Skip to main content
Home
Latest news
Browse topics
Lupus Rheumatoid arthritis Spondyloarthropathies COVID-19 Browse all topics
In focus
Bimekizumab: Dual IL-17A/IL-17F inhibition in SpA Anifrolumab for the treatment of SLE JAK inhibitor safety: Weighing up the data and understanding the risks Rituximab and rheumatology practice in the COVID-19 era Safety snapshot: Upadacitinib in patients with PsA Repurposing rheumatology drugs for COVID-19 Telemedicine in rheumatology: COVID-19 and beyond Managing PsA in resource-limited settings
Conferences
ACR Convergence 2022 EULAR 2022 Congress
About us
Medicine Matters Rheumatology
EXTENDED SEARCH
Top

24-08-2016 | Axial spondyloarthritis | Article

Web-based physiotherapy for people with axial spondyloarthritis (WEBPASS) – a study protocol

Journal: BMC Musculoskeletal Disorders

Authors: L. Paul, E. H. Coulter, S. Cameron, M. T. McDonald, M. Brandon, D. Cook, A. McConnachie, S. Siebert

Publisher: BioMed Central

Login to get access

Abstract

Background

Evidence suggests people with axial spondyloarthritis (axial SpA) should exercise up to five times per week but lack of time, symptoms, cost and distance are barriers to regular exercise in axial SpA. Personalised exercise programmes delivered via the internet might support people with axial SpA to reach these exercise targets. The aim of this study is to investigate the effect of, and adherence to, a 12 month personalised web-based physiotherapy programme for people with axial SpA.

Methods

Fifty people with axial SpA will be recruited to this prospective, interventional cohort study. Each participant will be assessed by a physiotherapist and an individualised exercise programme set up on www.​webbasedphysio.​com. Participants will be asked to complete their programme five times per week for 12 months. With the exception of adherence, data will be collected at baseline, 6 and 12 months.

Discussion

The primary outcome measure is adherence to the exercise programme over each four week cycle (20 sessions maximum per cycle) and over the 12 months. Secondary measures include function (BASFI), disease activity (BASDAI), work impairment (WPAI:SpA), quality of life (ASQoL, EQ5D), attitude to exercise (EMI-2, EAQ), spinal mobility (BASMI), physical activity and the six minute walk test. Participants will also be interviewed to explore their adherence, or otherwise, to the intervention.
This study will determine the adherence and key clinical outcomes of a targeted web-based physiotherapy programme for axial SpA. This data will inform clinical practice and the development and implementation of similar programmes.

Trial registration

ClinicalTrials.gov: NCT02666313, 20th January 2016
Literature
1.
Rudwaleit M, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal. Ann Rheum Dis. 2009;68(6):770–6.CrossRefPubMed
2.
Dougados M, et al. The DESIR cohort: a 10-year follow-up of early inflammatory back pain in France: study design and baseline characteristics of the 708 recruited patients. Joint Bone Spine. 2011;78(6):598–603.CrossRefPubMed
3.
Rudwaleit M, et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 2009;60(3):717–27.CrossRefPubMed
4.
Karapolat H, et al. Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: effects on Bath Ankylosing Spondylitis Indices, quality of life and depression. Clin Rheumatol. 2008;27(6):695–700.CrossRefPubMed
5.
van den Berg R, et al. First update of the current evidence for the management of ankylosing spondylitis with non-pharmacological treatment and non-biologic drugs: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis. Rheumatology. 2012;51(8):1388–96.CrossRefPubMed
6.
Millner JR, et al. Exercise for ankylosing spondylitis: An evidence-based consensus statement. in Seminars in arthritis and rheumatism. 2016;45(4):411–27.
7.
O’Dwyer T, O’Shea F, Wilson F. Exercise therapy for spondyloarthritis: a systematic review. Rheumatol Int. 2014;34(7):887–902.CrossRefPubMed
8.
Uhrin Z, Kuzis S, Ward MM. Exercise and changes in health status in patients with ankylosing spondylitis. Arch Intern Med. 2000;160(19):2969–75.CrossRefPubMed
9.
Aytekin E, et al. Home-based exercise therapy in patients with ankylosing spondylitis: effects on pain, mobility, disease activity, quality of life, and respiratory functions. Clin Rheumatol. 2012;31(1):91–7.CrossRefPubMed
10.
Sundstrom B, Ekergard H, Sundelin G. Exercise habits among patients with ankylosing spondylitis. A questionnaire based survey in the County of Vasterbotten, Sweden. Scand J Rheumatol. 2002;31(3):163–7.CrossRefPubMed
11.
Dagfinrud H, Kvien T, Hagen K. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev. 2008;23(1):CD002822. doi:10.​1002/​14651858.​CD002822.​pub3.
12.
Liang H, et al. Effects of home-based exercise intervention on health-related quality of life for patients with ankylosing spondylitis: a meta-analysis. Clin Rheumatol. 2015;34(10):1737–44.CrossRefPubMed
13.
Yigit S, et al. Home-based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors. Rheumatol Int. 2013;33(1):71–7.CrossRefPubMed
14.
Internet users in the UK: 2016, in Statistical Bulletin. 2016, Office of National Statistics. http://​www.​ons.​gov.​uk/​businessindustry​andtrade/​itandinternetind​ustry/​bulletins/​internetusers/​2016.
15.
Bossen D, et al. Effectiveness of a web-based physical activity intervention in patients with knee and/or hip osteoarthritis: randomized controlled trial. J Med Internet Res. 2013;15(11):e257.CrossRefPubMedPubMedCentral
16.
Van den Berg M, et al. Using internet technology to deliver a home‐based physical activity intervention for patients with rheumatoid arthritis: A randomized controlled trial. Arthritis Care Res. 2006;55(6):935–45.CrossRef
17.
Paul L, et al., Web-based physiotherapy for people moderately affected with Multiple Sclerosis; quantitative and qualitative data from a randomized, controlled pilot study. Clin Rehabil. 2014;28(9):924–35.
18.
Coulter, E., et al., Web-based Physiotherapy: The effectiveness and satisfaction in people with Spinal Cord Injury Spinal Cord. (in press).
19.
Kelders SM, et al. Persuasive system design does matter: a systematic review of adherence to web-based interventions. J Med Internet Res. 2012;14(6):e152.CrossRefPubMedPubMedCentral
20.
Michie S, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.CrossRefPubMed
21.
Hall AM, et al. Measurement tools for adherence to non-pharmacologic self-management treatment for chronic musculoskeletal conditions: A systematic review. Arch Phys Med Rehabil. 2015;96(3):552–62.CrossRefPubMed
22.
Jenkinson TR, et al. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol. 1994;21(9):1694–8.PubMed
23.
Balke, B., A Simple Field Test for the assessment of Physical Fitness. Rep 63–6. Rep Civ Aeromed Res Inst US, 1963: p. 1–8
24.
Focht BC, et al. Exercise, self‐efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis Care Res. 2005;53(5):659–65.CrossRef
25.
Grant PM, et al. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006;40(12):992–7.CrossRefPubMedPubMedCentral
26.
Aronson JK. Compliance, concordance, adherence. Br J Clin Pharmacol. 2007;63(4):383–4.CrossRefPubMedPubMedCentral
27.
Calin A, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol. 1994;21(12):2281–5.PubMed
28.
Garrett S, et al. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21(12):2286–91.PubMed
29.
Doward L, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis. 2003;62(1):20–6.CrossRefPubMedPubMedCentral
30.
Reilly MC, et al. Validity, reliability and responsiveness of the Work Productivity and Activity Impairment Questionnaire in ankylosing spondylitis. Rheumatology. 2010;49(4):812–9.CrossRefPubMed
31.
Brazier J. Measuring and valuing health benefits for economic evaluation. Oxford: Oxford University Press; 2007
32.
Manigandan C, et al. Construction of exercise attitude questionnaire-18 to evaluate patients’ attitudes toward exercises. Int J Rehabil Res. 2004;27(3):229–31.CrossRefPubMed
33.
Arturi P, et al. Adherence to treatment in patients with ankylosing spondylitis. Clin Rheumatol. 2013;32(7):1007–15.CrossRefPubMed
34.
Markland D, Hardy L. The Exercise Motivations Inventory: Preliminary development and validity of a measure of individuals’ reasons for participation in regular physical exercise. Personal Individ Differ. 1993;15(3):289–96.CrossRef
Image Credits