Self- and manual mobilization improves spine mobility in men with ankylosing spondylitis — a randomized study

Abstract

Aims: To evaluate effects of physiotherapeutic intervention in terms of self- and manual mobilization on chest expansion, vital capacity, posture, spine mobility and experienced consequences of the disease in patients with ankylosing spondylitis. Design: A prospective, randomized controlled study. Methods: Thirty-two men, aged between 23 and 60 years, with ankylosing spondylitis were randomized to active or no treatment for eight weeks. Physiotherapeutic intervention included individualized self- and manual mobilization for 1 hour twice a week and individually adjusted home exercises. Two blinded investigators made the assessments of chest expansion, posture and spinal mobility before and after the treatment period. The patient filled in three and the physiotherapist one of the four Bath Ankylosing Spondylitis scales (BAS scales). Results: In the treatment group chest expansion increased at the level of processus xiphoideus (P<0.01), with no difference in vital capacity compared with the control group. The posture improved in the cervical (C7—wall distance) (P<0.001) and in the thoracic spine (P<0.05). Thoracic and lumbar spine flexion improved (P<0.01) as did sagittal range of motion P<0.001 and P<0.01, respectively. The Bath Ankylosing Spondylitis Metrology Index total scoring improved (P<0.001) in the treatment group compared with the control group. The other three BAS scales showed no differences between groups. At four months follow-up of the treatment group, cervical spine posture, lumbar flexion and range of motion as well as BAS Metrology Index were still improved. Conclusion: This study shows that eight weeks of self- and manual mobilization treatment improved chest expansion, posture and spine mobility in patients with ankylosing spondylitis.