Aim. The aim of this study is to find out the clinical evidence regarding the conservative treatment of ankylosing spondylitis: active exercises, manual techniques, physical modalities, SPA therapy, and cost-efficacy index. Materials and methods. From October 2006 to June 2008, the authors searched the Biomedical Databases (PubMed, Cinhal, Cochrane Library, PEDro, Embase), without any date limitation. Keywords used: “physiotherapy / ankylosing spondylitis / efficacy / exercise / spa therapy / disability / rehabilitation” and "Spondylitis, Ankylosing"[MeSH] "Spondylitis, Ankylosing / rehabilitation"[MeSH]), "Physical Therapy Modalities"[MeSH]. Admitted languages: English, Spanish, Portuguese, French, and Italian. Results. The research found 129 articles; most part of them are anecdotic or tutorial publications, case reports or case series. The works considered for this review are 37 clinical trials (18 randomized controlled trials and 19 non randomized trial, controlled or not controlled) and 21 reviews (9 are systematic reviews). We divided the articles in some groups: SPA therapy, treatment with the supervision of a doctor or a physiotherapist, self-treatment, self-treatment combined to group treatment, Global Postural Reeducation, other treatments. Conclusions. This review confirms the efficacy of the physiotherapy (both individually and in a group), the self-treatment and the SPA therapy. These therapies seem to be effective when compared with no treatment or placebo, while we can not define the relative efficacy among different set of exercises, or which particular conservative treatment is the best. Further studies are needed, to compare the effectiveness of different kind of treatment, and to evaluate the long-term outcome and the cost/efficacy rate.
Obiettivo. L’obiettivo di questo lavoro è di ricercare evidenze cliniche sul trattamento conservativo in pazienti con Spondilite Anchilosante, in particolare: esercizi, tecniche manuali, terapia fisica strumentale, terapia termale e rapporto costo/efficacia. Materiali e metodi. Tra ottobre 2006 e giugno 2008 è stata effettuata una ricerca nelle principali Banche Dati Biomediche (PubMed, Cinhal, Cochrane Library, PEDro, Embase), utilizzando le seguenti parole chiave: e "Spondylitis, Ankylosing"[MeSH] "Spondylitis, Ankylosing / rehabilitation"[MeSH]), "Physical Therapy Modalities"[MeSH], senza limiti di data e nelle lingue inglese, spagnola, portoghese, francese e italiana. Risultati. Dei 129 lavori trovati, gran parte sono pubblicazioni aneddotiche o tutoriali, case reports o case series; 21 le review (di cui 9 sistematiche); 37 sono studi clinici, di cui 18 studi randomizzati controllati e 19 studi non randomizzati, controllati e non controllati. I risultati sono stati raggruppati in alcune categorie: terapia termale, trattamenti effettuati sotto supervisione del medico o fisioterapista, autotrattamento, autotrattamento unito a trattamento di gruppo, Rieducazione Posturale Globale, altri tipi di trattamento. Conclusioni. La revisione ha evidenziato la maggior efficacia del trattamento fisioterapico, sia individuale che di gruppo, dell’autotrattamento e della terapia termale, in confronto a nessun trattamento, ma non si possono trarre conclusioni rispetto alla comparazione tra esercizi di tipo diverso o tra esercizi ed altri trattamenti. Molti trial lasciano intravedere possibili spunti di ricerca per studi futuri, soprattutto per il confronto fra diversi trattamenti, la valutazione dell’outcome a lungo termine e il rapporto costo/efficacia.
The conservative treatment in Ankylosing Spondylitis: a literature review. Il trattamento conservativo in pazienti con Spondilite Anchilosante: revisione della letteratura
VANTI, CARLA
2009
Abstract
Aim. The aim of this study is to find out the clinical evidence regarding the conservative treatment of ankylosing spondylitis: active exercises, manual techniques, physical modalities, SPA therapy, and cost-efficacy index. Materials and methods. From October 2006 to June 2008, the authors searched the Biomedical Databases (PubMed, Cinhal, Cochrane Library, PEDro, Embase), without any date limitation. Keywords used: “physiotherapy / ankylosing spondylitis / efficacy / exercise / spa therapy / disability / rehabilitation” and "Spondylitis, Ankylosing"[MeSH] "Spondylitis, Ankylosing / rehabilitation"[MeSH]), "Physical Therapy Modalities"[MeSH]. Admitted languages: English, Spanish, Portuguese, French, and Italian. Results. The research found 129 articles; most part of them are anecdotic or tutorial publications, case reports or case series. The works considered for this review are 37 clinical trials (18 randomized controlled trials and 19 non randomized trial, controlled or not controlled) and 21 reviews (9 are systematic reviews). We divided the articles in some groups: SPA therapy, treatment with the supervision of a doctor or a physiotherapist, self-treatment, self-treatment combined to group treatment, Global Postural Reeducation, other treatments. Conclusions. This review confirms the efficacy of the physiotherapy (both individually and in a group), the self-treatment and the SPA therapy. These therapies seem to be effective when compared with no treatment or placebo, while we can not define the relative efficacy among different set of exercises, or which particular conservative treatment is the best. Further studies are needed, to compare the effectiveness of different kind of treatment, and to evaluate the long-term outcome and the cost/efficacy rate.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
