The efficacy of manual soft‐tissue mobilization in ankylosing spondylitis: A randomized controlled study

Abstract

Aim The aim of this randomized controlled study was to investigate the effect of soft‐tissue mobilization in patients with ankylosing spondylitis (AS). Method Twenty‐one patients (mean age 44.57 ± 10.40 years) were randomly divided into two groups. There were 13 patients (11 females, 2 males, age 43.69 ± 9.94 years) in the intervention group and 8 patients (5 females, 3 males, age 46.00 ± 11.67 years) in the control group. In the intervention group, soft‐tissue mobilization therapy and 20 spinal mobility exercises were applied. The control group received only 20 spinal mobility exercises. The Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Bath AS Metrology Index (BASMI) were used for assessment of disease activity, functional level, and mobility, respectively. Nottingham Health Profile (NHP) for quality of life and Roland Morris Disability Questionnaire (RMDQ) were used to determine disability levels. Results We found significant differences between pretreatment and post‐treatment scores of BASDAI (P = 0.049); BASFI (P = 0.009; lateral lumbar flexion (P = 0.005), maximal intermalleolar distance (P = 0.001) and total score (P = 0.001) of BASMI; pain subtest (P = 0.036) and total score (P = 0.036) of NHP; and RMDQ score (P = 0.004) in the intervention group. However, in the control group the BASMI score (P = 0.049) was observed to worsen significantly. Delta values were compared and differences in BASFI (P = 0.039), and in lateral lumbar flexion (P = 0.027), maximal intermalleolar distance (P = 0.045) and total score (P = 0.001) of BASMI were significant in favor of intervention group. Only tragus‐to‐wall distance (P = 0.039) of BASMI was observed to worsen significantly in the control group. Conclusion We recommend the use of soft‐tissue mobilization in addition to the exercises to treat AS patients.

Association between impaired lung function and risk of spondyloarthritis: a cross-sectional study in the UK Biobank

“… 46 PA not only counteracts these limitations but also actively protects against AS progression by improving symptoms and reducing disease activity through mechanisms like manual soft tissue mobilization and spinal mobility exercises. 47 – 50 While our subgroup analysis supports advocating PA as standard care throughout AS management, optimal exercise dosing requires further investigation. 51 This reinforces the clinical significance of PRISm as a biomarker for identifying at-risk individuals during modifiable pre-symptomatic phases, thereby potentially preventing progression and disability.…”

Association between impaired lung function and risk of spondyloarthritis: a cross-sectional study in the UK Biobank

“… 46 PA not only counteracts these limitations but also actively protects against AS progression by improving symptoms and reducing disease activity through mechanisms like manual soft tissue mobilization and spinal mobility exercises. 47 – 50 While our subgroup analysis supports advocating PA as standard care throughout AS management, optimal exercise dosing requires further investigation. 51 This reinforces the clinical significance of PRISm as a biomarker for identifying at-risk individuals during modifiable pre-symptomatic phases, thereby potentially preventing progression and disability.…”

Causal Relationships Between Total Physical Activity and Ankylosing Spondylitis: A Mendelian Randomization Study

“…Previously reported literature has demonstrated therapeutic benefits of PA for AS, including improving the symptoms of AS (30) and reducing global patient assessment of disease activity (31). Kabul et al show the manual soft tissue mobilization with spinal mobility exercises that significantly reduced deterioration of the disease condition (32). In addition, PA is advocated for as an integral part of standard care throughout the course of AS (7).…”

“…Kabul et al. show the manual soft tissue mobilization with spinal mobility exercises that significantly reduced deterioration of the disease condition ( 32 ). In addition, PA is advocated for as an integral part of standard care throughout the course of AS ( 7 ).…”

Ankylosing spondylitis and kinesiophobia

“…The BASFI score is obtained by dividing the total score by 10. The higher the BASFI score, the more severe the functional limitations ( Calin et al, 1994 ; Gur Kabul et al, 2021 ; Ozer et al, 2005 ).…”

Association between impaired lung function and risk of spondyloarthritis: a cross-sectional study in the UK Biobank

“… 46 PA not only counteracts these limitations but also actively protects against AS progression by improving symptoms and reducing disease activity through mechanisms like manual soft tissue mobilization and spinal mobility exercises. 47 – 50 While our subgroup analysis supports advocating PA as standard care throughout AS management, optimal exercise dosing requires further investigation. 51 This reinforces the clinical significance of PRISm as a biomarker for identifying at-risk individuals during modifiable pre-symptomatic phases, thereby potentially preventing progression and disability.…”

Causal Relationships Between Total Physical Activity and Ankylosing Spondylitis: A Mendelian Randomization Study

“…Previously reported literature has demonstrated therapeutic benefits of PA for AS, including improving the symptoms of AS (30) and reducing global patient assessment of disease activity (31). Kabul et al show the manual soft tissue mobilization with spinal mobility exercises that significantly reduced deterioration of the disease condition (32). In addition, PA is advocated for as an integral part of standard care throughout the course of AS (7).…”

“…Kabul et al. show the manual soft tissue mobilization with spinal mobility exercises that significantly reduced deterioration of the disease condition ( 32 ). In addition, PA is advocated for as an integral part of standard care throughout the course of AS ( 7 ).…”

Ankylosing spondylitis and kinesiophobia

“…The BASFI score is obtained by dividing the total score by 10. The higher the BASFI score, the more severe the functional limitations ( Calin et al, 1994 ; Gur Kabul et al, 2021 ; Ozer et al, 2005 ).…”

Association between impaired lung function and risk of spondyloarthritis: a cross-sectional study in the UK Biobank

“… 46 PA not only counteracts these limitations but also actively protects against AS progression by improving symptoms and reducing disease activity through mechanisms like manual soft tissue mobilization and spinal mobility exercises. 47 – 50 While our subgroup analysis supports advocating PA as standard care throughout AS management, optimal exercise dosing requires further investigation. 51 This reinforces the clinical significance of PRISm as a biomarker for identifying at-risk individuals during modifiable pre-symptomatic phases, thereby potentially preventing progression and disability.…”

Causal Relationships Between Total Physical Activity and Ankylosing Spondylitis: A Mendelian Randomization Study

“…Previously reported literature has demonstrated therapeutic benefits of PA for AS, including improving the symptoms of AS (30) and reducing global patient assessment of disease activity (31). Kabul et al show the manual soft tissue mobilization with spinal mobility exercises that significantly reduced deterioration of the disease condition (32). In addition, PA is advocated for as an integral part of standard care throughout the course of AS (7).…”

“…Kabul et al. show the manual soft tissue mobilization with spinal mobility exercises that significantly reduced deterioration of the disease condition ( 32 ). In addition, PA is advocated for as an integral part of standard care throughout the course of AS ( 7 ).…”

Ankylosing spondylitis and kinesiophobia

“…The BASFI score is obtained by dividing the total score by 10. The higher the BASFI score, the more severe the functional limitations ( Calin et al, 1994 ; Gur Kabul et al, 2021 ; Ozer et al, 2005 ).…”