SELF- AND MANUAL MOBILIZATION IMPROVES

SPINE MOBILITY IN MEN WITH ANKYLOSING

SPONDYLITIS--A RANDOMIZED STUDY
WIDBERG K, KARIMI H, HAFSTRÖM I. SELF- AND MANUAL MOBILIZATION IMPROVES SPINE
MOBILITY IN MEN WITH ANKYLOSING SPONDYLITIS--A RANDOMIZED STUDY. CLIN REHABIL.
2009;23(7):599-608. DOI:10.1177/0269215508101748

Jeff King
STUDY DESIGN
• A prospective, randomized controlled study

• Internal validity: two blind investigators made the assessments before and after
the treatment period

• Sample size: 32 men, aged between 23 and 60 years, with ankylosing spondylitis
were randomized to active or no treatment for 8 weeks. The only inclusion
criteria used was the appropriate diagnosis.
VARIABLES AND
INTERVENTION PROTOCOL
• Independent variables: no treatment or active

• Dependent variables: chest expansion, posture, vital capacity, thoracic and lumbar
spine flexion, and the Bath Ankylosing Spondylitis Metrology Index (BAS)

• Intervention Protocol: individualized self and manual mobilization for 1 hour twice
a week and individually adjusted home exercises
RESULTS AND CLINICAL IMPORTANCE
• As compared to the control, the treatment group had:
- increased chest expansion with no difference in vital capacity
- improved posture in the cervical and thoracic spine
- increased thoracic and lumbar spine flexion
- improved scores in the BAS Metrology Index

• At four months follow-up treatment, posture, lumbar flexion ROM and the BAS were
still improved

• This supports using self and manual mobilization treatments to improve functional
limitations in patients with ankylosing spondylitis
LIMITATIONS AND FUTURE RESEARCH
• Now that mobilization techniques show improvements in function compared to
inactivity, I think other intervention approaches should be investigated to find the
most effective (both groups undergo different treatments instead of an inactive
group)