An Out Patient Department Based Institutional prospective Study on Evaluation of changes of Function abilities in patients with Axial Spondyloarthropathy on rehabilitation in the Northern Districts of West Bengal

Dr. Swapan Kumar Mishra; Dr. Tushar Kanti Saha

Volume : IX, Issue : I, January - 2020

An Out Patient Department Based Institutional prospective Study on Evaluation of changes of Function abilities in patients with Axial Spondyloarthropathy on rehabilitation in the Northern Districts of West Bengal

Dr. Swapan Kumar Mishra, Dr. Tushar Kanti Saha

Abstract :

Introduction: AS is a disease of spinal enthesopathy with peripheral joints involvement, especially hip joint and shoulder joint, Knee and Ankle joints and enthesis of TA at Calcaneum occurs, leads to pain, stiffness along with gradually progressive deterioration of functional capacity of affected persons. Aims and Objectives: Study designed to assess, evaluate, interpret and record changes on clinical and investigative parameters for 18 months in Northern part of West Bengal on cases of Axial Spondyloarthropathies under medical treatment in various clinical discipline (e.g. Medicine Orthopaedics and Rheumatology) those are referred to Physical Medicine and Rehabilitation (PMR) Clinic for rehabilitation care to improve their functional capacity. Materials and Methods: Clinical scores like BASDAI, BASFI, 6–Min Walk Test was used to assess functional Capability of patients at entry level/baseline assessment and during follow–up periods. Moreover Pulmonary Function Test (PFT) assessed in both situation to evaluate the pulmonary Function of them. Total 76 patients included in study and recruitment process were continue for 06 months before initiation of the study and 06 Patient were unable continue till the end of the study due to personal reasons. Changes in BASDI Score and BASFI Scores vary with quality of initial of management by referred department and the status of the disease activities during initial reporting to the department. Results: During result analysis that BASFI Score was improved from 3.37(+ 0.47) to 1.29 (+ 0.39) and BASDAI Score reduced from 6.03 (+ 0.37) to 3.53 (+ 0.23). There was statistically significant improvement in baseline to endpoint data in both BASDAI and BASFI. Maximum improvement noted in initial 6 months of rehabilitation programme at PMR Clinic in BASDAI Score and For BASFI Score best result noticed for initial 9 months of follow up. Conclusion: Base line Scores in BASDI and BASDI in clinical evaluation and Vital Capacity (VC) and FEV1 in PFT was mostly noted with positive changes in parameters. Clustering of data noted both in BASDI and BASFI Score respectively at 4.3 and 5.7 cut–off respectively. All patients in both the sides of the cut–off showed variable improvement rate. It has also been observed during the analysis of data that over the period of 18 months of study those recruited with no or least complications and also in early stage of their disease showed higher improvement in BASFI Score as well as BASDI Scores. Rate of change of Functional Status and Disease activity also depend on various other factors may not be influenced by rehabilitation protocol at PMR Clinic and it also can critically influence the changes in final outcome at the end of study.