A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial

Abstract

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, randomized controlled trial, with assessments 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.