Occupational therapy in ankylosing spondylitis: Short-term prospective study in patients treated with anti-TNF-alpha drugs

• Published in: Joint, bone, spine : revue du rhumatisme bone, spine : revue du rhumatisme, 2008-01, Vol.75 (1), p.29-33
• Main Authors: Spadaro, Antonio, De Luca, Tania, Massimiani, Maria Pia, Ceccarelli, Fulvia, Riccieri, Valeria, Valesini, Guido
• Format: Article
• Language: English
• Subjects: Adult; Ankylosing spondylitis; Anti-TNF-alpha drugs; Antibodies, Monoclonal - therapeutic use; Blood Sedimentation; C-Reactive Protein - analysis; Combined Modality Therapy; Etanercept; Female; Health Status Indicators; Humans; Immunoglobulin G - therapeutic use; Infliximab; Internal Medicine; Male; Middle Aged; Occupational Therapy; Prospective Studies; Receptors, Tumor Necrosis Factor - therapeutic use; Recovery of Function; Rheumatology; Spondylitis, Ankylosing - drug therapy; Spondylitis, Ankylosing - rehabilitation; Tumor Necrosis Factor-alpha - antagonists & inhibitors
• ISSN: 1297-319X; 1778-7254
• DOI: 10.1016/j.jbspin.2007.07.006

Abstract Objective To assess the effect of occupational therapy (OT) on functional status in ankylosing spondylitis (AS) patients treated with anti-TNF-alpha drugs in a short-term open controlled prospective study. Methods Twenty-seven AS subjects treated with anti-TNF-alpha drugs, were allocated to OT ( n = 14) or control ( n = 13) group. At the study entry and at the 16th week we evaluated the following outcome parameters including BASFI, BASDAI, BASMI, Short-Form Health Survey (SF-36), pain, erythrocyte sedimentation rate (ESR), C-reactive protein CRP) and the adherence reported using self management methods, related to joint protection and energy conservation. Results At baseline, OT and control group had similar demographic and clinical features. After 16 weeks, we found that the changes from baseline of BASFI ( p < 0.05), BASDAI ( p < 0.02), SF-36 CMS ( p < 0.02) and pain ( p < 0.02) score improved more significantly in OT group than in control group, where the scores remained invariable. After 16 weeks from baseline, the OT group reported a significantly more frequent use of self management methods, related to joint protection and energy conservation, than the control group. Conclusion Our controlled study indicates that a combination treatment with anti-TNFα agents and OT was beneficial for patients with AS, with synergistic effects on pain, function and disability. Thus OT intervention could be also considered when the disease is stable and well controlled with drugs because it may represent a further tool to improve the health status of patients.