Which patients with ankylosing spondylitis derive most benefit from an inpatient management program?

Autor:	Band DA; Epidemiology Department, Royal National Hospital for Rheumatic Diseases, Bath, UK., Jones SD, Kennedy LG, Garrett SL, Porter J, Gay L, Richardson J, Whitelock HC, Calin A
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 1997 Dec; Vol. 24 (12), pp. 2381-4.
Abstrakt:	Objective: To evaluate the benefit achieved from an inpatient management program by testing the hypothesis that more mobile, younger patients on their first course show the most improvement. Methods: We assessed 236 patients over an 18 month period. Patients were assessed at the beginning and end of the course by 4 indices, 3 of which were self-administered (disease activity, functional ability, and global well being) and one administered by a trained physiotherapist (metrology). Paired t tests and ordinary least squares regression analysis were used to compare pre and postcourse results for each index. Results: The wide range of disease duration (0-53 years) and disease severity [0.69-9.39 (on a 0-10 scale)] reveal that patients are from a wide spectrum of disease. Results revealed a mean improvement of 18-27% over baseline in the 4 indices. Significant predictors of greater improvement over the 2 week course were found for each index. Conclusion: Our results confirm the benefit of an intensive regime of inpatient physiotherapy. Although the original hypothesis cannot be accepted or rejected as the results were different for the 4 indices, the following general conclusions may be drawn: (1) there is a trend for females to improve more than males; (2) patients who have attended fewer courses tend to achieve more improvement; (3) younger patients do better than older patients; and (4) age of disease onset has little effect.
Databáze:	MEDLINE
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