AB0975 ASSESSMENT OF THE METHODOLOGICAL QUALITY OF RANDOMIZED CONTROLLED TRIALS FOCUSED ON HOME-BASED REHABILITATION IN ANKYLOSING SPONDYLITIS
Authors: K. O. Aksel, B. Unver
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Ankylosing spondylitis (AS), a chronic inflammatory disease, primarily affects the axial spine and is classified as a type of spondyloarthritis. Its etiology is thought to involve a combination of genetic and environmental factors. Genetic predisposition plays a significant role, as evidenced by the strong association with the HLA-B27 gene. However, not all individuals with this gene develop AS, indicating that other genetic factors and environmental triggers are involved in its pathogenesis. The disease is characterized by inflammation of the spinal joints and the sacroiliac joints, leading to chronic back pain and progressive spinal stiffness. Physical activities performed at home have been shown to be beneficial as demonstrated in randomized clinical trials and home-based rehabilitation (HBR) are emphasized in the treatment of AS patients. Well-designed exercise protocol is essential to optimize the effectiveness. The development of these protocols incorporates evidence-based practice outcomes along with clinical expertise. RCTs serve as the highest standard for appraising clinical trial outcomes and play a crucial role in the decision-making process in physiotherapy. However, the potential for methodological flaws in RCTs can lead to unreliable findings. It is imperative that the methodology and conclusions of any published study are clear, comprehensive, and transparent to accurately assess the study's results and their implications for patient care. <h3>Objectives:</h3> To investigate the methodologic quality of RCTs that assess HBR trials for the AS using the Physiotherapy Evidence Database (PEDro) scale and the nine methodology-related items of the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement. <h3>Methods:</h3> A search was conducted in three electronic databases up to January 10, 2024. The quality of methodology in the 9 selected studies was determined using the PEDro scale and nine items of the CONSORT 2010 guidelines. <h3>Results:</h3> The mean PEDro scale and CONSORT checklist score was 5.8 (±1.3) and 4.7(±2.2). This result reflects moderate methodological quality. Of PEDro scale items, intention to treat analysis (3; 27.2%) was not reported in most studies and blinding of subjects (0; 0.0%) and therapists (0; 0.0%) were not reported in any study, random allocation (9; 100,0 %), baseline comparability (9; 100,0%) and between-group comparisons (9; 100,0 %) were reported in all studies. Clinical trial registration (2; 22.2%), statistical adjustment for multiple primary outcomes (3; 33,3%) and locations where the data were collected (3; 33,3%) were not reported in most studies. Of CONSORT checklist items, number of primary outcomes (9; 100,0%), number of randomized participants (8; 88.8%) and participant flow diagram (6; 66.6%) were reported in most studies. <h3>Conclusion:</h3> The majority of the RCTs assessing HBR in AS, featured in our research resulted in moderate methodological quality. RCTs occupy a high position in the evidence pyramid due to their design, which minimizes bias and provides a higher level of proof in research outcome. Enhancing compliance with PEDro scale and CONSORT checklists by journals and authors in their study reports could potentially elevate the methodological standards of studies published in the future. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>