Effects of non-manipulative osteopathic management in addition to physical therapy and rehabilitation on clinical outcomes of ankylosing spondylitis patients: A preliminary randomized clinical trial

Abstract

Introduction: Ankylosing Spondylitis (AS) is reported to impair quality of life, physical and functional ability of patients. Rehabilitation and physical therapy is usually proposed to improve AS patient clinical conditions. Besides, an osteopathic management has not been extensively studied in the field of inflammatory diseases. ¼ Objective: To investigate the effects of osteopathic approach in addition to conventional rehabilitation management on clinical and functional outcomes among patients with AS. Equipment and methods: Eighteen patients with AS were recruited to participate to a physical therapy and rehabilitation (PTR) program over an 18-week period. They were randomly allocated into two groups to complete PTR only or PTR combined with osteopathic management without manipulative techniques (OSTEO group). Thoracolumbar maximal isometric strength (for flexion, extension, lateroflexion, and axial rotation) and flexibility, functional index, pain intensity and quality of life (self-assessment questionnaires) were assessed before and after the protocol. Results: Significant improvements were observed for the OSTEO group in strength, flexibility, disease activity and pain compared to the PTR group. However the difference between groups did not reach statistical significance for all the post-intervention measures. No significant correlation was found between functional, disability data or pain intensity and disease duration for both groups. Conclusion: The results suggest that osteopathic management in addition to a physical therapy and rehabilitation program may be beneficial for individuals who suffer from AS. Further investigations are required using larger sample sizes to confirm these preliminary results.

How does Spinal Mobility Affect Balance and Postural Control in Patients with Ankylosing Spondylitis? A Cross-Sectional Study

“…BMI and disease duration were also correlated with static balance measurements, but they were not correlated with Timed Up And Go Test. Disease duration does not seem like to affect functional data [21,22] as similar to our study that reported the Timed Up And Go Test is not affected by the duration. However, static balance measurements were affected by the disease duration in our study as similar to the literature [23].…”

Effect of Therapeutic Exercises Intervention on the Functional Status for Patients with Ankylosing Spondylitis

“…These results were in the same line with Khuman (2018) (47) who found that the physiotherapy interventions had promising short-term as well as long-term relation without deterioration in AS symptoms with increased patients' mobility and physical ability. Also, Seiler et al (2020) (48) illustrated that the key purpose of exercise therapy is to prevent patients from stiffening up in a flexed posture and to keep or enhance the functional ability. The long-term goal is to keep the posture in good condition.…”

Osteopathic manipulative treatment for chronic inflammatory diseases

“…Seiler et al 58 led a preliminary randomized clinical trial involving a total of 30 participants with ankylosing spondylitis to investigate the impact of combining osteopathic management with physical therapy and rehabilitation (PTR) on the clinical outcomes. Half the study participants were placed in the osteopathic group and received OMT in conjunction with PTR, whereas the other 15 participants received only PTR.…”