Effect of Cardiovascular Training on Fitness and Perceived Disease Activity in People With Ankylosing Spondylitis

Abstract

Objective. Several studies suggest that patients with ankylosing spondylitis (AS) have an increased risk of cardiovascular disease. This study aimed to evaluate the effects of a 12-week, individually monitored, with moderate heart rate level intensity cardiovascular training on cardiovascular fitness and perceived disease activity in AS patients. Methods. Patients diagnosed with AS according to the modified New York criteria were randomized to either cardiovascular training or attention control. The training group performed 3 cardiovascular training units per week. All participants attended 1 weekly usual care flexibility training session. Attention control contained regular discussion groups on coping strategies. Adherence was self-monitored. Assessments were performed at baseline and after the intervention period of 3 months. Physical fitness was the primary end point, measured in watts using a submaximal bicycle test following the physical work capacity 75% protocol. All analyses controlled for sex, age, body mass index, baseline fitness and physical activity levels, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Results. Of 106 AS patients enrolled, 40% were women and the mean ؎ SD age was 49 ؎ 12 years. A total of 74.6% of the training group reported exercising at least 3 times a week. At the 3-month followup, the fitness level in the training group was significantly higher than in the control group (mean ؎ SE 90.32W ؎ 4.52W versus 109.84W ؎ 4.72W; P ‫؍‬ 0.001), independent of other covariates. The mean BASDAI total score was 0.31 points lower (P ‫؍‬ 0.31) in the training group, reaching significance for the peripheral pain subscore (1.19; P ‫؍‬ 0.01) but not for back pain or fatigue. Conclusion. Cardiovascular training, in addition to flexibility exercise, increased fitness in AS patients and reduced their peripheral pain.

Decreased physical activity and cardiorespiratory fitness in adults with ankylosing spondylitis: a cross-sectional controlled study

“…Small increases in absolute VO 2PEAK are associated with lower mortality from cardiovascular disease. Recent exercise programmes incorporating aerobic components (swimming, cycling, brisk walking and Nordic walking) have been effective in improving aerobic capacity of AS groups [41,46,47]; this study observed a strong association between cardiorespiratory capacity and PA BOUTS .…”

“…Niedermann et al [41] observed that on completion of a 12-week aerobic exercise intervention, habitual PA levels measured by accelerometer returned to pre-intervention levels. The inclusion of motivational strategies (based on social cognitive theory, motivational interviewing, self-determination theory or cognitive behavioural theory) can increase adherence to exercise, improve self-efficacy, reduce levels of activity limitation and have a positive effect on long-term PA behaviour [42].…”

Decreased health-related physical fitness in adults with ankylosing spondylitis: a cross-sectional controlled study

“…Flexibility is the fitness component traditionally most targeted by exercise interventions in AS cohorts. More recently, exercise interventions have also been directed towards aerobic and muscular fitness [22][23][24]44]. With aerobic capacity being significantly associated with ASQoL score, aerobic training could potentially offer additional improvements in patient QoL.…”

Spondyloarthrites. La rééducation : pour qui, quand, comment ?

“…Ceux-ci peuvent également intégrer la pratique d'activités physiques dont l'objectif est de corriger une éventuelle altération de la capacité physique à l'effort. L'effet de l'activité physique en monothérapie sur la fonction et l'activité de la maladie reste à ce jour discuté [29][30][31].…”