Exercise is a core treatment method in the management of Axial Spondyloarthritis. Clinical guidelines recommend a combination of pharmacologic and non-pharmacologic approaches to reduce disease activity and symptoms and improve physical function. The COVID-19 pandemic has accelerated the provision of healthcare services remotely and the digitalization of rehabilitation services. Telerehabilitation methods provide advantages in terms of transportation, prevention of infections that may occur due to suppression of immunity with drugs, and continuity of treatment in patients with axial spondyloarthritis. In this context, it is important to evaluate the effects of remote physiotherapy and rehabilitation delivery in chronic inflammatory rheumatic diseases. This study, which will examine the effects of telerehabilitation in the disease management processes of individuals with axial spondyloarthritis, is thought to shed light on future studies. The aim of this study was to compare the effectiveness of telerehabilitation or pre-recorded video-based core exercise program on core endurance, disease activity and physical function in subjects with axial spondyloarthritis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
Core exercises
Haydarpasa Numune Research and Training Hospital
Istanbul, Turkey (Türkiye)
Acıbadem Mehmet Ali Aydınlar University
Istanbul, Turkey (Türkiye)
Core Endurance Tests : Trunk Flexion Test
The patient will be asked to cross his/her hands over his/her chest and positioned with the trunk in 60° flexion and knees in 90° flexion. The time in this position will be measured and recorded with a stopwatch. If there is any deterioration in the patient's position, the stopwatch will be stopped and the test will be terminated.
Time frame: 8 weeks
Core Endurance Tests : Side Plank (Side Bridge Test):
The patient will be asked to lie on his/her side on the dominant side and cross his/her foot over the other foot. The non-dominant arm will be crossed over the chest and placed over the dominant shoulder. The patient will be asked to stand on the dominant forearm and elbow. The time in this position will be measured with a cronometer and recorded. If there is any deterioration in the patient's position, the stopwatch will be stopped and the test will be terminated.
Time frame: 8 weeks
Core Endurance Tests : Modified Plank
The patient will be asked to position on his/her knees and elbows with his/her face to the floor. He/she will be fixed over his/her knees with the help of a belt and the duration of his/her stay in this position will be measured and recorded with a cornometer. If there is any deterioration in the patient's position, the stopwatch will be stopped and the test will be terminated.
Time frame: 8 weeks
Core Endurance Tests : Biering-Sorenson Test
Patients will be positioned in a prone position with their spina iliaca anterior superior to the edge of the bed. Participants will be asked to extend their upper body straight forward from the edge of the table. They will be immobilized over their knees with the help of a belt and the time they stay in this position will be measured and recorded with a cornometer. If there is any deterioration in the patient's position, the stopwatch will be stopped and the test will be terminated.
Time frame: 8 weeks
Bath Ankylosing Spondylitis Functional Index (BASFI)
The questionnaire used to assess physical function in patients consists of 10 items related to activities of daily living. Each item is scored between 0-10 (0 meaning no difficulty, 10 meaning impossible).
Time frame: 8 weeks
Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
The BASDAI is used to measure ankylosing spondylitis disease activity. In this index, fatigue, pain due to spinal and peripheral joint involvement, local tenderness at the sites of insertion, duration and severity of morning stiffness in the last 1 week are evaluated. It consists of a total of 6 items and each item is scored between 0-10 (0 meaning no difficulty, 10 meaning impossible).
Time frame: 8 weeks
Bath Ankylosing Spondylitis Metrology Index (BASMI)
It is an index that includes several measurements used to evaluate spinal mobility. These measurements are tragus-wall distance, lumbar lateral flexion test, Modified Schober test, intermalleolar distance.
Time frame: 8 weeks
Global Rating of Change (GROC)
It is used to assess the patient's current health status and to calculate the difference between the initial health status.
Time frame: 8 weeks
Pain intensity (Numeric Rating Scale/NRS)
It is a scale used to determine the severity of pain. It allows the patient to describe their pain in numbers. The scale starts with the absence of pain (0) and is expressed as unbearable pain (10 or 100).
Time frame: 8 weeks
Ankylosing Spondylitis Quality of Life
The ASQoL consists of 18 questions and patients are asked to answer yes or no to each question. The total score ranges from 0-18. Higher scores indicate a poorer quality of life.
Time frame: 8 weeks
Timed Up and Go Test
The patients sit on a chair and are asked to stand up and walk for 3 meters then sit again. The time to complete this task is recorded.
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Time frame: 8 weeks
30 Seconds Sit and Stand Test
The patient sits and stands for 30 s in a chair whose height is adjusted so that the knees are 90° when seated. The number of times the patient can sit and stand during this time will be calculated and recorded.
Time frame: 8 weeks