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.

Summary 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. 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.