Exercise in ankylosing spondylitis: how much is optimum?

Abstract

Objective: To evaluate how much exercise patients with ankylosing spondylitis perform on a regular basis, to analyze demographic and clinical variables that might influence adherence to exercise, and to determine the effect of exercise on disease activity and function.

Methods: We analyzed 4282 patients who completed a self-administered questionnaire regarding physical exercise. To determine the relationship between exercise, demographic data, and clinical variables, patients who exercise 2 to 4 hours and 10 or more hours per week were compared to nonexercising controls matched for age, sex, and disease duration.

Results: Most of the patients reported 2 to 4 hours of exercise or no exercise. The group who performed moderate exercise had improved function and lower disease activity (p < 0.001, p < 0.015, respectively). The group who performed intensive exercise had improved function, but no difference in disease activity was found (p=0.033, p=0.394, respectively). Adherence to a regular exercise regime is associated with rheumatologist followup, beliefs in the benefits of exercise, and a higher education level.

Conclusion: This study suggests there is an optimum duration for exercise performed over a weekly period. Consistency, rather than quantity, is of most importance. Individuals most likely to follow this regime attend a rheumatologist, believe that exercise is of benefit, and are in the higher education category. Those who are less educated and followed by general practitioners should be targeted.