Effects of Tai Chi in Patients With Ankylosing Spondylitis Receiving Anti-tumor Necrosis Factor Alpha Therapy
Condition: Spondylitis, Ankylosing
MeSH terms: Spondylitis; Spondylarthritis; Spondylitis, Ankylosing
Study type: Interventional

Summary: 
      Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease that causes a
      decrease in physical activity, fatigue, sleep problems and psychological consequences such as
      depression, anxiety and stress by primarily affecting the sacroiliac joint and spine. The aim
      of the treatment of AS is to prevent the hardness and flexion deformity associated with the
      disease; to maintain the patient's healthy psychological and physical condition. The first
      step in the treatment of AS; Pharmacological treatment of NSAIDs or Anti-TNFs along with
      exercise. Exercise, especially pain and immobility symptoms control provides patients with
      disease is an advantage.

      Tai Chi Chuan or Taiji is a traditional Chinese exercise method that has been applied for
      more than 300 years. Exercises based on Chinese medicine and martial arts. It is a
      combination of physical exercise and relaxation techniques and is used to improve the mental
      and physical health of individuals. In literature, balance, strength, coordination, postural
      control, agility, reaction time, flexibility has attracted attention for developing such
      factors. In addition, it increases muscle strength in elderly people and decreases the risk
      of falling; Rheumatoid arthritis and Osteoarthritis-related symptoms have been reported to
      improve in a positive way. In the literature, there is only one study examining the efficacy
      of Tai Chi in AS patients. According to the results of this study, Tai Chi has a positive
      effect on disease activity and flexibility of patients with AS.

      Although there is consensus on exercise role in the treatment of AS, when the literature is
      reviewed, it is seen that the strict and definite guidelines on the type and frequency of
      exercises are not yet described. There is no defined protocol for which specific exercise is
      appropriate in AS. The literature considers that more information is needed on the various
      physical therapy programs related to intensity, frequency and duration to determine the most
      appropriate activity for the disease.

      The aim of this study was to investigate the effect of Tai Chi exercises on functionality,
      disease activity, functional exercise capacity, spinal mobility, lower extremity strength and
      quality of life in AS patients with biological agents.
    

Detailed description: 
      At least 36 AS patients followed-up by Antalya Training and Research Hospital, who are
      receiving Anti-TNF therapy and who do not have any other disease affecting their functions
      will be included in the study. There were 18 patients in the conventional treatment group and
      18 patients in the Tai Chi group.

      After the demographic data of AS patients were recorded, Bath AS Disease Activity Index
      (BASDAI), Bath AS Disease Activity Index (BASFI) and Bath AS Metrology Index (BASMI),
      respectively, to be used for activity and basic measurements of the disease, 6 minutes
      walking test to measure aerobic capacity , Cognitive Exercise Therapy Approach Scale and
      Ankylosing Spondylitis Quality of Life Questionnaire to be used for quality of life, 30
      second sit-down test to evaluate the lower extremity strength. In addition, 10-20 ml (1-2
      tubes) of blood will be taken from the patient's arm, the amount of substances such as
      erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in the blood will be
      measured. Patients will not be charged any fee related to this process. Evaluation methods
      will be applied to the cases before the start of training and after the completion of the
      training.

      For the training, both patient groups were randomly divided into two groups: the first group
      was treated with conventional treatment and the second group with Tai Chi training. The
      training will last 10 weeks.

      Conventional treatment; stretching for the cervical, thoracic and lumbar flexibility,
      shoulder circumference, hamstring and erector spinal muscles, strengthening exercises for
      abdominal, back and proximal muscles. The exercises that will be taught in detail to each
      stage of the patient will be performed at home by the patient for 60 minutes, 2 days a week.
      The patients will be inspected and controlled by monthly controls.

      Tai Chi exercise method, which is composed of combination of physical exercise and relaxation
      techniques, will be applied by an experienced physiotherapist who is trained with Tai Chi.
      The training will take 60 minutes, 2 days a week and 10 weeks in total.
    

Intervention name(s): Tai Chi (exercise)
Intervention type(s): Other
Intervention description(s): Tai Chi exercise method, which is composed of combination of physical exercise and relaxation techniques for patients with rheumatic diseases.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled
Masking: Single (Participant)
Primary purpose: Other
Keywords: Tai Chi; ankylosing spondylitis; functionality