High intensity exercise for 3 months reduces disease activity in axial spondyloarthritis (axSpA): a multicentre randomised trial of 100 patients.
Adult
Cardiorespiratory Fitness
/ physiology
Disease Progression
Exercise Therapy
/ adverse effects
Fatigue
/ prevention & control
High-Intensity Interval Training
/ adverse effects
Humans
Middle Aged
Myalgia
/ prevention & control
Pain
/ prevention & control
Resistance Training
/ adverse effects
Spondylarthritis
/ physiopathology
Time Factors
Young Adult
exercise
exercise rehabilitation
randomised controlled trial
Journal
British journal of sports medicine
ISSN: 1473-0480
Titre abrégé: Br J Sports Med
Pays: England
ID NLM: 0432520
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
08
08
2018
revised:
22
01
2019
accepted:
24
01
2019
pubmed:
13
2
2019
medline:
29
2
2020
entrez:
13
2
2019
Statut:
ppublish
Résumé
Exercise is considered important in the management of patients with rheumatic diseases, but the effect of high intensity exercises on disease activity is unknown. To investigate the effectiveness of high intensity exercises on disease activity in patients with axial spondyloarthritis (axSpA). Assessor blinded multicentre randomised controlled trial. 100 patients (aged from their 20s to their 60s) with axSpA were randomly assigned to an exercise group or to a no-intervention control group. The exercise group performed cardiorespiratory and muscular strength exercises at high intensity over 3 months. The control group received standard care and was instructed to maintain their usual physical activity level. Primary outcome was disease activity measured with the Ankylosing Spondylitis (AS) Disease Activity Scale (ASDAS, higher score=worst) and the Bath AS Disease Activity Index (BASDAI, 0-10, 10=worst). Secondary outcomes were inflammatory markers, physical function and cardiovascular (CV)-health. There was patient involvement in the design and reporting of this study. 97 of the 100 (97%) randomised patients completed the measurements after the intervention. There was a significant treatment effect of the intervention on the primary outcome (ASDAS: -0.6 [-0.8 to -0.3], p<0.001 and BASDAI: -1.2 [-1.8 to -0.7], p<0.001). Significant treatment effects were also seen for inflammation, physical function and CV-health. High intensity exercises reduced disease symptoms (pain, fatigue, stiffness) and also inflammation in patients with axSpA. It improves patients' function and CV health. This debunks concerns that high intensity exercise might exacerbate disease activity in patients with axSpA. NCT02356874.
Sections du résumé
BACKGROUND
BACKGROUND
Exercise is considered important in the management of patients with rheumatic diseases, but the effect of high intensity exercises on disease activity is unknown.
OBJECTIVE
OBJECTIVE
To investigate the effectiveness of high intensity exercises on disease activity in patients with axial spondyloarthritis (axSpA).
METHOD
METHODS
Assessor blinded multicentre randomised controlled trial. 100 patients (aged from their 20s to their 60s) with axSpA were randomly assigned to an exercise group or to a no-intervention control group. The exercise group performed cardiorespiratory and muscular strength exercises at high intensity over 3 months. The control group received standard care and was instructed to maintain their usual physical activity level. Primary outcome was disease activity measured with the Ankylosing Spondylitis (AS) Disease Activity Scale (ASDAS, higher score=worst) and the Bath AS Disease Activity Index (BASDAI, 0-10, 10=worst). Secondary outcomes were inflammatory markers, physical function and cardiovascular (CV)-health. There was patient involvement in the design and reporting of this study.
RESULTS
RESULTS
97 of the 100 (97%) randomised patients completed the measurements after the intervention. There was a significant treatment effect of the intervention on the primary outcome (ASDAS: -0.6 [-0.8 to -0.3], p<0.001 and BASDAI: -1.2 [-1.8 to -0.7], p<0.001). Significant treatment effects were also seen for inflammation, physical function and CV-health.
CONCLUSION
CONCLUSIONS
High intensity exercises reduced disease symptoms (pain, fatigue, stiffness) and also inflammation in patients with axSpA. It improves patients' function and CV health. This debunks concerns that high intensity exercise might exacerbate disease activity in patients with axSpA.
TRIAL REGISTRATION NUMBER
BACKGROUND
NCT02356874.
Identifiants
pubmed: 30745314
pii: bjsports-2018-099943
doi: 10.1136/bjsports-2018-099943
doi:
Banques de données
ClinicalTrials.gov
['NCT02356874']
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
292-297Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.