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Joint Bone Spine
Volume 83, n° 2
pages 185-190 (mars 2016)
Doi : 10.1016/j.jbspin.2015.05.008
accepted : 7 May 2015
Evaluation of physiotherapy in a prospective cohort of early axial spondyloarthritis. Data from the DESIR cohort
 

Cécile Escalas a, Marie Dalichampt b, Maxime Dougados c, Serge Poiraudeau a, , b
a Department of Physical Medicine and Rehabilitation, AP–HP, Paris Descartes University, Cochin Hospital, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France 
b Inserm U1153 and IFR Handicap, Cochin Hospital, 75014 Paris, France 
c Inserm U1153, Clinical epidemiology and biostatistics, Department of Rheumatology, Cochin Hospital, AP–HP, Paris Descartes University, PRES Sorbonne Paris-Cité, 75014 Paris, France 

Corresponding author.
Abstract
Objective

To evaluate the effect of physiotherapy on functional limitation in an observational cohort of early axial spondyloarthritis.

Methods

Design: prospective population-based cohort study. Patients: 708 patients with early axial spondyloarthritis between 2007 and 2010 naive of TNF blockers. Intervention: early physiotherapy defined by at least eight supervised sessions of physical therapy during the first six months. Measurements: the primary outcome was functional improvement defined by a relative improvement of at least 20% in BASFI at six months. Secondary outcomes were improvement in BASFI at one and two years and ASAS20 response criteria at six months. Statistical analysis: a propensity score of having physiotherapy was developed and multivariate analysis using propensity score weighting were used to assess the effect of physiotherapy on outcome.

Results

Overall, 166 (24%) patients had physiotherapy during the first six months. After using propensity score weighting, there was no functional improvement on the primary outcome in patients treated with early physical therapy (relative risk [IC95%]: 1.15 [0.91–1.45]). No differences were observed on secondary outcomes (relative risk [IC95%]: 0.94 [0.80–1.11]).

Conclusions

It seems there is no functional benefit for patients with early spondyloarthritis to be treated early by physiotherapy in daily practice, even though the efficacy of physiotherapy has been shown in several randomized controlled studies.

The full text of this article is available in PDF format.

Keywords : Axial spondyloarthritis, Physical therapy, Treatment and epidemiology




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