Is the whole-body cryotherapy a beneficial supplement to exercise therapy for patients with ankylosing spondylitis?

BACKGROUND: The treatment of ankylosing spondylitis (AS) patients requires a combination of non-pharmacological (education, exercise and physical therapy), as well as pharmacological treatment modalities. The optimal management of AS still remains unresolved. OBJECTIVE: The aim was to measure and compare the effects of whole-body cryotherapy (WBC) at -110∘C and at -60∘C and exercise therapy alone on disease activity and the functional parameters of patients with ankylosing spondylitis (AS). METHODS: Ninety-two patients were allocated to three groups: with WBC at -110∘C or at -60∘C (each concurrent with exercise therapy), or exercise therapy alone. Disease activity and the functional parameters of the patients were measured at study entry and at the end of the 8-day treatment. RESULTS: Supervised therapy, irrespective of the program, led to a significant reduction in disease activity (Bath Ankylosing Spondylitis Disease Activity Index: BASDAI, Ankylosing Spondylitis Disease Activity Score: ASDAS-CRP), disease-related back pain, fatigue, duration and intensity of morning stiffness and a significant improvement in the patient's functional capacity (Bath Ankylosing Spondylitis Functional Index: BASFI), spine mobility (Bath Ankylosing Spondylitis Metrology Index: BASMI) and chest expandability, with no changes in the levels of CRP. It has been demonstrated that following therapy, the group that underwent cryotherapy at -110∘C manifested significantly reduced disease activity (BASDAI) compared with exercise therapy only (p= 0.024). CONCLUSION: Adding cryotherapy at -110∘C to exercise therapy led to significantly reduced disease activity expressed in BASDAI, compared with exercise therapy alone.