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Factors related to change in global health after group physical therapy in ankylosing spondylitis

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Summary

The purpose of this study was to evaluate how improvements in global health in patients with ankylosing spondylitis (AS), who had received group physical therapy, were associated with changes in physical functioning and other outcome measures.

Sixty-seven AS patients from 2 outpatient departments (modified New York criteria) received group physical therapy weekly. After 9 months we studied the following variables to explain changes in global health: disease duration, spinal mobility, fitness, functional status (SIP, HAQ and Functional Index), pain, stiffness, and articular and enthesis indices. Change scores were calculated as baseline values minus scores at 9-month follow-up. Personality traits (neuroticism, social inadequacy, self-esteem and health locus of control) and loneliness were also included as possibly explanatory variables. Patient's assessment of change in global health after 9 months of group physical therapy was self-reported on a 10 cm visual analogue scale (−5=maximum worsening, 0=no change, +5=maximum improvement). Correlations were calculated between change in global health and all candidate explanatory variables. In this pre/post test design multiple and stepwise regression analyses were performed to study the relations between changes in global health and all explanatory variables.

Pearson correlation coefficients between improved global health and the explanatory variables were significant for lower self-esteem (0.27) and improvements in chest expansion (0.31), fitness (0.32), HAQ-S (0.29), and stiffness (0.33). Regression analysis revealed 2 significantly explanatory steps: changes in fitness explained 16% of total variance of changes in global health, and changes in stiffness contributed an additional 11%.

In AS, the beneficial effects of group therapy on global health are partly mediated by increased fitness and relief of stiffness. Group physical therapy in patients with AS may be expected to improve global health status and to bring relief of characteristic disability symptoms of disease such as stiffness.

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Author notes

  1. A. Hidding PT, MSc, PhD

    Present address: Netherlands Institute for Health Sciences, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands

Authors and Affiliations

  1. Department of Internal Medicine, Division of Rheumatology, University of Limburg and University Hospital of Maastricht, Maastricht, The Netherlands

    A. Hidding PT, MSc, PhD & S. Van Der Linden

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  1. A. Hidding PT, MSc, PhD
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  2. S. Van Der Linden
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Hidding, A., Van Der Linden, S. Factors related to change in global health after group physical therapy in ankylosing spondylitis. Clin Rheumatol 14, 347–351 (1995). https://doi.org/10.1007/BF02208352

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