Using an exercise ball to help improve muscle strength provides relief from ankylosing spondylitis according to a recent study. The results of this trial offer hope of effective conservative therapy for those with back and neck pain from the condition and may help reduce reliance on pain medications as well as delay the need for neck surgery.
What is Ankylosing Spondylitis and Who Gets It?
Ankylosing spondylitis is an autoimmune condition that is also known as Bekhterev’s disease/syndrome and Marie-Strumpell disease. This degenerative condition involves chronic inflammatory arthritis that affects the whole body and which causes bones to fuse together, creating physical deformities. This is often most apparent in the cervical spine where the neck begins to curve forwards and those with the condition have difficulties looking upwards. The condition usually begins between 20 and 40 years of age and is three times more likely to occur in men than in women.
Treating Ankylosing Spondylitis
Because ankylosing spondylitis is degenerative and occurs relatively early in life it is essential that conservative treatments that can be applied long-term are made available to patients. Use of stretching and strengthening exercises for the spine may be part of such treatment strategies but such recommendations have not been clearly defined, which could leave patients at risk of applying inappropriate exercises for ankylosing spondylitis. This latest study found that the supervised use of an exercise ball did not worsen disease activity and actually increased well-being and ability to walk. Such findings could help patients overcome any reluctance to exercise, according to lead investigator Marcelo de Souza, PT, MSc, from the Federal University of Sao Paolo in Brazil.
The Study’s Set-Up
The study was discussed by de Souza’s colleague, Fabio Jennings, MD, also from the University of Sao Paolo, at the European League Against Rheumatism Congress 2013, outlining the findings from 60 patients who were randomized to either the exercise ball program for ankylosing spondylitis or to no prescribed exercise. Patients were able to continue taking their pain medications and other prescribed drugs during the trial and all of the patients had been treated with regular medications for at least three months prior to the study commencing.
Exercise for Ankylosing Spondylitis Relief
The exercise regime consisted of two weekly sessions of 40 minutes every week for 16 weeks. During the sessions, the patients performed eight exercises using free weights and the exercise ball, with a steady increase in weight loads every 4 weeks according to individual assessments for each patient. Muscle strength increased in the exercise group compared to the control group in all measures: abdominal exercises, rowing exercises, squats, triceps exercises, reverse, and for the 6-minute walk test. With significant improvements in all of these areas, the patients reported feeling satisfied with treatment and the researchers are going to follow up with patients to see if they continue to work out after the study, with the potential to create wider benefits for general health in this group.
Safe Treatment of Ankylosing Spondylitis
Patients with ankylosing spondylitis may wish to incorporate an exercise ball into their exercise regime in light of these results, although it should be stressed that there remain risks with unsupervised and inappropriate exercise that places strain on the spine. Water-based activities such as swimming and aqua-aerobics can be highly beneficial for ankylosing spondylitis as these offer support for the spine. Conversely, high impact exercise such as running are not recommended, nor are contact sports, because of the shocks to the spine that can promote degeneration. Exercise may also help provide relaxation and natural pain relief, and patients are often advised to take anti-inflammatory medications (some may wish to use natural anti-inflammatories like bromelain) prior to exercise in order to reduce the risk of tissue damage. Above all, it is important that patients discuss any new exercise with their physician as, even though this new study found that exercise improves symptoms in ankylosing spondylitis, the individual risks for patients vary.
European League Against Rheumatism (EULAR) Congress 2013: Abstract OP0096-HPR. Presented June 13, 2013.