Ankylosing spondylitis (AS) can be a troubling diagnosis. At its worst, this inflammatory condition can cause disability, physical deformity and a significantly reduced quality of life. AS is characterized by calcification and ossification of ligaments that surrounding joints. This eventually leads to total fusion and loss of mobility of the affected joints. The spine and pelvis are most often affected. Many individuals afflicted with AS manage to remain active and productive. Exercise can play a key role in the long-term successful management of this condition.
Stretching
The most obvious consequence of progressive AS is the loss of joint mobility. Regular stretching is very important in the effort to maintain good functional ranges of motion in the spine, hips and other joints. A study published in the journal "Physical Therapy" in 2006 showed that AS patients who engaged in a three-month course of exercise, including stretching, actually improved their spinal flexibility compared to a control group that did not perform the exercises.
Breathing Exercises
In as little as six weeks, AS study-subjects were able to increase their chest expansion and other measures of respiratory function by following a home-based program of breathing exercises. This study, published in the Journal of Clinical Rheumatology in 2009, was important in that it showed how a low-cost intervention can help mitigate one of the more serious, potential complications of AS. As the spine and ribcage lose mobility, normal respiration can be hampered. The secondary effects of poor respiratory exchange may include a loss of activity tolerance, infections and even a reduced life-expectancy. Deep breathing exercises are especially important for people with AS.
Aerobic Exercise
Efforts to avoid the more serious cardio-respiratory consequences of AS may be best served through regular aerobic exercise. Aerobic-type exercises tend to involve repetitive mobilization of multiple joints, as well as the chest-expanding effects necessitated by the heavy breathing associated with these activities. By adding swimming or walking to conventional exercises, researchers have shown that AS patients can achieve improvements in pulmonary function and multiple other quality of life measurements. These findings were reported in the July 2009 "European Journal of Physical and Rehabilitation Medicine."
Resistance Exercise
Many of our normal daily activities are performed in a slightly flexed posture. Even when you sit at your computer, you probably are slightly hunched forward over your keyboard. It is not surprising that advanced AS tends to result in a progressively rigid flexed posture. Performance of selective resistance exercises may help mitigate the progression of postural deformity caused by AS.
The National Strength and Conditioning Association (NSCA) has excellent instructional videos (see Resources) on a number of weight-training techniques. Choose exercises that are designed to strengthen the muscles that extend the spine and hips. Exercises to strengthen the muscles that pull the shoulders back are also good choices.
References
- "Physical Therapy"; Effects of a Multimodal Exercise Program for People with Ankylosing Spondylitis; G Ince, T Sarpel, B Durgun and S Erdogan; 2006
- "Journal of Clinical Rheumatology"; The Effect(s) of a Six-Week Home-Based Exercise Program on the Respiratory Muscle and Functional Status in Ankylosing Spondylitis; O Ortancil, S Sarikaya, P Sapmaz, et al; March 2009
- "European Journal of Physical and Rehabilitative Medicine"; Are Swimming or Aerobic Exercise Better Than Conventional Exercise in Ankylosing Spondylitis Patients? A Randomized Controlled Study; H Karapolat, S Eyigor, M Zoghi, et al; July 2009
