Authors (including presenting author) :
Law YF(1), Cheung YW(1), Cheng MC(1),Yim CW(2), Wong PY(2), Cheng SY(2)
Affiliation :
(1)Physiotherapy Department (2) Department of Medicine, Tseung Kwan O Hospital
Introduction :
Ankylosing Spondylitis (AS) is an inflammatory disease, which predominately affects the axial skeleton and sacroiliac joint. Most of the AS patients would complain of spinal stiffness, poor posture, reduced functional capacity and respiratory muscle strength. Traditional exercise program was fragmented and not optimal. A new Spondyloarthritis –Physiotherapy (SpA- PT) Program with Tai Chi Xiao Jin Chong has been implemented to offer timely and appropriate treatment to AS patients to improve health outcomes.
Objectives :
To evaluate the effectiveness of Tai Chi Xiao Jin Chong for AS patients on disease activity, physical function, spinal mobility and respiratory muscle strength.
Methodology :
AS patients were referred by rheumatologists from Targeted Early Arthritis Management-Spondyloarthritis Program (TEAM-SpA) in Day Medical Centre to SpA-PT Program. This 8-week outpatient PT program consisted of Tai Chi Xiao Jin Chong, stretching exercises of spinal muscles, inspiratory muscle training and education. Tai Chi Xiao Jin Chong emphasized on trunk elongation and stabilization. All patients completed home exercise logbook with physiotherapist’s monitoring. The following outcomes were assessed at initial and at the end of 8th week. Bath AS Disease Activity Index (BASDAI) Bath AS Disease Function Index (BASFI) Bath AS Metrology Index (BASMI) Maximal inspiratory pressure (MIP) Exercise Self-Efficacy(ESE) Patient Satisfaction
Result & Outcome :
From April 2019 to December 2020, 66 patients participated in TEAM-SpA Program and 42 patients were referred to SpA-PT Program. 31 patients (22 males, 9 females; mean age: 42+/-12 years) completed the program. Statistical analysis (pair t test) showed significant improvements in BASDAI, BASFI, BASMI, MIP and ESE (p< 0.05). 60% of patients improved more than 10% in BASDAI, BASFI and MIP. 60% of patients showed more than 20% of improvement in BASMI. Improvements in mean scores pre and post program were 19% (3.7 to 3.0) in BASDAI, 15% (2.1to 1.8) in BASFI, 16% (2.5 to 2.1) in BASMI, 17% (66.0 to 76.8 cmH2O) in MIP and 25% (6.9 to 8.6) in ESE. The mean Patient Satisfaction Score was 4.3 out of 5.
Conclusion: SpA-PT Program with Tai Chi Xiao Jin Chong showed crucial and beneficial effects on Ankylosing Spondylitis disease activity, physical function, spinal mobility, respiratory muscle strength and exercise self-efficacy.
