with the Bath Ankylosing Spondylitis Functional Index ( BASFI ) . Secondary outcomes included well-being , spinal and hip mobility , and health-related quality of life measured with the Medical Outcome Study Short Form-36 . Overall treatment effects were estimated with Mixed models repeated measures analyses . RESULTS Significant overall treatment effects in favour of the rehabilitation group were found in the BASDAI score ( mean difference over the 1-year period -10.0 , 95 % confidence interval : -3.7 to -16.3 ) , in well-being ( -7.3 , 95 % confidence interval : -1.0 to -14.7 ) , and in the Medical Outcome Study Short Form-36 variables social functioning , role physical , role mental and bodily pain ( mean differences ranging from 5.8 ( pain ) to 10.7 ( role physical ) ) . CONCLUSION A 3-week in-patient rehabilitation programme had positive overall effects on disease activity , pain , function and well-being , and should be considered an important complement to medical disease management in persons with ankylosing spondylitis
Aerobic exercise did not improve BASFI , CRP or ESR .
CONCLUSION Aerobic exercise did not provide beneficial effects either on disease activity or on physical function and biological parameters when compared to a control group in axial spondyloarthritis
AIM To evaluate the impact of an aerobic fitness program on disease activity , defined by the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) and on C-reactive protein ( CRP ) , erythrocyte sedimentation rate ( ESR ) and the Bath Ankylosing Spondylitis Functional Index ( BASFI ) in case of axial spondyloarthritis .