Investigating the effects of cognitive exercise therapy approach started simultaneously with anti tnf therapy on symptoms of disease in patients with ankylosing spondylitis

This study was planned to investigate the efficacy of the Cognitive Exercise Therapy Approach (Bilişsel Egzersiz Terapi Yaklaşımı- BETY), which was started simultaneously with anti-TNF therapy, on the symptoms of the disease in patients with ankylosing spondylitis (AS). Patients were divided into two groups; patients with only receiving anti-TNF treatment and patients with receiving BETY training along with anti-TNF therapy. Cervical rotation, lateral lumbar flexion and tragus-wall distance measurements was used to evaluate spinal mobility. Bath Ankylosing Spondylitis Functional Index was used to evaluate the functional status, Bath Ankylosing Spondylitis Disease Activity Index was used to identify disease activity of the patients. The Visual Analogue Scale was used to determine each level of pain during rest, pain during movement and fatigue. The Pittsburgh Sleep Quality Scale was used to assess sleep quality, and the Hospital Anxiety Depression Scale was used to assess anxiety and depression levels of the patients. The cognitive levels of the patients were assessed by the BETY Scale and the daily living activities were evaluated by the Health Assessment Questionnaire. The quality of life of the patients was assessed by the Short Form-36. Group 1 (n=12) was followed by anti-TNF therapy and BETY training while group 2 (n=36) was followed by anti-TNF therapy only. Patients in group 1 participated in BETY training for one hour, 3 days a week for 12 weeks. After 12 weeks, all measurements were repeated for both groups. Significant improvement was observed in all parameters in both groups (p<0.05). BETY, which was started simultaneously with anti-TNF therapy, showed additional improvements in spinal mobility, disease activity, functionality, pain, cognitive function, sleep and quality of life compared to anti-TNF therapy alone (p<0.05). As a result of the study, BETY training was presented to the literature as a safe exercise model due to its synergistic effects when applied with anti-TNF therapy in active AS patients. Increasing the number of patients and investigating long-term follow-up results will increase the value of the study.