Pozitivni efekti četvoronedeljnog rehabilitacionog banjskog programa na kvalitet života bolesnika sa ankilozirajućim spondilitisom
Sažetak
Ovo je otvorena nekontrolisana studija o pozitivnim efektima četvoronedeljnog rehabilitacijskog banjskog programa na kvalitet života kod 74 bolesnika sa ankilozirajućim spondilitisom. Procjenjivali smo sledeće parametre zdravstvenog stanja na prijemu i prilikom otpusta iz Instituta Igalo: BASFI, BASDAI, ASDAS-CRP, ASAS 20 kriterijume poboljšanja, kao i upitnik kvaliteta života SF-36. Bila je to „test-retest studija“. Svi pacijenti su imali šest dana banjskog fizikalnog liječenja sedmično tokom četiri sedmice programa rehabilitacije, što je ukupno predstavljalo 24 terapijska dana. Terapijski set je obuhvatao vježbe u sali i u bazenu sa mineralnom vodom, vježbe disanja, manuelne masaže, balneoterapije (blatne kupke, mineralne i biserne kupke, podvodne masaže), elektroterapije, sonoterapije, kao i talasoterapiju. Fizioterapijske procedure je propisivao ljekar individualno za svakog pacijenta ponaosob u skladu sa njegovim opštim zdravstvenim stanjem i eventualnim kontraindikacijama. U svim posmatranim parametrima statistička analiza pokazala je da postoji vrlo značajno poboljšanje (p <0,01). Nakon četiri sedmice rehabilitacije, indeks poboljšanja ASAS 20 postignut je kod 74,3% pacijenata s ankilozirajućim spondilitisom. Zaključeno je da četiri sedmice kompleksnog banjskog programa fizikalne terapije u Institutu Igalo dovodi do značajnog poboljšanja svih ispitivanih pokazatelja aktivnosti bolesti, funkcionalnog stanja, kao i u svim domenima kvaliteta života.
Reference
2. Medical Outcomes Trust Editors. How to Score the SF-36 Health Survey (SF-36). Boston Medical Outcomes Trust, 1994.
3. Zochling J. Measures of symptoms and disease status in ankylosing spondylitis: Ankylosing Spondylitis Disease Activity Score (ASDAS), Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score (BAS-G), Bath Ankylosing Spondylitis Metrology Index (BASMI), Dougados Functional Index (DFI), and Health Assessment Questionnaire for the Spondylarthropathies (HAQ-S). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S47-58.
4. Dagfinrud H, Kvien TK, Hagen KB. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev. 2008 Jan 23;(1).
5. Lubrano E, D’Angelo S, Spadaro A et al. Rehabilitation for ankylosing spondylitis in the era of biologics: any room left for this treatment? J Rheumatol. 2011;38(7): 1228-30.
6. Dragoi RG, Amarical E, Dragoi M et al. Inspiratory muscle training improves aerobic capacity and pulmonary function in patients with ankylosing spondylitis: a randomized controlled study. Clin Rehabil. 2016 Apr;30(4):340-6.
7. Levitova A, Hulejova H, Spiritovic M et al. Clinical improvement and reduction in serum calprotectin levels after an intensive exercise programme for patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis. Arthritis Res Ther. 2016 Nov 25;18(1):275.
8. Pecourneau V, Degboe Y, Barnetche T et al. Effectiveness of Exercise Programs in Ankylosing Spondylitis: A Meta-Analysis of Randomised Controlled Trials. Arch Phys Med Rahabil. 2018 Feb;99(2):383-9.
9. Lukas C, Landewe R, Sieper J et al. Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis 2009; 68: 18–24.
10. Xu M, Lin Z, Deng X et al. The Ankylosing Spondylitis Disease Activity Score is a highly discriminatory measure of disease activity and efficacy following tumour necrosis factor-alpha inhibitor therapies in ankylosing spondylitis and undifferentiated spondyloarthropathies in China. Rheumatology (Oxford) 2011; 50: 1466–72.
11. Lubrano E, D’Angelo S, Parsons WJ et al. Effectiveness of rehabilitation in active ankylosing spondylitis assessed by the ASAS response criteria. Rhheumatology (Oxford). 2007 Nov;46(11):1672-5.
12. Dagfinrud H, Mengshoel AM, Hagen KB et al. Health status of patients with ankylosing spondylitis: a comparison with the general population. Ann Rheum Dis. 2004 Dec;63(12):1605-10.
13. Karagulle M, Kardes S, Karagulle MZ. Real-Life effectiveness of spa therapy in rheumatic and musculoskeletal diseases: a retrospective study of 819 patients. Int J Biometeorol. 2017 Nov;61(11):1945-56.
14. Cozzi F, Ciprian L, Carrara M et al. Balneotherapy in chronic inflammatory rheumatic diseases-a narrative review. Int J Biometeorol. 2018 Dec;62(12):2065-71.
15. Kjeken I, Bø I, Rønningen A et al. A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial. J Rehabil Med. 2013 Mar;45(3):260-7.
16. Staalesen Strumse YA, Nordvag BY, Stanghelle JK et al. Efficacy of rehabilitation for patients with ankylosing spondylitis: comparison of a four week rehabilitation programme in a Mediterranean and a Norwegian setting. J Rehabl Med. 2011 May;43(6):534-42.