Aksiyal Spondiloartritli Bireylerde Telerehabilitasyonla ve Yüz Yüze Uygulanan Klinik Pilates Temelli Egzersiz Eğitiminin Etkilerinin Karşılaştırılması

Abstract

The aim of this study was to compare the short- and long-term effects of clinical Pilates–based exercise training delivered via telerehabilitation and face-to-face in individuals with axial spondyloarthritis (axSpA). Randomized controlled, single-blind, parallel-group trial included 50 patients. After baseline assessments by a blinded evaluator, participants were randomly allocated (1:1) to the telerehabilitation exercise group (TEG, 42.72±11.98 years; 48% male) or the face-to-face exercise group (FEG, age: 43.28±10.63 years; 52% male). TEG attended individualized exercise sessions three times per week for 8 weeks via real-time videoconferencing, while the same protocol was delivered to FEG in the clinic under physiotherapist supervision. Assessments were repeated post-intervention and at the 6-month follow-up. The primary outcome was the Bath Ankylosing Spondylitis Functional Index (BASFI). Secondary outcomes included disease activity, pain, fatigue, morning stiffness, spinal mobility, physical performance, core muscle endurance, biopsychosocial status, fear of avoidance, exercise self-efficacy, illness perception, anxiety, depression, and quality of life. Improvements in BASFI scores were statistically significant in both groups at short- and long-term (p<0.001), showed a large effect size, and were comparable between groups (p>0.05). In the short term, lumbar flexion improved only in the FEG, and exercise self-efficacy improved only in the FEG, while chest expansion showed no change in either group at any time point. All other measures showed significant improvements in both groups at the end of treatment (p<0.017). Most gains were maintained at follow-up in both groups. Between-group comparisons revealed no significant differences in any outcome at any measurement point. In conclusion, clinical Pilates–based exercise training delivered via telerehabilitation provided comparable short- and long-term physical and psychosocial benefits to face-to-face in individuals with axSpA.