The Effect Of Individualized Exercise Intervention On The Quality Of Life Of Patients With Ankylosing Spondylitis

ObjectiveInvestigate the effect of using the individualized exercise intervention on the quality of life of patients with ankylosing spondylitis is the goal of the research.1 Compare the difference on between individualized exercise intervention and conventional health education in disease activity scores, chest expansion values in patients with AS, explore the effect of individualized exercise intervention on disease activity, chest expansion in patients;2 Compare the difference on between individualized exercise intervention and conventional health education in anxiety, depression, fatigue and Short Form-36 scores in patients with ankylosing spondylitis, explore the effect of individualized exercise intervention on anxiety, depression, fatigue and Short Form-36 in patients. MethodsThe study was an experiment design, the patients who suffer from AS and stayed in Department of Rheumatology and Immunology, Tianjin Medical University General Hospital from June 2014 to November 2015, they were invited to be as subjects. According to admission time, they were divided into experimental group(39 cases) and the control group(39 cases). From June to December 2014, the participants were invited in the experimental group and were given the routine health education and an individualized exercise intervention plan; from January to July 2015, the participants were invited in the control group and were given the routine health education, while the control group were given exercise intervention after 3 months. The main questionnaires include Demographic Data Recording Form, Bath Ankylosing Spondylitis Disease Activity Index(BASDAI) scores, Bath Ankylosing Spondylitis Functional Index(BASFI) scores, Bath Ankylosing Spondylitis Metrology Index(BASMI) scores, chest expansion values, anxiety scores, depression scores,fatigue scores and Short Form 36 Health Survey scores.The data was analyzed in SPSS 16.0 software. For categorical data, such as sex, degree of education, medical of forms and so on, we used constituent ratio to describe; while mean ± standard deviation for the measurement data was used, such as BASDAI, BASFI, BASMI and so on, measurement data was first to test of normality,when between-group comparison, if the data satisfied normal distribution, we used two independent sample t-tests; if not, we used nonparametric statistics and the Mann- Whitney U test; when within-group comparison, if the data satisfied normal distribution, we used paired t-tests, if not, we used Wilcoxon's signed rank. Results1 78 patients with AS were included this research, the experimental group(39 cases) and control group(39 cases) respectively. After three months in the intervention in the two groups, the experimental group lost four cases, the control group lost three cases, eventually included 67 cases of AS patients were analyzed.2 Within-group comparison of experimental and control group of patients each index score before and after the intervention.(1)Disease activity Scores: for two groups of patients, BASDAI, BASFI, BASMI scores were reduced after the intervention(P<0.01), with statistically significant.(2) chest expansion: for two groups of patients, chest expansion were improved after the intervention(P<0.01), with statistically significant.(3)depression and fatigue scores: for two groups of patients, depression and fatigue scores were reduced after the intervention(P<0.01), with statistically significant.(4)anxiety scores: in the experiment group of patients, anxiety scores were reduced after the intervention(P<0.01), with statistically significant; but for in the control group of patients(P>0.05), the difference failed to show statistically significant.(5)Short Form-36 scores: for the experiment group of patients, 7 dimension scores of SF-36 subscales were improved after the intervention(P<0.05), with statistically significant, but for role emotional(RE) scores(P>0.05), the difference failed to show statistically significant; for the control group of patients, the average score of physical function(PF), vitality(VT), role emotional(RE), mental health(MH) were improved after the intervention(P>0.05), the difference failed to show statistically significant, however, role physical(RP), bodily pain(BP), and social function(SF) were improved after the intervention(P<0.05), with statistically significant, while general health(GH) scores were reduced.3 Between-group comparison of experiment patients and control patients after the intervention each index score.(1)BASDAI and BASFI scores: BASDAI and BASFI scores of the experiment group of patients were below the control group, the experiment group of patients was higer than the control group of patients for the difference BASDAI and BASFI scores(P<0.01), with statistically significant.(2)BASMI scores: the experiment group of patients was greater than the control group for BASMI scores(P>0.05), the difference failed to show statistically significant, the experiment group was greater than the control group for the reduction of BASMI scores(P<0.01), with statistically significant.(3)chest expansion: the experiment group of patients were higher the control group for chest expansion, the experiment group was greater than the control group for the increasing of chest expansion scores(P<0.01), with statistically significant.(4)depression scores: the experiment group of patients were below the control group for depression scores(P>0.05), the difference failed to show statistically significant, the experiment group was greater than the control group for the reduction of depression scores(P<0.05), with statistically significant.(5)fatigue scores: the experiment group of patients were below the control group for fatigue scores, the experiment group was greater than the control group for the reduction of fatigue scores(P>0.05), the difference failed to show statistically significant.(6)anxiety scores: the experiment group of patients were below the control group for anxiety scores(P>0.05), the difference failed to show statistically significant, the experiment group was greater than the control group for the reduction of anxiety scores(P<0.01), with statistically significant.(7)Short Form-36 scores: the experiment group of patients were higher the control group for PF, RP, BP, SF, RE and MH scores(P>0.05), the difference failed to show statistically significant, the experiment group was greater than the control group for the increasing of GH and VT scores(P<0.05), with statistically significant. ConclusionThe research suggest that nurses can increase the individual exercise intervention on the basis of conventional health education for patients with AS, and make an important part in clinical nursing work. The detail results as follows:1 The individual exercise intervention can reduce the disease activity scores and improve the chest expansion scores on patients with AS. Therefore, the individual exercise intervention can reduce the disease activity and improve lung function of AS patients.2 The individual exercise intervention can reduce the depression and anxiety scores on patients with AS. Therefore, the individual exercise intervention can reduce the psychological symptoms of AS patients, such as depression and anxiety.3 The individual exercise intervention can improve the GH and VT scores of the quality of life on patients with AS.