Articles

The Impact of Physiotherapy on a patient with Ankylosing Spondylitis Following Bilateral Total Hip Replacement: A Case Study

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Ankylosing spondylitis (AS) is a chronic, progressive inflammatory disorder primarily affecting the axial skeleton, with a prevalence of approximately 0.25% in India, predominantly in males. This case study explores the physiotherapeutic management of a 35-year-old male patient underwent bilateral Total Hip Replacement and presented with primary complaint of progressive stiffness in the back and neck region along with pain in his right hip joint. Outcome measures included Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Visual Analog Scale (VAS), and Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) with significant improvements observed over 12 weeks: BASFI improved from 7 to 2, BASDAI from 8.1 to 3.8, VAS pain from 8 to 3, and HOOS, JR score from 40 to 60. The results demonstrate that AS-specific exercises combined with a home-based exercise protocol can significantly enhance pain management, functional capacity, disease activity and hip disability in AS patients.

Physical Therapy Approaches in Ankylosing Spondylitis: A Systematic Review

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Background: Ankylosing spondylitis (AS) is a chronic, progressive, inflammatory disorder that mainly affects the axial skeleton with aseptic inflammation of synovial tissue, spinal ligaments, intervertebral discs and facet joints. The purpose of this review is to describe the effectiveness of different physical therapy approaches in patients with AS.

Method: This review followed PRISMA guidelines. A search was conducted in electronic databases Google Scholar, PubMed, and Cochrane. Publications were included if the study group included patients with a diagnosis of AS according to the classification system described in the New York criteria.

Results: A total of 6 clinical trials and 4 reviews were included in this review. One trial (n=1) had no intervention, most studies (n=4) and all the reviews (n=4) compared a variation in type of exercises, such as aerobic exercise, Pilates, swimming, one trial (n=1) was a follow-up evaluation.

Conclusions: The results of this review show that different types of treatment programs improve areas related to the physical health of patients with AS such as pain intensity, mobility, functionality, muscle strength, balance, fatigue, anxiety, depression. The most significant improvement in pain across all research data is noted after aquatic therapy. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity and pain in patients with AS.