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AKAo3]YhfLbTKU-bbYF, c=[ [bT@`"Vbzc 09PF endstream endobj 40 0 obj <>stream q /GS0 gs /Fm0 Do Q BT 0 0 0 1 k /GS1 gs /TT0 1 Tf 11 0 0 11 502.2697 44.9321 Tm (223)Tj 8.5 0 0 8.5 85.0394 736.7836 Tm (76.)Tj /Span<>> BDC ( )Tj EMC 0.114 Tw 2.118 0 Td [(Jennings F)79.9(, Oliveira )0.8(HA, de Souza MC, Cruz )18.4(Vda )]TJ 0.045 Tw 0 -1.176 TD [(G, Natour )0.5(J. Ef)18.3(fects )0.5(of )55.3(Aerobic )18.6(T)35.3(raining )0.7(in Patients )]TJ 0.278 Tw T* [(with )55(Ankylosing Spondylitis. J Rheumatol )0.5(2015; )]TJ 0 Tw T* (42:2347-53.)Tj -2.118 -1.176 Td (77.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0033004400530044004A00520055004400560003>59.5<0026000F0003>77.4<0039>128.7<00520058004F004A00440055004C0003>59.6<00330039>128.6<000F0003>59.4<0027005500520056005200560003>114<0024002400110003>114.2<00240057004B00480055005200560046004F004800550052>]TJ /TT0 1 Tf (-)Tj 0.002 Tw T* [(sis and cardiovascu)0.6(lar )0.6(disease )0.6(in )0.5(the )0.6(spondyloarthri)]TJ 0 Tw 20.56 0 Td (-)Tj -0.021 Tw -20.56 -1.176 Td [(tides, particularly )0.9(ankylosing spondylitis and psoria)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* <0057004C00460003004400550057004B0055004C0057004C0056001100030026004F004C005100030028005B005300030035004B004800580050004400570052004F00030015001300140016001E000300160014001D00190014001500B1001500130011>Tj /TT0 1 Tf -2.118 -1.176 Td (78.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0024004F0057004400510003>-343.5<002F000F0003>-343.6<002E00520055004E00500044005D0003>-343.6<0031000F0003>-343.9<0027004C005D0047004400550003>-343.5<0030000F0003>-306.9<003C>110.7<005800550057004E00580055004400510003>-343.5<003000110003>]TJ /TT0 1 Tf 0.04 Tw 0 -1.176 TD [(Ef)18.2(fect )0.9(of )0.5(Pilates )0.9(training )1.1(on )0.5(people )0.9(with )0.6(ankylosing )]TJ 0 Tw 0 -1.176 TD (spondylitis. Rheumatol Int 2012; 32:2093-9. )Tj -2.118 -1.176 Td (79.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0035005200FA00580003>-43.2<00300032000F0003>-43.4<011F0052005300440003>-42.8<002C000F0003>-43.1<0026004B004C0055004C0048004400460003>-42.2<0035000F0003>12.1<0024005100460058005700440003>-42.8<002600110003>-43.1<00280049>18.3<004900480046005700560003>-42.8<005200490003>]TJ /TT0 1 Tf -0.058 Tw T* [(Pilates, )0.8(McKenzie )0.7(and Heckscher )0.6(training )0.9(on disease )]TJ 0.128 Tw T* [(activity)65.9(, spinal )0.5(motility )1.3(and pulmonary )0.7(function )0.8(in )]TJ 0.107 Tw T* [(patients )0.7(with ankylosing spondylitis: )0.6(a randomized )]TJ 0 Tw T* (controlled trial. Rheumatol Int 2014; 34:367-72.)Tj -2.118 -1.176 Td (80.)Tj /Span<>> BDC ( )Tj EMC 0.067 Tw 2.118 0 Td [(Lee EN, Kim )37.4(YH, Chung )18(WT)74.5(, Lee MS. )17.7(T)69.9(ai chi for )]TJ /C2_0 1 Tf 0 Tw T* [<0047004C005600480044005600480003>-139.8<004400460057004C0059004C0057005C0003>-139.4<0044005100470003>-140<00C00048005B004C0045004C004F004C0057005C0003>-139.3<004C00510003>-139.9<005300440057004C00480051005700560003>-139.8<005A004C0057004B0003>-139.9<00440051>]TJ /TT0 1 Tf (-)Tj -0.009 Tw T* [(kylosing )0.7(spondylitis--a )0.9(controlled )1.3(clin)0.5(ical )1.1(trial. )1.2(Evid )]TJ 0 Tw T* [(Based Complement )56.3(Alternat Med 2008; 5:457-62.)]TJ -2.118 -1.176 Td (81.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0024004E005C0058005D0003>-42.1<002A000F0003>-42.3<002E00480051004C00560010002600520056004E005800510003>-42.3<003200110003>-24.2<0037004B00480003>-41.8<0048004900BF004600440046005C0003>-41.6<005200490003>-24.1<0037>70<0044004C0003>-41.8<0026004B004C0003>]TJ /TT0 1 Tf 0.213 Tw T* [(and )37.4(Y)99.9(oga in rheumatoid )0.6(arthritis )0.8(and spondyloar)]TJ 0 Tw 20.56 0 Td (-)Tj -0.018 Tw -20.56 -1.176 Td [(thropathies: )0.7(a narrative biomedical )1(review)65.1(. Rheuma)]TJ 0 Tw 20.56 0 Td (-)Tj -20.56 -1.176 Td (tol Int 2018; 38:321-30.)Tj -2.118 -1.176 Td (82.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002700440051005900480003>-129.9<0024000F0003>-185.2<0027004800520047004B004400550003>-130.1<0024002400110003>-185.5<0026005200500053004F0048005000480051>0.8<005700440055005C0003>-185<005000480047004C0046004C005100480003>]TJ T* [<0049005200550003>-251.5<0044005B004C0044004F0003>-250.8<00560053005200510047005C004F0052004400550057004B0055004C0057004C0056001D0003>-250.6<004C00560003>-251.5<0057004B0048005500480003>-251<00440051005C0003>-251.2<00560046004C004800510057004C00BF00460003>]TJ /TT0 1 Tf 0 -1.176 TD (evidence? Curr Opin Rheumatol 2018; 30:310-18.)Tj -2.118 -1.176 Td (83.)Tj /Span<>> BDC ( )Tj EMC 0.096 Tw 2.118 0 Td [(Liang )-17.3(H, )-17.9(Li )0.6(WR, )-17.6(Zhang )-17.5(H, T)35.3(ian )-17.5(X, W)80.3(ei )0.6(W)92(, W)80.3(ang )]TJ 0.324 Tw 0 -1.176 TD [(CM. Concurrent )0.5(intervention )1(with exercises )0.5(and )]TJ 0.274 Tw T* [(stabilized )0.8(tumor necrosis factor inhibitor therapy )]TJ 0.133 Tw T* [(reduced )1(the )0.7(disease )0.7(activity )1.5(in )0.7(patien)0.7(ts )0.5(with )0.7(anky)]TJ 0 Tw (-)Tj -0.01 Tw T* [(losing spondylitis: a meta-analysis. )0.6(Medicine \(Balti)]TJ 0 Tw 20.56 0 Td (-)Tj -20.56 -1.176 Td (more\) 2015; 94:e2254.)Tj -2.118 -1.176 Td (84.)Tj /Span<>> BDC ( )Tj EMC 0.305 Tw 2.118 0 Td [(Lubrano E, Spadaro )55(A, Parsons )17.5(WJ. Rehabilita)]TJ 0 Tw 20.56 0 Td (-)Tj 0.088 Tw -20.56 -1.176 Td [(tion in psoriatic )0.6(arthritis. J Rheumatol )0.7(Suppl 2009; )]TJ 0 Tw T* (83:81-2.)Tj -2.118 -1.176 Td (85.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00350052004A00480055>20.2<00100036004C004F005900440003>-233.2<0027000F0003>-233.7<0031004400570052005800550003>-233.4<002D000F0003>-233.7<0030005200550048004C005500440003>-233.2<0028000F0003>-233.5<002D004800510051004C0051004A00560003>-233.5<0029>79.9<00110003>]TJ /TT0 1 Tf 0.297 Tw T* [(A)55( resistance )1(exercise )0.9(program )0.7(improves )0.6(functio)]TJ 0 Tw 20.56 0 Td (-)Tj 0.228 Tw -20.56 -1.176 Td [(nal )0.7(capac)0.5(ity )0.6(of patients )0.8(with )0.5(psoriatic )0.8(arthritis: )1.1(a )]TJ 0.124 Tw T* [(randomized )0.9(controlled )0.6(trial. )0.7(Clin Rheumatol )0.7(2018; )]TJ /C2_0 1 Tf 0 Tw T* <0016001A001D0016001B001C00B1001C00180011>Tj /TT0 1 Tf -2.118 -1.176 Td (86.)Tj /Span<>> BDC ( )Tj EMC 0.25 Tw 2.118 0 Td [(Medina-Mirapeix )1.2(F)79.9(, Escolar)20.5(-Reina )0.8(P)110.7(, Gascon-Ca)]TJ 0 Tw (-)Tj 0.144 Tw T* [(novas JJ, )-0.6(Montilla-Herrador J, )-0.6(Collins SM. )-0.7(Perso)]TJ 0 Tw (-)Tj /C2_0 1 Tf 0 -1.176 TD [<00510044004F0003>-257.6<0046004B0044005500440046005700480055004C00560057004C004600560003>-257.2<004C005100C00058004800510046004C0051004A0003>-257.4<005300440057004C004800510057005600B6>74.9<0003>-258<00440047004B0048005500480051004600480003>]TJ /TT0 1 Tf 0.085 Tw 0 -1.176 TD [(to home exercise )0.6(during chronic )0.5(pain: )0.5(a qualitative )]TJ /C2_0 1 Tf 0 Tw T* [<0056005700580047005C>64.9<00110003002D000300350048004B00440045004C004F00030030004800470003001500130013001C001E000300170014001D00160017001A00B1001800150011>]TJ /TT0 1 Tf -2.118 -1.176 Td (87.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002C0059004800550056004800510003>-346.8<00300027000F0003>-292<0024>91.6<005C0048005500560003>-346.8<002E000F0003>-347.1<00330044004F005000560057004800510003>-291.2<0024000F0003>-329<003A>80.2<00440051004A0003>-346.7<002B003A>91.8<000F0003>]TJ T* [<00270044004F005700550052005C0003>-136.1<002F002B00110003>-136.5<0033005500480047004C004600570052005500560003>-136.1<005200490003>-136.4<0048005B004800550046004C005600480003>-135.8<00450048004B00440059004C005200550003>-136<004400570003>-136.1<0056004C005B0003>]TJ /TT0 1 Tf 0.154 Tw T* [(months )0.5(in patients )1(with rheumatoid )1.1(arthritis. )0.9(Phys )]TJ /C2_0 1 Tf 0 Tw T* <0037004B0048005500030015001300130017001E0003001B0017001D001A0013001900B1001400190011>Tj /TT0 1 Tf -2.118 -1.176 Td (88.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00290044004F004E00480051004500440046004B0003>-223.4<002400110003>-279.3<0027004C005600440045004C004F004C0057005C0003>-278.6<005000520057004C005900440057004800560003>-278.3<005300440057004C00480051005700560003>-278.6<005A004C0057004B0003>]TJ /TT0 1 Tf 0.196 Tw T* (ankylosing spondylitis for more frequent physical )Tj /C2_0 1 Tf 0 Tw T* [<0048005B004800550046004C0056004800110003>55.8<002400550046004B00030033004B005C00560003003000480047000300350048004B00440045004C004F00030015001300130016001E0003001B0017001D0016001B001500B100160011>]TJ /TT0 1 Tf -2.118 -1.176 Td (89.)Tj /Span<>> BDC ( )Tj EMC -0.014 Tw 2.118 0 Td [(Barlow )0.6(JH. Understanding )0.8(exercise )1(in )0.6(the )0.8(context )1.1(of )]TJ -0.017 Tw T* [(chronic disease: an exploratory investigation )0.7(of self-)]TJ /C2_0 1 Tf 0 Tw T* [<0048004900BF004600440046005C>65.4<001100030033004800550046004800530057000300300052005700030036004E004C004F004F005600030014001C001C001B001E0003001B001A001D00170016001C0010001700190011>]TJ /TT0 1 Tf -2.118 -1.176 Td (90.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0036005A004C00510051004800510003>-35<0037003A>92.1<000F0003>-35<0039004F00440048005C004800510003>-52.6<002D003A0036000F0003>-53.2<002700440051004E004400480055005700560003>-34.7<003A>92<000F0003>-35<003A>80.2<004800560057004B0052>]TJ /TT0 1 Tf (-)Tj 0.038 Tw T* [(vens R, de )18.5(Vlam )0.5(K. )55.3(Activity )0.9(Limitations )1.4(in patients )]TJ 0.119 Tw T* [(with axial spondyloarthritis: )0.5(a role for fear of mo)]TJ 0 Tw (-)Tj 0.201 Tw T* [(vement )1.1(and )0.5(\(re\)injury )0.9(beliefs. )0.9(J Rheumatol )1(2018; )]TJ 0 Tw 0 -1.176 TD (45:357-66.)Tj -2.118 -1.176 Td (91.)Tj /Span<>> BDC ( )Tj EMC -0.031 Tw 2.118 0 Td [(Santos H, )-0.6(Brophy S, )-0.6(Calin )55.3(A. )-0.6(Exercise in ankylosing )]TJ 0.177 Tw 0 -1.176 TD [(spondylitis: )0.9(How much )0.7(is optimum? )1.1(J Rheumatol )]TJ 0 Tw T* (1998; 25:2156-60.)Tj 23.227 74.118 Td (92.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00330044005600560044004F0048005100570003>-155.4<002F0024000F0003>-155.8<0036005200480059004800550003>-155.6<002F002D000F0003>-155.7<003200B60036004B004800440003>-155.8<00290027000F0003>-156.1<002C00510050004400510003>-155.4<0035002700110003>]TJ /TT0 1 Tf 0.308 Tw T* [(Exercise )1(in )0.6(ankylosing spondylitis: )0.9(discrepancies )]TJ 0.048 Tw T* [(between recommen)0.8(dations and reality)65.7(. J )-0.6(Rheumatol )]TJ 0 Tw T* (2010; 37:835-41.)Tj -2.118 -1.176 Td (93.)Tj /Span<>> BDC ( )Tj EMC 0.112 Tw 2.118 0 Td [(V)110.7(ernon Roberts B. )55.3(Ankylosing spondylitis: )0.7(Pathol)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* [<0052004A005C>64.9<00110003>-0.8<002C0051001D0003>-0.7<002E004F004C005300530048004F0003002D002B000F0003>-1.2<0027004C004800530053004800030033>91.7<0024000F0003>-1<00480047005600110003>-0.9<0035004B004800580050004400570052004F0052004A005C>65.8<00110003>]TJ /TT0 1 Tf T* [(2nd ed. London: Mosby)65.1(, 1998: 181-6.)]TJ -2.118 -1.176 Td (94.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00360058004E00480051004C004E0003>-190.6<0036000F0003>-135.7<00240045005800100036004B0044004E005500440003>-190.8<0030000F0003>-190.9<0029004F005800560056004800550003>-190.9<002700110003>-190.9<00250044004F0051004800520057004B0048>]TJ /TT0 1 Tf 20.56 0 Td (-)Tj 0.171 Tw -20.56 -1.176 Td [(rapy in autoimmune )0.8(disease. Isr J Med Sci 1997; )]TJ 0 Tw 0 -1.176 TD (33:258-61.)Tj -2.118 -1.176 Td (95.)Tj /Span<>> BDC ( )Tj EMC 0.258 Tw 2.118 0 Td [(Altan )0.7(L, )0.5(Bing\366l )0.8(U, )55.3(Aslan M, )37.3(Y)110.7(urtkuran )0.7(M. )18.2(The )]TJ 0.06 Tw 0 -1.176 TD [(ef)18.2(fect of balneothe)0.8(rapy on patients with ankylosing )]TJ 0 Tw T* (spondylitis. Scand J Rheumatol 2006;35:283-9. )Tj -2.118 -1.176 Td (96.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0032004F0069004B0003>-13.2<0030000F0003>-13.5<002E005200510046005D0003>42.2<0024000F0003>-13.5<00290048004B007000550003>-13.2<002D000F0003>-13.5<002E0069004F0050006900510046005D>0.8<004B0048005C0003>-13.2<002D000F0003>-13.5<0032004F0069004B0003>-13.2<0026000F0003>]TJ /TT0 1 Tf 0.114 Tw T* [(Balogh S, Nagy G, Bender )18.1(T)74.4(. )17.8(The ef)18.3(fect of balne)]TJ 0 Tw 20.56 0 Td (-)Tj 0.163 Tw -20.56 -1.176 Td [(otherapy on C-reactive )0.6(protein, serum cholesterol, )]TJ 0.052 Tw T* [(triglyceride, )0.8(total antioxidant )0.7(status and HSP-60 )-0.8(le)]TJ 0 Tw (-)Tj T* (vels. Int J Biometeorol 2010; 54:249-54.)Tj -2.118 -1.176 Td (97.)Tj /Span<>> BDC ( )Tj EMC 0.156 Tw 2.118 0 Td [(Fran\347on )55.4(A, Forestier R. Spa therapy )0.5(in rheumato)]TJ 0 Tw 20.56 0 Td (-)Tj 0.05 Tw -20.56 -1.176 Td [(logy)65.1(. Indications based on the clinical )0.9(guidelines of )]TJ -0.013 Tw T* [(the French National )55.4(Authority for health and the Eu)]TJ 0 Tw (-)Tj 0.016 Tw T* [(ropean )0.9(League )56.3(Against )0.7(Rheumatism, )1.4(and )0.7(the )0.9(results )]TJ -0.023 Tw T* [(of 19 randomized )0.7(clinical )1.2(trials. )0.6(Bull )55.6(Acad Natl Med )]TJ 0 Tw T* (2009;193:1345-56.)Tj -2.118 -1.176 Td (98.)Tj /Span<>> BDC ( )Tj EMC 0.01 Tw 2.118 0 Td [(Ciprian L, Lo Nigro )55.1(A, Rizzo M, Gava )55.2(A, Ramonda )]TJ 0.137 Tw T* [(R, Punzi L, Cozzi)0.5( F)80(. )17.7(The ef)18.2(fects of combined spa )]TJ 0.113 Tw 0 -1.176 TD [(therapy )0.8(and rehabilitation )1.8(on patients )0.9(with )0.5(ankylo)]TJ 0 Tw (-)Tj 0.11 Tw 0 -1.176 TD [(sing spondylitis being treated with )17.9(TNF inhibitors. )]TJ 0 Tw T* (Rheumatol Int 2013; 33:241-5.)Tj -2.118 -1.176 Td (99.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0030005800560057005800550003>6.1<0027000F0003>24.3<0039>59.9<0058004D00440056004C005100520059004C00FC00100036005700580053004400550003>6.7<0031000F0003>6<002C004F004F00480003>24.8<0037>74.4<00110003>6.2<002C005100C0005800480051004600480003>6.5<005200490003>]TJ /TT0 1 Tf -0.026 Tw T* [(physical )0.6(treatment )1.3(on disease )0.5(activity )1.1(and health )0.8(sta)]TJ 0 Tw (-)Tj 0.046 Tw T* [(tus of patients with chronic arthritis. )0.7(Srp )55(Arh Celok )]TJ 0 Tw T* (Lek 2008;136:104-9.)Tj -2.118 -1.176 Td (100.)Tj /Span<>> BDC ( )Tj EMC 0.022 Tw 2.118 0 Td [(Ozgocmen )0.9(S, )55.4(Akgul O, )55.4(Altay )0.7(Z, )55.8(Altindag )0.9(O, Baysal )]TJ /C2_0 1 Tf 0 Tw T* [<0032000F0003>-56.1<00260044004F004C00560003>-55.6<0030000F0003>-55.9<002600440053004E004C00510003>-55.7<0028000F0003>-55.8<002600480059004C004E0003>-55.6<0035000F0003>-55.9<0027005800550050005800560003>-56.1<0025000F0003>-56<002A005800550003>-0.9<0024000F0003>]TJ /TT0 1 Tf 0.247 Tw T* [(Kamanli )56(A, Karkucak )0.5(M, Madenci )0.6(E, Melikoglu )]TJ 0.025 Tw T* [(MA, )-0.8(Nas )-0.6(K, )-0.6(Senel K, )-0.6(Ugur )-0.7(M; )54.8(Anatolian Group )-0.6(for )]TJ /C2_0 1 Tf 0 Tw T* [<0057004B00480003>-6<00240056005600480056005600500048005100570003>-61.2<004C00510003>-61.3<0035004B00480058005000440057004C00460003>-60.6<0027004C00560048004400560048005600110003>-61.6<0028005B00530048005500570003>-61.1<00520053004C>]TJ /TT0 1 Tf (-)Tj 0.013 Tw T* [(nion and key recom)0.5(mendations for the physical the)]TJ 0 Tw (-)Tj 0.122 Tw T* [(rapy and rehabilita)1.1(tion )0.5(of patients )0.8(with ankylosing )]TJ /C2_0 1 Tf 0 Tw T* <00560053005200510047005C004F004C0057004C005600110003002C005100570003002D00030035004B00480058005000030027004C005600030015001300140015001E00140018001D00150015001C00100016001B0011>Tj /TT0 1 Tf -2.118 -1.176 Td (101.)Tj /Span<>> BDC ( )Tj EMC 0.084 Tw 2.118 0 Td [(Gemignani )0.6(G, Olivieri )0.6(I, Ruju G, Pasero G. )17.9(T)35.3(rans)]TJ 0 Tw (-)Tj 0.019 Tw T* [(cutaneous )0.7(electrical )1.7(nerve )0.6(stimulation )1.2(in )0.5(ankylosing )]TJ 0.169 Tw 0 -1.176 TD [(spondylitis: a double-blind study)64.9(. )54.8(Arthritis Rheum )]TJ /C2_0 1 Tf 0 Tw 0 -1.176 TD <0014001C001C0014001E000300160017001D001A001B001B00B1001C0011>Tj /TT0 1 Tf -2.118 -1.176 Td (102.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0026004B004800510003>-123.5<00290026000F0003>-123.9<002D004C00510003>-123.7<003D002F000F0003>-105.3<003A>80.2<00440051004A0003>-123.6<00270029>79.8<00110003>-68.5<0024>55<0003>-123.7<0055004800570055005200560053004800460057004C005900480003>-123.1<0056005700580047005C0003>]TJ /TT0 1 Tf 0.264 Tw T* [(of )0.5(transcutaneous )1.2(electrical )2(nerve )0.8(stimulation )1.5(for )]TJ -0.032 Tw T* [(chronic )0.5(pain following ankylosing spondylitis. )0.5(Med)]TJ 0 Tw (-)Tj T* [(icine \(Baltimore\) 2018; 97:e1)39.2(1265.)]TJ -2.118 -1.176 Td (103.)Tj /Span<>> BDC ( )Tj EMC 0.122 Tw 2.118 0 Td [(T)35.3(uran )37.5(Y)128.8(, Bayraktar)0.6( K, Kahvecioglu )0.9(F)79.9(, )18.4(T)70(astaban )0.7(E, )]TJ 0.072 Tw T* [(A)91.6(ydin )0.7(E, )0.6(Kurt )0.5(Omurlu )0.6(I, )0.5(Berkit )1(IK. 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Physiotherapy management )0.7(of )]TJ 0.273 Tw T* [(ankylosing spondylitis. In: Porter SB, ed. )17.8(T)35.3(idy\222)55.3(s )]TJ -0.019 Tw T* [(Physiotherapy)65.3(. 14th ed. Edinbur)18.4(gh-Sydney: Elsevier )]TJ 0 Tw T* (Limited, 2008: 519-39.)Tj -2.118 -1.176 Td (51.)Tj /Span<>> BDC ( )Tj EMC 0.098 Tw 2.118 0 Td [(Vliet )19.1(Vlieland )19.2(TPC, )0.5(Li )0.8(LC. )0.7(Rehabilit)1(ation )0.9(in )0.7(rheu)]TJ 0 Tw (-)Tj 0.148 Tw T* [(matoid )0.7(arthritis )0.7(and ankylosing spondylitis: )0.6(dif)18.2(fer)]TJ 0 Tw 20.56 0 Td (-)Tj 0.237 Tw -20.56 -1.176 Td [(ence and similarities. )0.7(Clin Exp Rheumatol 2009; )]TJ 0 Tw T* (27:S171-8.)Tj -2.118 -1.176 Td (52.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002700440003>-223<002600520056005700440003>-222.8<0027000F0003>-223.1<00270055004C0057005600440003>-222.8<0030000F0003>-223.1<0035004C0051004A0003>-167.6<0024000F0003>-223.1<0029004C0057005D0046004B00440055004F004800560003>-222.4<0030002400110003>]TJ /TT0 1 Tf 0.178 Tw T* [(Mental )0.8(health )0.8(status and leisure-time)1.2( physical )0.8(ac)]TJ 0 Tw (-)Tj 0.39 Tw 0 -1.176 TD [(tivity )0.5(contribute )0.5(to fatigue )0.5(intensit)0.6(y in patients )]TJ 0.288 Tw 0 -1.176 TD [(with spondyloarthropathy)65.7(. )54.7(Arthritis Rheum 2004; )]TJ 0 Tw T* (51:1004-8.)Tj -2.118 -1.176 Td (53.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00330070004600520058005500510048004400580003>2.6<0039>128.8<000F0003>-15.9<00270048004A0045005200700003>21.3<003C>128.8<000F0003>-15.9<0025004400550051004800570046004B00480003>2.9<0037>74.4<000F0003>-15.9<00260044005100570044004A00550048004F0003>40.1<0024000F0003>]TJ /TT0 1 Tf 0.063 Tw T* [(Constantin )55.5(A, Ruyssen-W)40(itrand )55.5(A. Ef)18.2(fectiveness of )]TJ -0.036 Tw T* (exercise programs in ankylosing spondylitis: a meta-)Tj -0.013 Tw T* [(analysis of randomized Controlled )18.7(T)35.3(rials. )55.3(Arch Phys )]TJ 0 Tw T* (Med Rehabil 2018; 99:383-9.e1.)Tj -2.118 -1.176 Td (54.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0024>91.6<005C00570048004E004C00510003>-108.9<0028000F0003>-109.3<00260044004A004F004400550003>-108.9<00310036000F0003>-109.8<0032005D004A00520051004800510048004F0003>-109<002F000F0003>-91.2<0037>35.4<00580057005800510003>-109.3<0036000F0003>-109.6<00270048>]TJ /TT0 1 Tf (-)Tj /C2_0 1 Tf T* [<0050004C0055005C005200510057004400550003>-4.2<0027003C>128.6<000F0003>-4.8<002700480050004C00550003>-4.5<0036002800110003>-4.7<002B0052005000480010004500440056004800470003>-4.5<0048005B004800550046004C005600480003>-4.2<0057004B0048>]TJ /TT0 1 Tf (-)Tj 0.041 Tw T* [(rapy in patients with ankylosing spondylitis: ef)18.2(fects )]TJ 0.19 Tw T* [(on pain, mobility)65.8(, disease activity)65.9(, quality of life, )]TJ 0.302 Tw T* [(and )0.7(respiratory )0.9(functions. )0.9(Clin )0.9(Rheumatol )1.2(2012; )]TJ /C2_0 1 Tf 0 Tw T* <00160014001D001C001400B1001A0011>Tj /TT0 1 Tf -2.118 -1.176 Td (55.)Tj /Span<>> BDC ( )Tj EMC 0.052 Tw 2.118 0 Td [(Liang )1(H, Zhang )0.9(H, )0.5(Ji )0.6(H, )18.4(W)80.3(ang )0.7(C. )0.5(Ef)18.2(fects )0.9(of )0.5(home-)]TJ -0.003 Tw T* [(based exercise inte)0.5(rvention )0.5(on health-)0.6(related )0.8(quality )]TJ -0.048 Tw T* (of life for patients with ankylosing spondylitis: a me)Tj 0 Tw (-)Tj 0 -1.176 TD (ta-analysis. Clin Rheumatol 2015; 34:1737-44.)Tj -2.118 -1.176 Td (56.)Tj /Span<>> BDC ( )Tj EMC 0.08 Tw 2.118 0 Td [(Braun J, van den Ber)18.3(g R, Baraliakos )0.7(X, Boehm H, )]TJ 0 Tw 0 -1.176 TD [(Bur)18.1(gos-V)110.5(ar)18.2(gas R,)]TJ -2.118 -1.176 Td (57.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00260052004F004F004400510057004800560010002800560057004800590048005D0003>-344.6<0028000F0003>-345.7<00270044004A00BF00510055005800470003>-346.1<002B000F0003>-346<0027004C004D004E00500044005100560003>-345.6<0025000F0003>]TJ T* [<002700520058004A00440047005200560003>-163.7<0030000F0003>-163.8<0028005000480055005C0003>-163.1<0033>110.7<000F0003>-163.5<002A0048004B004800550003>-163.5<0033>110.7<000F0003>-163.5<002B0044005000500052005800470048004B0003>-163.1<0030000F0003>]TJ T* [<002C00510050004400510003>-56.1<00350027000F0003>-56.5<002D00520051004A004E0048004800560003>-56.4<0030000F0003>-56.6<002E004B004400510003>-56.4<00300024000F0003>-56.7<002E004C004F0057005D0003>-55.9<0038000F0003>-56.5<002E0059004C004800510003>]TJ /TT0 1 Tf -0.002 Tw T* [(T)74.4(, Leirisalo-Repo )0.8(M, Maksymowych )18(WP)110.8(, Olivieri )0.5(I, )]TJ 0.097 Tw T* [(Pavelka )0.8(K, Sieper )0.6(J, Stanislawska-Bi)0.5(ernat )0.8(E, )18.5(W)80.2(en)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* [<0047004F004C0051004A0003>-15.9<0027000F0003>-16.4<0032005D004A005200460050004800510003>-15.6<0036000F0003>-16.4<0059004400510003>-16<002700550052004A004800510003>-16.3<0026000F0003>-16.2<0059004400510003>-16<00350052005C004800510003>-16.1<0025000F0003>]TJ T* [<0059004400510003>37.4<0047004800550003>37.4<002B0048004C004D004700480003>37.9<002700110003>37.1<00150013001400130003>37.2<0058005300470044005700480003>37.7<005200490003>37.2<0057004B00480003>92.8<0024003600240036001200280038002F002400350003>]TJ /TT0 1 Tf -0.037 Tw T* [(recommendations )0.9(for the management)1.1( of ankylosing )]TJ /C2_0 1 Tf 0 Tw T* [<00560053005200510047005C004F004C0057004C005600110003>55.5<00240051005100030035004B00480058005000030027004C00560003001500130014>37.1<0014001E0003001A0013001D001B001C00190010001C001300170011>]TJ /TT0 1 Tf -2.118 -1.176 Td (58.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00270044004A00BF00510055005800470003>-64.5<002B000F0003>-64.6<002E0059004C004800510003>-46.1<0037002E000F0003>-64.4<002B0044004A004800510003>-64.2<002E002500110003>-64.5<0033004B005C0056004C00520057004B0048005500440053005C0003>]TJ /TT0 1 Tf 0.162 Tw T* [(interventions )1.3(for )0.5(ankylosing )0.7(spondylitis. )0.8(Cochrane )]TJ /C2_0 1 Tf 0 Tw T* <0027004400570044004500440056004800030036005C0056005700030035004800590003001500130013001B001E0003000B0014000C001D00260027001300130015001B001500150011>Tj /TT0 1 Tf -2.118 -1.176 Td (59.)Tj /Span<>> BDC ( )Tj EMC 0.052 Tw 2.118 0 Td [(V)59.9(iitanen )0.5(JV)128.6(, Lehtinen )0.5(K, Suni J, Kautiainen )0.5(H. Fif)]TJ 0 Tw (-)Tj 0.023 Tw T* [(teen )0.5(months\222)74( follow-up of intensive )0.7(inpatient )1.1(physi)]TJ 0 Tw (-)Tj 0.324 Tw 0 -1.176 TD [(otherapy )0.7(and exercise )0.5(in ankylosing spondylitis. )]TJ 0 Tw 0 -1.176 TD (Clin Rheumatol 1995;14:413-9.)Tj -2.118 -1.176 Td (60.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002B004C00470047004C0051004A0003>76.6<0024000F0003>21.2<0059004400510003>21.5<0047004800550003>21.4<002F004C00510047004800510003>21.7<0036000F0003>21.1<002700480003>39.4<003A>40.2<004C0057005700480003>21.9<002F00110003>39.5<0037004B004800550044005300480058>]TJ /TT0 1 Tf 20.56 0 Td (-)Tj 0.04 Tw -20.56 -1.176 Td [(tic )0.7(ef)18.2(fects )0.6(on individual )0.7(physical )0.7(therapy )0.7(in ankylo)]TJ 0 Tw (-)Tj 0.08 Tw T* (sing spondylitis related to duration of disease. Clin )Tj 0 Tw T* (Rheumatol 1993;12:334-40.)Tj 23.227 76.471 Td (61.)Tj /Span<>> BDC ( )Tj EMC 0.116 Tw 2.118 0 Td [(Levitova )55.8(A, Hulejova H, Spiritovic )0.5(M, Pavelka K, )]TJ -0.066 Tw T* [(Senolt )0.6(L, Husakova M. Clinical )1.3(improvement )1.1(and re)]TJ 0 Tw (-)Tj 0.014 Tw T* [(duction )1(in )0.6(serum )0.7(calprotectin )1.7(levels )1(after )0.8(an )0.7(intensi)]TJ 0 Tw 20.56 0 Td (-)Tj 0.02 Tw -20.56 -1.176 Td (ve exercise programme for patients with ankylosing )Tj 0.118 Tw T* (spondylitis and non-radiographic axial spondyloar)Tj 0 Tw 20.56 0 Td (-)Tj -20.56 -1.176 Td [(thritis. )55.7(Arthritis Res )18.4(Ther 2016 25; 18:275.)]TJ -2.118 -1.176 Td (62.)Tj /Span<>> BDC ( )Tj EMC 0.357 Tw 2.118 0 Td (Cameron MH. Physical agents in rehabilitation: )Tj -0.023 Tw T* [(from research to practice. )0.8(2nd ed. St. Louis: Elsevier )]TJ 0 Tw T* (Science, 2003: 261-306.)Tj -2.118 -1.176 Td (63.)Tj /Span<>> BDC ( )Tj EMC -0.038 Tw 2.118 0 Td [(Bulstrode )0.8(SJ, Barefoot )1(J, Harrison R, )0.5(Clarcke )56.3(A. )18.3(The )]TJ -0.006 Tw T* [(role of passive stretching in the treatment )0.8(of ankylo)]TJ 0 Tw (-)Tj T* (sing spondylitis. Br J Rheumatol 1987; 26:40-2.)Tj -2.118 -1.176 Td (64.)Tj /Span<>> BDC ( )Tj EMC -0.02 Tw 2.118 0 Td [(Ortancil O, Sarikaya S, Sapmaz P)110.7(, Basaran )55.2(A, Ozdo)]TJ 0 Tw (-)Tj -0.06 Tw T* [(lap S. )17.7(The ef)18.3(fect\(s\) of a six-week home-based exerci)]TJ 0 Tw 20.56 0 Td (-)Tj 0.006 Tw -20.56 -1.176 Td [(se )0.5(program )0.5(on )0.5(the )0.8(respiratory )0.9(muscle )1(and )0.7(functional )]TJ 0.135 Tw T* [(status in ankylosing )0.5(spondylitis. )0.5(J Clin )0.6(Rheumatol )]TJ 0 Tw T* (2009; 15:68-70.)Tj -2.118 -1.176 Td (65.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0025004400560044004E0046004C0003>-44.7<00260044004F004C004E0003>-44.6<0025000F0003>-45.1<002A005800550003>-45.3<002E004400450058004F0003>-45<0028000F0003>-26.9<0037>70<00440056004E00D500510003>-45<002B000F0003>-27.2<0037>70<0048004F004F004C0003>10.6<002400570044>]TJ /TT0 1 Tf (-)Tj /C2_0 1 Tf T* [<004F0044005C0003>-73.6<0032000F0003>-74.2<0025004400560003>-18.8<00240056004F004400510003>-74<0038000F0003>-56<0037>70<00440056004600D50003>-73.7<0030000F0003>-74.1<002500D500460044004E0046>0.6<00D50003>-73.8<0029>79.9<000F0003>-36.8<003C00D5004F004700D5005D0003>-18.3<0024002C00110003>]TJ T* [<0037004B00480003>-68.7<0048004900BF0046004C004800510046005C0003>-68.7<005200490003>-69<004C005100560053004C00550044005700520055005C0003>-68.7<0050005800560046004F00480003>-68.5<005700550044004C0051004C0051004A0003>-68.3<004C00510003>-68.9<00530044>]TJ /TT0 1 Tf (-)Tj 0.234 Tw T* [(tients with ankylosing spondylitis. Rheumatol )0.5(Int )]TJ 0 Tw T* (2018; 38:1713-20.)Tj -2.118 -1.176 Td (66.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<00250044004E004800550003>27<002D0029>79.8<000F0003>44.7<0039>128.7<005200510003>26.7<00290048004F004700570003>27<002D000F0003>26.6<00300052005600570052005800BF001000300052004400450003>26.3<0036000F0003>26.5<003100520044004C00560048004B0003>26.9<002A000F0003>]TJ T* [<0037>70<00440055004400570058005700440003>-5.5<0028000F0003>-6.1<002E004C00500003>11.9<003A>92<000F0003>-6.3<002F0048005200510044005500470003>-5.8<0030002500110003>-6.5<0027004800BF0046004C005700560003>-6.1<004C00510003>-6.1<0050005800560046004F00480003>]TJ T* [<0050004400560056000F0003>-331<0050005800560046004F00480003>-330.6<0047004800510056004C0057005C>65.2<000F0003>-331<0044005100470003>-330.8<005000520047004C00BF004800470003>-331<00440056005600520046004C00440057004C0052005100560003>]TJ /TT0 1 Tf 0.128 Tw T* [(with fat in rheumatoid arthritis. )55.8(Arthritis Care Res )]TJ 0 Tw 0 -1.176 TD (\(Hoboken\) 2014; 66:1612-8. )Tj -2.118 -1.176 Td (67.)Tj /Span<>> BDC ( )Tj EMC 0.113 Tw 2.118 0 Td [(Ekdahl )0.9(C, Broman )0.7(G. Muscle )0.5(strength, )0.5(endurance, )]TJ 0.03 Tw 0 -1.176 TD [(and )0.6(aerobic )0.7(capacit)1(y in )0.6(rheumatoid )1.2(arthritis: )1.3(a )0.6(com)]TJ 0 Tw (-)Tj 0.21 Tw T* [(parative )1.3(study with )0.6(healthy )1.1(subjects. )56(Ann Rheum )]TJ /C2_0 1 Tf 0 Tw T* <0027004C005600030014001C001C0015001E000300180014001D001600180010001700130011>Tj /TT0 1 Tf -2.118 -1.176 Td (68.)Tj /Span<>> BDC ( )Tj EMC 0.093 Tw 2.118 0 Td [(Hsieh LF)80(, )17.8(W)80.2(atson CP)110.7(, Mao HF)79.8(. Rheumatologic )0.7(re)]TJ 0 Tw (-)Tj -0.003 Tw T* [(habilitation. )1.6(In: Braddom )0.6(RL, ed. Physical )0.7(medicine )]TJ 0.277 Tw T* [(and )0.6(rehabilitation. )1.6(5th )0.6(ed. )0.6(Philadelp)0.7(hia: )0.9(Elsevier)40.6(, )]TJ 0 Tw T* (2015: 665-84.)Tj -2.118 -1.176 Td (69.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002700480050005200510057004C00560003>95.2<0024000F0003>57.5<0037>35.4<00550044004C0051004C005700520003>39.9<0036000F0003>39.5<00270048004F0003>39.8<00290048004F004C004600480003>95.5<0024000F0003>39.5<003000440056004C0048005500520003>40<003600110003>39.5<00290044>]TJ /TT0 1 Tf (-)Tj -0.023 Tw T* [(vorable )0.8(ef)18.2(fect )0.8(of rehabilitation )1.6(on balance )0.6(in )0.5(ankylo)]TJ 0 Tw (-)Tj 0.063 Tw T* [(sing spondylitis: )0.8(a quasi-randomized )1.2(controlled )1(cli)]TJ 0 Tw 20.56 0 Td (-)Tj -20.56 -1.176 Td (nical trial. Rheumatol Int 2016; 36:333-9.)Tj -2.118 -1.176 Td (70.)Tj /Span<>> BDC ( )Tj EMC -0.029 Tw 2.118 0 Td [(Gunay )0.5(SM, )0.5(Keser )0.5(I, )0.5(Bicer )1(ZT)74.5(. )18.6(The )0.8(ef)18.2(fects )0.6(of )0.6(balance )]TJ 0.133 Tw T* [(and )0.7(postural )0.8(stabil)0.5(ity )0.9(exercises )1(on )0.6(spa )0.7(based )0.7(reha)]TJ 0 Tw (-)Tj 0.274 Tw T* [(bilitation )1.5(programme )1(in )0.6(patients )1(with )0.6(ankylosing )]TJ 0.268 Tw T* [(spondylitis. )0.6(J Back Musculoskelet )0.8(Rehabil )0.8(2018; )]TJ 0 Tw 0 -1.176 TD (31:337-46.)Tj -2.118 -1.176 Td (71.)Tj /Span<>> BDC ( )Tj EMC 0.318 Tw 2.118 0 Td [(Souchard P)110.7(. Global posture reeducation )0.6(method. )]TJ 0 Tw 0 -1.176 TD (Barcelona: Paidotribo, 1998.)Tj -2.118 -1.176 Td (72.)Tj /Span<>> BDC ( )Tj EMC 0.113 Tw 2.118 0 Td [(Fernandez-de-Las-Penas )0.5(C, )54.9(Alonso-Blanco C, Mo)]TJ 0 Tw (-)Tj -0.019 Tw T* [(rales-Cabezas )0.6(M, Miangolarra-Page )0.7(JC. )17.8(T)70(wo exerci)]TJ 0 Tw 20.56 0 Td (-)Tj -0.018 Tw -20.56 -1.176 Td [(se interventions )0.6(for the )0.8(management )1.5(of patients )1.1(with )]TJ 0.029 Tw T* (ankylosing spondylitis: a randomized controlled tri)Tj 0 Tw (-)Tj /C2_0 1 Tf T* [<0044004F00110003>55.5<002400500003002D00030033004B005C00560003003000480047000300350048004B00440045004C004F00030015001300130018001E0003001B0017001D00170013001A00B10014001C0011>]TJ /TT0 1 Tf -2.118 -1.176 Td (73.)Tj /Span<>> BDC ( )Tj EMC 0.169 Tw 2.118 0 Td [(Fern\341ndez-de-Las-Pe\361as )-54.6(C, Alonso-Blanco )-55(C, Al)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* [<004A005800440046004C004F00100027004C0048004A00520003>-238.1<002C0030000F0003>-239<0030004C00440051004A0052004F0044005500550044001000330044004A00480003>-238.2<002D002600110003>-239<0032005100480010005C0048004400550003>]TJ /TT0 1 Tf 0.061 Tw T* [(follow-up of two exercise )0.6(interventions )0.8(for the ma)]TJ 0 Tw (-)Tj 0.047 Tw T* (nagement of patients with ankylosing spondylitis: a )Tj -0.031 Tw T* [(randomized controlled trial. )55.5(Am J Phys Med Rehabil )]TJ /C2_0 1 Tf 0 Tw T* <0015001300130019001E0003001B0018001D00180018001C00B10019001A0011>Tj /TT0 1 Tf -2.118 -1.176 Td (74.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0027005800550050005800FA0003>-31.9<0027000F0003>23.3<0024004F0044005C004F004C0003>-31.3<002A000F0003>-31.8<0038005D005800510003>-31.7<0032000F0003>-13.8<0037>69.9<004400510047004800550003>-31.7<0025000F0003>-31.7<002600440051005700810055004E0003>-31.4<0029>79.9<000F0003>]TJ /TT0 1 Tf -0.052 Tw T* [(Bek )37.2(Y)128.7(, Erkan L. Ef)18.3(fects of two exercise)0.6( interventions )]TJ 0.021 Tw T* [(on pulmonary functions in the patient)0.8(s with ankylo)]TJ 0 Tw (-)Tj 0 -1.176 TD (sing spondylitis. Joint Bone Spine 2009; 76:150-5. )Tj -2.118 -1.176 Td (75.)Tj /Span<>> BDC ( )Tj EMC 0.091 Tw 2.118 0 Td [(Karapolat H, Eyigor S, Zoghi M, )54.8(Akkoc )36.9(Y)128.8(, Kirazli )]TJ -0.031 Tw 0 -1.176 TD [(Y)128.7(, Keser G. )55.2(Are swimming )0.7(or aerobic )0.6(exercise )0.6(better )]TJ -0.015 Tw T* [(than conventional )0.9(exercise )0.5(in ankylosing spondylitis )]TJ 0.01 Tw T* [(patients? )55.6(A)55.1( randomized )0.5(controlled )0.5(study)64.9(. 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Ef)18.3(fects of a )0.6(modular )]TJ 0.197 Tw T* [(behavioural )0.9(arthrit)0.7(is education )1(programme: )0.9(a pra)]TJ 0 Tw (-)Tj 0.218 Tw T* [(gmatic )0.6(parallel-group )0.6(randomized )0.5(controlled )0.6(trial. )]TJ 0 Tw T* (Rheumatology \(Oxford\) 2008; 47:1712-8.)Tj -2.118 -1.176 Td (32.)Tj /Span<>> BDC ( )Tj EMC 0.209 Tw 2.118 0 Td [(W)40.2(illiams )0.6(B, Pace )55.3(AE. Problem based learning in )]TJ -0.007 Tw T* [(chronic disease management: )1.3(a review of the resear)]TJ 0 Tw 20.56 0 Td (-)Tj -20.56 -1.176 Td (ch. Patient Educ Couns 2009; 77:14-9.)Tj -2.118 -1.176 Td (33.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0036005700480058004F0057004D0048005100560003>78.7<00280030000F0003>78.1<00270048004E004E004800550003>78.2<002D000F0003>77.9<0025005200580057004800550003>78.4<002F0030000F0003>78<0059004400510003>78.3<00360046004B004400440055004700480051>]TJ /TT0 1 Tf (-)Tj /C2_0 1 Tf T* [<004500580055>18.1<004A0003>-40.1<0027000F0003>-40.2<0059004400510003>-39.8<002E0058005C004E0003>-40.2<00300024000F0003>-40.4<0059004400510003>-39.9<0047004800510003>-39.9<00280051004700480003>-39.7<0026002B00110003>-40.2<003200460046005800530044>]TJ /TT0 1 Tf (-)Tj 0.057 Tw T* [(tional therapy for rheumatoid )0.5(arthritis: )0.5(a systematic )]TJ /C2_0 1 Tf 0 Tw 0 -1.176 TD [<005500480059004C0048005A>65.2<00110003>55.2<002400550057004B0055004C0057004C005600030035004B004800580050000300150013001300150003002700480046000300140018001E0017001A000B0019000C001D0019001A00150010001B00180011>]TJ /TT0 1 Tf -2.118 -1.176 Td (34.)Tj /Span<>> BDC ( )Tj EMC 0.003 Tw 2.118 0 Td [(Masiero S, Boniolo )54.9(A, )17.7(W)80.3(assermann L, Machiedo H, )]TJ /C2_0 1 Tf 0 Tw 0 -1.176 TD [<0039>128.7<0052004F00440051005700480003>-34<0027000F0003>-34.8<003300580051005D004C0003>-34.5<002F00110003>-34.5<00280049>18.2<004900480046005700560003>-34.3<005200490003>-34.7<004400510003>-34.5<004800470058004600440057004C005200510044004F001000450048004B0044>]TJ /TT0 1 Tf 20.56 0 Td (-)Tj 0.069 Tw -20.56 -1.176 Td [(vioral )0.8(joint )0.8(protection )1.1(program )0.6(on people )0.7(with mo)]TJ 0 Tw (-)Tj 0.085 Tw T* (derate to severe rheumatoid arthritis: a randomized )Tj 0 Tw T* (controlled trial. Clin Rheumatol. 2007; 26:2043-50.)Tj -2.118 -1.176 Td (35.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0027005800550050005800560003>18.8<0025000F0003>74.1<0024004F00570044005C0003>19.3<003D000F0003>19.1<002800560052005C0003>56.1<003C>128.7<000F0003>19<00250044005C00560044004F0003>19.2<0032000F0003>18.9<00270052004A004400510003>18.9<002800110003>19.2<00330052>]TJ /TT0 1 Tf (-)Tj 0.019 Tw T* (stural stability in patients with ankylosing spondyli)Tj 0 Tw (-)Tj /C2_0 1 Tf T* [<0057004C0056001100030027004C005600440045004C004F000300350048004B00440045004C004F00030015001300140013001E000300160015001D0014>38.6<0014001800190010001900150011>]TJ /TT0 1 Tf -2.118 -1.176 Td (36.)Tj /Span<>> BDC ( )Tj EMC 0.195 Tw 2.118 0 Td [(Swann, J. )55.2(Ankylosing spondylitis: )0.6(living )0.6(with the )]TJ 0.034 Tw T* [(condition. )1.1(Br )0.5(J Healthcare )56.4(Assistants \(BJHA\) 2009; )]TJ 0 Tw T* (3:235-7.)Tj -2.118 -1.176 Td (37.)Tj /Span<>> BDC ( )Tj EMC -0.027 Tw 2.118 0 Td [(Grazio S, Znika M. )54.9(A)55( Guide to safe exercise for peo)]TJ 0 Tw (-)Tj -0.042 Tw T* [(ple )0.5(with rheumatic )1(diseases. 1st ed. Zagreb: )0.8(Croatian )]TJ 0 Tw T* [(League )55.8(Against Rheumatism, 2004: 1-1)38.2(12. )]TJ -2.118 -1.176 Td (38.)Tj /Span<>> BDC ( )Tj EMC 0.191 Tw 2.118 0 Td [(Roberts CK, Hevener )55.2(AL, Barnard RJ. Metabolic )]TJ 0.074 Tw T* [(syndrome and insulin resistance: )0.8(underlying )0.5(causes )]TJ /C2_0 1 Tf 0 Tw 0 -1.176 TD [<0044005100470003>12.8<005000520047004C00BF004600440057004C005200510003>13.4<0045005C0003>12.7<0048005B004800550046004C005600480003>13.2<005700550044004C0051004C0051004A00110003>13.2<002600520050005300550003>12.9<0033004B005C0056004C>]TJ /TT0 1 Tf (-)Tj /C2_0 1 Tf 0 -1.176 TD <0052004F00030015001300140016001E00030016001D001400B10018001B0011>Tj /TT0 1 Tf -2.118 -1.176 Td (39.)Tj /Span<>> BDC ( )Tj EMC -0.024 Tw 2.118 0 Td [(Stewart )0.5(KJ, Bacher )55.4(AC, )18(T)35.3(urner K, Lim )0.6(JG, Hees PS, )]TJ -0.033 Tw T* [(Shapiro EP)110.9(, )18.2(T)70(ayback )0.6(M, Ouyang P)110.7(. Exercise )0.8(and risk )]TJ 0.011 Tw T* [(factors associated )0.7(with metabolic )1.1(syndrome in older )]TJ /C2_0 1 Tf 0 Tw T* [<004400470058004F0057005600110003>55.5<002400500003002D00030033005500480059000300300048004700030015001300130018001E00030015001B001D001C00B10014001B0011>]TJ /TT0 1 Tf -2.118 -1.176 Td (40.)Tj /Span<>> BDC ( )Tj EMC 0.103 Tw 2.118 0 Td [(Lautenschlager )1(NT)74.2(, Cox KL, Flicker L, Foster JK, )]TJ 0.049 Tw T* [(van Bockxmeer )0.7(FM, Xiao J, Greenop KR, )55.2(Almeida )]TJ 0.012 Tw T* [(OP)110.5(. Ef)18.1(fect of physical )0.7(activity )1.1(on cognitive )0.8(function )]TJ 0.072 Tw T* [(in older adults at risk for )55(Alzheimer )0.6(disease: a ran)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* [<004700520050004C005D004800470003>3.9<00570055004C0044004F00110003>3.8<002D0003>58.3<002400500003>3.2<0030004800470003>58.4<002400560056005200460003>2.8<001500130013001B001E0003>3.2<001600130013001D001400130015001A00B10016001A0011>]TJ /TT0 1 Tf -2.118 -1.176 Td (41.)Tj /Span<>> BDC ( )Tj EMC 0.079 Tw 2.118 0 Td [(Rubenstein LZ, Josephson KR, )17.8(T)35.3(rueblood PR, Loy )]TJ 0.103 Tw T* [(S, Harker )0.6(JO, Pietruszka )0.5(FM, Robbins )55.4(AS. Ef)18.2(fects )]TJ 0.118 Tw T* [(of a group exercis)0.5(e program )0.6(on strength, mobility)65.8(, )]TJ -0.03 Tw T* [(and falls among fall-prone )0.7(elderly )0.6(men. J Gerontol )55.5(A)55( )]TJ 0 Tw T* (Biol Sci Med Sci 2000; 55:M317-21.)Tj -2.118 -1.176 Td (42.)Tj /Span<>> BDC ( )Tj EMC 0.004 Tw 2.118 0 Td [(Franco MR, )-0.6(Pereira LS, Ferreira PH. )-0.7(Exercise inter)]TJ 0 Tw 20.56 0 Td (-)Tj 0.108 Tw -20.56 -1.176 Td (ventions for preventing falls in older people living )Tj /C2_0 1 Tf 0 Tw T* [<004C005100030057004B00480003004600520050005000580051004C0057005C>66.3<00110003002500550003002D0003003600530052005500570056000300300048004700030015001300140017001E00030017001B001D001B0019001A00B1001B00110003>]TJ /TT0 1 Tf -2.118 -1.176 Td (43.)Tj /Span<>> BDC ( )Tj EMC 0.088 Tw 2.118 0 Td [(Harding )55.6(A)110.7(T)74.3(, Beck )0.6(BR. Exercise, )0.9(Osteoporosis, and )]TJ 0 Tw T* [(Bone Geometry)65.6(. Sports \(Basel\) 2017;5.)]TJ -2.118 -1.176 Td (44.)Tj /Span<>> BDC ( )Tj EMC 0.145 Tw 2.118 0 Td [(Mikkelsen )0.8(K, Stojanovska )0.6(L, )0.7(Polenakovic )0.8(M, Bo)]TJ 0 Tw (-)Tj 0.174 Tw T* [(sevski M, )55.2(Apostolopoulos )18.4(V)128.7(. Exercise )0.8(and )0.5(mental )]TJ 0 Tw T* (health. Maturitas 2017; 106:48-56.)Tj -2.118 -1.176 Td (45.)Tj /Span<>> BDC ( )Tj EMC 0.103 Tw 2.118 0 Td [(Pedersen BK. Muscle as a secretory or)18(gan. Compr )]TJ 0 Tw T* (Physiol 2013; 3:1337-62.)Tj -2.118 -1.176 Td (46.)Tj /Span<>> BDC ( )Tj EMC 0.164 Tw 2.118 0 Td [(Pedersen BK. Muscles )0.7(and their )0.8(myokines. J Exp )]TJ 0 Tw T* [(Biol 201)37.4(1; 214:337-46.)]TJ /TT1 1 Tf 10 0 0 10 303.8755 792.4365 Tm (Grazio et al.)Tj /TT0 1 Tf 5.248 0 Td ( Rehabilitation in spondyloarthritis)Tj ET 0 0 0 0 k /GS0 gs 496.346 41.752 28.346 12.874 re f endstream endobj 36 0 obj <>stream q /GS0 gs /Fm0 Do Q BT 0 0 0 1 k /GS1 gs /TT0 1 Tf 11 0 0 11 76.7894 44.9321 Tm (220)Tj 0.28 Tw 10 0 0 10 99.2126 735.7435 Tm [(distance, )1(as well )0.7(as decrease )0.9(acute )1(phase )0.5(re)]TJ 0 Tw (-)Tj 0.152 Tw 0 -1.3 TD [(actants )1(when used alongside )0.8(with )0.5(conventional )]TJ /C2_0 1 Tf 0 Tw T* [<0056005C00510057004B00480057004C00460003>7.8<0047004C005600480044005600480010005000520047004C0049005C004C0051004A0003>7.7<004700550058004A00560003>7<000B00460056002700300024003500270056000C0003>]TJ T* [<004600520050005300440055004800470003>-44.3<005700520003>-44.8<004600560027003000240035002700560003>-45.7<0044004F0052005100480003>-44.4<000B0014>37.1<00140013000C00110003>-45<002B0052005A0048005900480055>40.1<000F0003>]TJ /TT0 1 Tf 0.085 Tw T* [(these results require a careful interpretation )0.7(due )]TJ -0.015 Tw T* [(to the poor methodological )1.1(quali)0.5(ty of the studies. )]TJ -0.01 Tc 0.283 Tw 0 -1.583 TD [(In conclusion, although we are witnessing the)-9.9( )]TJ 0.054 Tw 0 -1.3 TD (increasing availability of potent drugs for the tre)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.006 Tw T* [(atment of patients with SpA)55( conditions, non-phar)]TJ 0 Tc 0 Tw 19.226 0 Td (-)Tj -0.01 Tc 0.356 Tw -19.226 -1.3 Td [(macological/non-sur)18(gical )0.5(approach still )0.5(has an)-10( )]TJ 0.167 Tw T* [(essential role in the treatment and rehabilitation)-10( )]TJ 0.076 Tw T* [(of these patients. )17.7(The most important component)-9.9( )]TJ -0.008 Tw 21.543 14.583 Td [(of such an approach is therapeutic exercise, which)-10( )]TJ /C2_0 1 Tf 0.01 Tw T* [<0047004800500052005100560057005500440057004800470003>-245.5<0048004900BF004600440046005C0003>-245.5<004C00510003>-245.5<00550048004700580046004C0051004A0003>-245.5<00530044004C0051000F0003>-245.6<004C0050005300550052>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj -0.01 Tc 0.214 Tw T* [(ving functionality and quality of life. )55.5(Although)-10( )]TJ 0.123 Tw T* [(the number of high-quality studies is increasing,)-10( )]TJ -0.014 Tw T* [(further research is needed to determine the ef)18(fecti)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc T* (ve rehabilitation protocols for these patients.)Tj /C2_1 1 Tf 0 Tc 0 -2.25 TD <0029003800310027002C0031002A>Tj /C2_0 1 Tf 0 -1.867 TD [<0031005200030056005300480046004C00BF004600030049005800510047004C0051004A0003005A0044005600030055004800460048004C005900480047000300490052005500030057004B004C005600030056005700580047005C>66<0011>]TJ /C2_1 1 Tf 0 -2.25 TD [<003700350024003100360033>45<00240035002800310026003C0003002700280026002F002400350024>55.1<0037002C00320031>]TJ /C2_0 1 Tf 0 -1.867 TD <00260052005100C0004C0046005700560003005200490003004C0051005700480055004800560057001D0003003100520057004B004C0051004A0003005700520003004700480046004F0044005500480011>Tj /TT1 1 Tf -21.543 -3.379 Td (REFERENCES)Tj /TT0 1 Tf 8.5 0 0 8.5 99.2126 538.9377 Tm (1.)Tj /Span<>> BDC ( )Tj EMC 0.137 Tw 2.118 0 Td [( Khan MA. )55.5(An overview )0.7(of clinical )1.5(spectrum )0.9(and )]TJ /C2_0 1 Tf 0 Tw 0 -1.176 TD [<004B00480057004800550052004A004800510048004C0057005C0003>-49.7<005200490003>-50.7<00560053005200510047005C004F0052004400550057004B00550052005300440057004B004C0048005600110003>-49.8<0035004B0048005800500003>-50.4<0027004C00560003>]TJ /TT0 1 Tf T* [(Clin North )55.5(Am 1992;18:1-10.)]TJ -2.118 -1.176 Td (2.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<003500580047005A0044004F0048004C00570003>16.9<0030000F0003>16.1<0059004400510003>16.4<0047004800550003>16.4<002B0048004C004D004700480003>16.7<0027000F0003>16<002F0044005100470048005A00700003>16.7<0035000F0003>16.3<002F004C00560057004C0051004A0003>]TJ /TT0 1 Tf 0.027 Tw T* [(J, )54.7(Akkoc N, Brandt J, Braun J, Chou CT)74.4(, Collantes-)]TJ /C2_0 1 Tf 0 Tw T* [<002800560057004800590048005D0003>-21.3<0028000F0003>-21.8<002700520058004A00440047005200560003>-22.2<0030000F0003>-22.1<002B005800440051004A0003>-22<0029>79.9<000F0003>-21.9<002A00580003>-22<002D000F0003>-22.1<002E004B004400510003>-22<00300024000F0003>]TJ /TT0 1 Tf -0.019 Tw T* [(Kirazli )37.8(Y)128.7(, Maksymowych )18.1(WP)110.8(, Mielan)0.5(ts H, S\370rensen )]TJ 0.07 Tw T* [(IJ, Ozgocmen )0.9(S, Roussou E, )18.8(V)110.6(alle-O)0.5(\361ate )1(R, )18.6(W)80.2(eber )]TJ 0.04 Tw T* [(U, )18(W)80.3(ei J, Sieper )0.5(J. )18.2(The )0.5(development )1.1(of )55.3(Assessment )]TJ 0.407 Tw T* [(of SpondyloArthritis international)1.3( Society cla)]TJ 0 Tw 20.56 0 Td (-)Tj /C2_0 1 Tf -20.56 -1.176 Td [<00560056004C00BF004600440057004C005200510003>-196<00460055004C005700480055004C00440003>-195.5<0049005200550003>-196.4<0044005B004C0044004F0003>-195.7<00560053005200510047005C004F0052004400550057004B0055004C0057004C00560003>-195.7<000B00530044005500570003>]TJ 0 -1.176 TD [<002C002C000C001D0003>-92.2<00590044004F004C004700440057004C005200510003>-91.4<0044005100470003>-92.2<00BF00510044004F0003>-92.1<00560048004F004800460057004C0052005100110003>-36.4<0024005100510003>-92.3<0035004B0048005800500003>-92<0027004C005600110003>]TJ /TT0 1 Tf 0 -1.176 TD (2009; 68:777-83.)Tj -2.118 -1.176 Td (3.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002A00550044005D004C00520003>-403.7<003600110003>-404.1<0026004F004400560056004C00BF004600440057004C005200510003>-403.3<0044005100470003>-403.8<0047004C0044004A005100520056004C00560003>-403.8<005200490003>-403.9<0044005B004C0044004F0003>]TJ T* [<00560053005200510047005C004F0052004400550057004B0055004C0057004C0047004800560003>-75<00B10003>-75.9<004B004C0056005700520055005C>65.1<000F0003>-75.8<00530055004800560048005100570003>-75.5<005600570044005700480003>-75.4<0044005100470003>-75.7<005300480055>]TJ /TT0 1 Tf 20.56 0 Td (-)Tj /C2_0 1 Tf -20.56 -1.176 Td <00560053004800460057004C00590048005600110003003500480058005000440057004C005D0044005000030015001300140019001E000300190016000B0036005800530053004F00030014000C001D001400B10014001A00110003>Tj /TT0 1 Tf -2.118 -1.176 Td (4.)Tj /Span<>> BDC ( )Tj EMC 0.076 Tw 2.118 0 Td [(Stolwijk )0.7(C, van )0.5(Onna M, Boonen )55.6(A, van )18.6(T)35.3(uber)18.2(gen )]TJ 0.117 Tw T* [(A. Global prevalence )0.6(of spondyloarthritis: )0.5(a syste)]TJ 0 Tw (-)Tj 0.013 Tw T* [(matic )0.6(review and meta-regression )0.5(analysis. )55.3(Arthritis )]TJ 0 Tw T* (Care Res \(Hoboken\) 2016; 68:1320-31. )Tj -2.118 -1.176 Td (5.)Tj /Span<>> BDC ( )Tj EMC -0.041 Tw 2.118 0 Td [(Bostan EE, Borman P)110.7(, Bodur H, Bar\347a N. Functional )]TJ 0.008 Tw T* [(disability )0.9(and quality )0.8(of life )0.6(in patients )0.7(with ankylo)]TJ 0 Tw (-)Tj T* (sing spondylitis. Rheumatol Int 2003; 23:121-6.)Tj -2.118 -1.176 Td (6.)Tj /Span<>> BDC ( )Tj EMC 0.383 Tw 2.118 0 Td [(van Echteld )0.9(I, Cieza )56(A, Boonen )55.5(A, Stucki G, )]TJ /C2_0 1 Tf 0 Tw T* [<003D00520046004B004F004C0051004A0003>-135.9<002D000F0003>-136.8<002500550044005800510003>-136.4<002D000F0003>-136.8<0059004400510003>-136.4<0047004800550003>-136.4<002B0048004C004D004700480003>-136.2<002700110003>-136.7<002C0047004800510057004C00BF00460044>]TJ /TT0 1 Tf 20.56 0 Td (-)Tj 0.029 Tw -20.56 -1.176 Td [(tion )0.8(of the most )0.6(common )0.8(problems )0.7(by )0.5(patients )1.1(with )]TJ -0.026 Tw T* [(ankylosing )0.8(spondylitis )0.8(using )0.5(the )0.8(intern)0.5(ational )1.3(classi)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* [<00BF004600440057004C005200510003>35.1<005200490003>34.6<00490058005100460057004C00520051004C0051004A000F0003>35.2<0047004C005600440045004C004F004C0057005C0003>35.5<0044005100470003>34.7<004B00480044004F0057004B00110003>35.3<002D0003>34.4<0035004B00480058>]TJ /TT0 1 Tf (-)Tj T* (matol 2006; 33:2475-83.)Tj -2.118 -1.176 Td (7.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0025005200520051004800510003>88.4<0024000F0003>33<0026004B00520055005800560003>88.1<0024000F0003>32.9<0030004C004800470048005000440003>33.8<002B000F0003>32.9<0059004400510003>33.2<0047004800550003>33.3<002B0048004C004D004700480003>33.6<0027000F0003>]TJ /TT0 1 Tf 0.057 Tw T* [(van der )17.9(T)69.9(empel H, van der Linden S. Employment, )]TJ 0.061 Tw T* [(work disability)65.7(, and work days lost in patients )0.7(with )]TJ 0.214 Tw 0 -1.176 TD [(ankylosing spondylitis: )0.8(a cross sectional )0.9(study of )]TJ /C2_0 1 Tf 0 Tw 0 -1.176 TD [<0027005800570046004B0003005300440057004C004800510057005600110003>56<00240051005100030035004B00480058005000030027004C005600030015001300130014001E000300190013001D0016001800160010001B0011>]TJ /TT0 1 Tf -2.118 -1.176 Td (8.)Tj /Span<>> BDC ( )Tj EMC 0.143 Tw 2.118 0 Td [(Gobelet )0.9(C, )0.5(Luthi )0.9(F)79.9(, )55.6(Al-Khodairy )55.8(A)110.6(T)74.4(, )0.5(Chamberlain )]TJ /C2_0 1 Tf 0 Tw T* [<0030002400110003>-115.9<003A>80.3<00520055004E0003>-133.7<004C00510003>-133.4<004C005100C00044005000500044005700520055005C0003>-132.9<0044005100470003>-133.5<00470048004A004800510048005500440057004C005900480003>-132.8<004D0052004C005100570003>]TJ T* <0047004C005600480044005600480056001100030027004C005600440045004C004F000300350048004B00440045004C004F0003001500130013001A001E00030015001C001D00140016001600140010001C0011>Tj /TT0 1 Tf -2.118 -1.176 Td (9.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002A00550044005D004C00520003>-68.5<0036000F0003>-69<002D0044004D004C00FC0003>-68.4<003D000F0003>-68.7<00310048005000FE004C00FC0003>-50.1<0037>74.4<000F0003>-68.9<002D0044004D004C00FC0003>-68.3<002C00110003>-50.8<003A>80.2<00520055004E0003>-68.9<00460044005300440046004C0057005C0003>]TJ /TT0 1 Tf 0.157 Tw T* [(evaluation )1.2(in )0.5(patients )0.9(with ankylosing )0.6(spondylitis. )]TJ 0 Tw T* (Reumatizam 1997; 46:1-5. )Tj -2.118 -1.176 Td (10.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002B005800560051004C0003>-150<00300028000F0003>-149.8<0030004800550052004F00440003>-149.8<002D0029>79.7<000F0003>-149.8<002700440059004C00510003>-149.7<003600110003>-131.9<0037004B00480003>-149.5<00530056005C0046004B0052005600520046004C0044004F0003>]TJ /TT0 1 Tf 0.034 Tw T* [(burden )0.6(of psoriatic )1.1(arthritis. )1(Semin )55.9(Arthritis )0.9(Rheum )]TJ 0 Tw T* (2017; 47:351-60.)Tj 23.234 49.416 Td [(1)37.1(1.)]TJ /Span<>> BDC ( )Tj EMC 0.084 Tw 2.118 0 Td [(W)40.2(u JJ, Penfold RB, Primatesta )0.6(P)110.6(, Fox )17.7(TK, Stewart )]TJ -0.032 Tw T* [(C, Reddy SP)110.5(, Egeber)18.1(g )54.8(A, Liu J, Simon G. )17.5(The risk of )]TJ 0.08 Tw T* [(depression, suicidal ideation )0.6(and suicide attempt )0.7(in )]TJ 0.052 Tw T* (patients with psoriasis, psoriatic arthritis or ankylo)Tj 0 Tw (-)Tj /C2_0 1 Tf T* [<0056004C0051004A0003>-314.4<00560053005200510047005C004F004C0057004C005600110003>-313.9<002D0003>-314.4<0028005800550003>-259.2<00240046004400470003>-314.3<0027004800550050004400570052004F0003>-295.7<0039>110.7<004800510048005500480052004F0003>]TJ /TT0 1 Tf T* [(2017; 31:1)37.4(168-75.)]TJ -2.118 -1.176 Td (12.)Tj /Span<>> BDC ( )Tj EMC -0.029 Tw 2.118 0 Td [(Meesters JJ, )-0.7(Bremander )55.4(A, )-0.6(Ber)18.3(gman S, )-0.6(Petersson IF)79.9(, )]TJ -0.041 Tw T* [(T)35.3(urkiewicz )55.7(A, Englund M. )17.8(The risk for depression in )]TJ 0.129 Tw T* [(patients )0.8(with ankylosing )0.5(spondylitis: )0.6(a population-)]TJ -0.007 Tw 0 -1.176 TD [(based cohort study)65(. )55.2(Arthritis Res )18.1(Ther 2014; 16:418.)]TJ 0 Tw -2.118 -1.176 Td (13.)Tj /Span<>> BDC ( )Tj EMC 0.174 Tw 2.118 0 Td [(Meesters J, Ber)18.2(gman S, Haglund E, Jacobsson L, )]TJ 0.163 Tw 0 -1.176 TD [(Petersson IF)80(, Bremander )55.6(A. Prognostic )0.6(factors )0.5(for )]TJ 0.206 Tw T* [(change )0.9(in self-reported )0.7(anxiety )1.1(and )0.6(depression )0.6(in )]TJ 0.207 Tw T* [(spondyloarthritis patients: )0.6(data from the populati)]TJ 0 Tw 20.56 0 Td (-)Tj 0.046 Tw -20.56 -1.176 Td (on-based SpAScania cohort from southern Sweden. )Tj 0 Tw T* (Scand J Rheumatol 2018; 47:185-93.)Tj -2.118 -1.176 Td (14.)Tj /Span<>> BDC ( )Tj EMC 0.049 Tw 2.118 0 Td [(Zochling )0.9(J. Measures of symptoms )0.5(and disease )0.5(sta)]TJ 0 Tw (-)Tj 0.017 Tw T* [(tus in ankylosing spondylitis: )55.8(Ankylosing Spondyli)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* [<0057004C00560003>-256.3<0027004C005600480044005600480003>-201.2<002400460057004C0059004C0057>0.7<005C0003>-256.6<003600460052005500480003>-256.3<000B00240036002700240036>-0.8<000C000F0003>-201.4<00240051004E005C004F00520056004C0051004A0003>]TJ /TT0 1 Tf 0.21 Tw T* [(Spondylitis )0.9(Quality )1(of )0.6(Life )1(Scale )1(\(ASQoL\), Bath )]TJ /C2_0 1 Tf 0 Tw T* [<00240051004E005C004F00520056004C0051004A0003>-515.1<00360053005200510047005C004F004C0057004C00560003>-514.8<0027004C005600480044005600480003>-459.8<002400460057004C0059004C0057005C0003>-514.5<002C005100470048005B0003>]TJ T* [<000B00250024003600270024002C000C000F0003>19.4<002500440057004B0003>75.5<00240051004E005C004F00520056004C0051004A0003>20.2<00360053005200510047005C004F004C0057004C00560003>20.4<00290058005100460057004C005200510044004F0003>]TJ /TT0 1 Tf -0.033 Tw T* [(Index \(BASFI\), )-0.7(Bath )54.9(Ankylosing Spondylitis Global )]TJ 0.145 Tw T* [(Score \(BAS-G\), )-0.8(Bath )55.2(Ankylosing Spondylitis Me)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* [<005700550052004F0052004A005C0003>43.4<002C005100470048005B0003>43.2<000B0025002400360030002C000C000F0003>42.9<002700520058004A00440047005200560003>42.9<00290058005100460057004C005200510044004F0003>43.8<002C005100470048005B0003>]TJ T* [<000B00270029002C000C000F0003>-15.7<0044005100470003>-15.3<002B00480044004F0057004B0003>40.2<00240056005600480056005600500048005100570003>-15.4<00340058004800560057004C0052005100510044004C005500480003>-14.9<0049005200550003>-15.4<0057004B00480003>]TJ /TT0 1 Tf 0.162 Tw 0 -1.176 TD [(Spondylarthropathies )1.3(\(HAQ-S\). )55(Arthritis )0.9(Care )0.8(Res )]TJ 0 Tw 0 -1.176 TD [(\(Hoboken\) 201)37.1(1; 63 \(Suppl 1)37.3(1\):S47-58.)]TJ -2.118 -1.176 Td (15.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<002A004F004400470050004400510003>-401.1<00270027000F0003>-401.9<002B0048004F004F004C005A0048004F004F0003>-400.8<0033>110.7<000F0003>-401.5<003000480044005600480003>-401.5<0033002D000F0003>-401.9<003100440056004B0003>-401.7<0033>110.7<000F0003>]TJ /TT0 1 Tf 0.136 Tw T* [(Ritchlin )0.5(C, )17.8(T)70(aylor )18.1(W)91.9(. )54.9(Assessment of patients with )]TJ 0.224 Tw T* [(psoriatic arthritis: )0.5(a review of currently available )]TJ 0 Tw T* [(measures. )55.5(Arthritis Rheum 2004; 50:24-35.)]TJ -2.118 -1.176 Td (16.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<003A002B003200110003>-308<002C0051005700480055005100440057004C005200510044004F0003>-306.8<0046004F004400560056004C00BF004600440057004C005200510003>-307<005200490003>-307.9<00490058005100460057004C00520051004C0051004A000F0003>]TJ /TT0 1 Tf 0.128 Tw T* [(disability )1.2(and heal)0.5(th. )0.5(Geneva: )18.9(W)80.2(orld Health )0.8(Or)17.9(ga)]TJ 0 Tw (-)Tj T* (nization, 2001.)Tj -2.118 -1.176 Td (17.)Tj /Span<>> BDC ( )Tj EMC /C2_0 1 Tf 2.118 0 Td [<0036005700580046004E004C0003>-267.7<002A00110003>-268.2<002C0051005700480055005100440057004C005200510044004F0003>-267<0026004F004400560056004C00BF004600440057004C005200510003>-267.4<005200490003>-268<00290058005100460057004C0052>]TJ /TT0 1 Tf (-)Tj /C2_0 1 Tf T* [<0051004C0051004A000F0003>-41.8<0027004C005600440045004C004F004C0057005C>65.6<000F0003>-42<0044005100470003>-41.8<002B00480044004F0057004B0003>-41.5<000B002C00260029000C00110003>13<0024>55<0003>-42<0053005500520050004C0056004C0051004A0003>-41.6<004900550044>]TJ /TT0 1 Tf (-)Tj /C2_0 1 Tf T* [<00500048005A00520055004E0003>-29.7<0044005100470003>-29.8<0046004F004400560056004C00BF004600440057004C005200510003>-29.2<0049005200550003>-29.9<00550048004B00440045004C004F004C>0.8<005700440057004C005200510003>-29.2<005000480047004C0046004C>]TJ /TT0 1 Tf 20.56 0 Td (-)Tj -20.56 -1.176 Td [(ne. )55.3(Am J Phys Med Rehabil 2005; 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In the peripheral )0.9(forms of SpA)54.9( )]TJ 0.117 Tw T* [(conditions, orthoses are sometimes )0.6(used for re)]TJ 0 Tw (-)Tj 0.285 Tw T* [(ducing joint )0.5(load and preventing )0.7(deformation )]TJ 0.062 Tw T* [(and contracture, )0.5(while orthopaedic )0.7(shoes can be )]TJ /C2_1 1 Tf 0 Tw T* [<004500480051004800BF0046004C0044004F0003>-123.6<004C00510003>-124.3<0057004B00480003>-124.1<00460044005600480003>-124.2<005200490003>-124.4<00500044004D005200550003>-124<00490052005200570003>-124.2<004700480049005200550050004C0057004C004800560003>]TJ /TT0 1 Tf 0.05 Tw T* (\(22\). It should be noted that there are no studies )Tj 0.025 Tw T* [(on the use of orthoses in SpA)54.8( conditions. Howe)]TJ 0 Tw (-)Tj 0.06 Tw T* [(ver)40.2(, from the data in the studies of RA)55( it can be )]TJ /C2_1 1 Tf 0 Tw T* [<0046005200510046004F00580047004800470003>-56.6<0057004B00440057000F0003>-56.7<0049005200550003>-57.2<0048005B004400500053004F0048000F0003>-56.4<00BF0051004A004800550003>-57<005200550057004B00520056004800560003>-57.3<0046004400510003>]TJ /TT0 1 Tf -0.041 Tw T* [(be ef)18.2(fective )0.8(in correcting )0.7(deformations )0.7(and incre)]TJ 0 Tw 19.226 0 Td (-)Tj 0.063 Tw -19.226 -1.3 Td [(asing stability )0.9(and dexterity)65.7(, while foot orthoses )]TJ 0.306 Tw T* [(can )0.7(be ef)18.3(fective )1.1(in )0.5(reducing )0.8(pain, )0.7(improving )]TJ -0.026 Tw T* [(function )0.8(and )0.6(delaying )1(the )0.7(development )1.3(of bunion )]TJ 0.108 Tw T* [(\(106\). )55(Also, a systematic )0.6(review has shown )-0.6(the )]TJ /C2_1 1 Tf 0 Tw T* [<0048004900BF004600440046005C0003>33.9<005200490003>33.4<0056005300480046004C0044004F0003>34.1<0056004B0052004800560003>33.3<004C00510003>33.6<00550048004700580046004C0051004A0003>34<00530044004C00510003>33.7<0044005100470003>33.6<004C0050>]TJ /TT0 1 Tf (-)Tj T* (proving function \(107\).)Tj 0.181 Tw 0 -1.583 TD (It is important to note that orthoses should be )Tj 0.316 Tw 0 -1.3 TD (prescribed for a shortest possible period and )Tj 0.041 Tw T* [(always combined with active therapeutic )0.8(exerci)]TJ 0 Tw 19.226 0 Td (-)Tj 0.044 Tw -19.226 -1.3 Td [(se, due )0.6(to )0.5(possible )0.7(negative )1.2(ef)18.3(fects )0.6(of prolonged )]TJ 0 Tw T* (immobilization.)Tj 0.149 Tw 0 -1.583 TD [(Prescription of mobility )0.5(aids, such as crutches, )]TJ 0.097 Tw 0 -1.3 TD [(cane, )0.6(walker )0.5(or wheelchair )1(is also an important )]TJ 0.296 Tw T* [(part of rehabilitation )1.4(intervent)0.8(ions in patients )]TJ 0.009 Tw T* [(with SpA)54.8( condit)0.5(ions, especially )1(in cases of seve)]TJ 0 Tw (-)Tj T* [(re disability)65.9(. )]TJ /C2_0 1 Tf 0 -2.25 TD <00300024003100380024002F00030037002B0028003500240033003C>Tj /TT0 1 Tf 0.188 Tw 0 -1.867 TD [(Manual )0.5(therapy )0.6(is a traditional )1.3(method )0.6(of tre)]TJ 0 Tw (-)Tj 0.132 Tw 0 -1.3 TD [(atment, practice)1(d in clinics, although there is a )]TJ /C2_1 1 Tf 0 Tw T* [<004F00440046004E0003>-147.3<005200490003>-147.7<005400580044004F004C0057005C0003>-147.1<0056005700580047004C004800560003>-147.6<005A004B004C0046004B0003>-147.5<004600520058004F00470003>-147.6<00460052005100BF005500500003>-147.5<004C005700560003>]TJ /TT0 1 Tf 0.037 Tw T* [(ef)18.2(fectiveness, SpA)54.9( patients inclu)0.5(ded. )17.9(W)40.2(idber)18.3(g et )]TJ -0.055 Tw T* (al. conducted a small study on a cohort of patients )Tj 0.028 Tw T* [(with )55.6(AS \(n = 32\) who were randomized )0.9(for self-)]TJ 0.052 Tw T* [(mobilization )1.8(and )0.5(manual )1.1(spinal )0.8(mobilization )1.8(for )]TJ 0.046 Tw T* (8 weeks and compared to a control group \(108\). )Tj /C2_1 1 Tf 0 Tw T* [<00300044005100580044004F0003>-102.8<0057004B0048005500440053005C0003>-102.6<004A00550052005800530003>-103.1<0056004B0052005A004800470003>-103.3<00440003>-103<0056004C004A0051004C00BF00460044005100570003>-102.6<004C0050>]TJ /TT0 1 Tf (-)Tj -0.045 Tw T* [(provement )0.6(in chest expansion index, posture, spi)]TJ 0 Tw (-)Tj -0.03 Tw T* [(nal mobility )0.9(and functionality)66(, with improvement )]TJ 0.034 Tw T* [(in )0.7(posture, )0.6(spinal )0.7(mobility )1.3(and )0.6(functionality )1.6(ma)]TJ 0 Tw (-)Tj T* (intained for 6 months \(108\).)Tj /C2_0 1 Tf 0 -2.25 TD <00240026003800330038003100260037003800350028>Tj /TT0 1 Tf 0.094 Tw 0 -1.867 TD [(Acupuncture is increasingly )0.5(becoming a part of )]TJ 0.126 Tw 0 -1.3 TD [(treatment )0.8(in rheumatic )0.6(conditions \(109\). )54.8(A)54.9( me)]TJ 0 Tw (-)Tj /C2_1 1 Tf T* [<005700440010004400510044004F005C0056004C00560003>-121.8<0057004B004400570003>-121.9<004800590044004F005800440057004800470003>-121.4<0057004B00480003>-122.1<0048004900BF0046004C004800510046005C0003>-122<005200490003>-122.3<004400460058>]TJ /TT0 1 Tf (-)Tj 0.053 Tw T* [(puncture )0.7(in )55.6(AS patients )0.9(demonstrated )1.1(that )0.7(it )0.6(can )]TJ 0.361 Tw T* [(further improve the clinical )0.8(ef)18.2(fect, including )]TJ 0.03 Tw T* [(functional )1.1(measures )0.6(such as occiput-wall )1.2(distan)]TJ 0 Tw (-)Tj /C2_1 1 Tf T* [<00460048000F0003>-134.7<0046004B0048005600570003>-134.6<0048005B0053004400510056004C005200510003>-134.6<004C005100470048005B0003>-134.7<0044005100470003>-134.8<00BF0051004A004800550057004C0053001000570052001000C00052005200550003>]TJ /TT1 1 Tf 0.34 70.513 Td (Grazio et al.)Tj /TT0 1 Tf 5.248 0 Td ( Rehabilitation in spondyloarthritis)Tj ET 0 0 0 0 k /GS0 gs 496.346 41.752 28.346 12.874 re f endstream endobj 32 0 obj [/ICCBased 73 0 R] endobj 73 0 obj <>stream HyTSwoɞc [5laQIBHADED2mtFOE.c}08׎8GNg9w߽'0 ֠Jb  2y.-;!KZ ^i"L0- @8(r;q7Ly&Qq4j|9 V)gB0iW8#8wթ8_٥ʨQQj@&A)/g>'Kt;\ ӥ$պFZUn(4T%)뫔0C&Zi8bxEB;Pӓ̹A om?W= x-[0}y)7ta>jT7@tܛ`q2ʀ&6ZLĄ?_yxg)˔zçLU*uSkSeO4?׸c. 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reduced in these patients \(92\).)Tj -0.015 Tc 0.197 Tw 0 -1.583 TD (In spite of its widespread use in clinical practi)Tj 0 Tc 0 Tw (-)Tj -0.015 Tc 0.155 Tw 0 -1.3 TD [(ce, ef)18.1(fects of hydrotherapy and balneotherapy in)-15( )]TJ 0.138 Tw T* [(rheumatic conditions are still a matter of debate.)-15( )]TJ 0.087 Tw T* [(A)55( water)20(-based exercise program can improve cir)]TJ 0 Tc 0 Tw 19.226 0 Td (-)Tj /C2_0 1 Tf -0.015 Tc 0.015 Tw -19.226 -1.3 Td [<00460058004F00440057004C00520051000F0003>-105.3<0050005800560046004F00480003>-105.3<00560057005500480051004A0057004B000F0003>-105.3<00C00048005B004C0045004C004F004C0057005C0003>-105.3<0044005100470003>-105.3<005500440051004A00480003>-105.3<00520049>-15<0003>]TJ /TT0 1 Tf 0.141 Tw T* (motion, coordination, cardiovascular and respira)Tj 0 Tc 0 Tw (-)Tj -0.015 Tc -0.025 Tw T* [(tory conditioning and reduction of pain and muscle)-14.9( )]TJ 0.032 Tw T* [(spasm \(62, 93\). )55.5(As for )55.6(AS, several studies showed)-15( )]TJ -0.003 Tw T* [(a positive ef)18.1(fect of hydrotherapy \(therapeutic exer)]TJ 0 Tc 0 Tw 19.226 0 Td (-)Tj -0.015 Tc 0.03 Tw -19.226 -1.3 Td [(cise )0.5(included\) )0.5(and )0.5(balneotherapy in these)]TJ 0 Tc 0 Tw ( )Tj -0.015 Tc 0.015 Tw 16.319 0 Td [(patients.)-15( )]TJ 0.205 Tw -16.319 -1.3 Td [(A)55( )0.5(meta-analysis )0.5(in )55.7(AS )0.5(patients )0.5(showed )0.5(that )0.6(the)-14.8( )]TJ 0.169 Tw T* [(ef)18.1(fect of combined hydrotherapy and land-based)-15( )]TJ -0.038 Tw T* [(therapy was better than land-based therapy alone in)-15( )]TJ 0.087 Tw T* [(terms )0.5(of )0.6(pain )0.5(reduction, )0.6(improvement )0.5(in )0.5(physical)-14.8( )]TJ -0.043 Tw T* [(function and global health assessment \(94\). )54.9(A)55( study)-15( )]TJ 0.009 Tw T* [(by Olah et al. compared the ef)18.1(fect of hydrotherapy)-15( )]TJ 0.122 Tw T* [(in pipe water and in mineral water and observed)-15( )]TJ 0.07 Tw T* [(that mineral water had a better ef)18.1(fect on some in)]TJ 0 Tc 0 Tw (-)Tj /C2_0 1 Tf -0.015 Tc 0.015 Tw T* [<00C00044005000500044005700520055005C0003>-155.6<005000440055004E0048005500560003>-155.5<0044005100470003>-155.5<005600480055005800500003>-155.5<004F004C0053004C00470003>-155.5<004F004800590048004F00560003>-155.5<000B001C0018000C0011>-15<0003>]TJ /TT0 1 Tf 0.056 Tw T* [(Assessing the results of 16 randomized controlled)-15( )]TJ 0.055 Tw T* [(studies, Fran\347on and Forestier concluded )0.5(that bal)]TJ 0 Tc 0 Tw (-)Tj -0.015 Tc 0.187 Tw T* [(neotherapy resulted in long-term pain reduction,)-15( )]TJ /C2_0 1 Tf 0.015 Tw T* [<0047004800460055004800440056004800470003>-240.6<0058005600480003>-240.7<005200490003>-240.6<00510052005100560057004800550052004C00470044004F0003>-240.6<004400510057004C0010004C005100C00044005000500044005700520055005C>-15<0003>]TJ T* [<004700550058004A00560003>-202.6<000B003100360024002C00270056000C0003>-202.7<0044005100470003>-202.6<004C00500053005500520059004800500048005100570003>-202.7<004C00510003>-202.6<00490058005100460057004C005200510044004F>-14.8<0003>]TJ /TT0 1 Tf T* [(ability and/or quality of life in )55.5(AS and RA)55( patients)-15.1( )]TJ T* (\(96\).)Tj /CS0 cs 0.129 0.129 0.129 scn /GS0 gs 0 Tc 0 Tw ( )Tj 0 0 0 1 k /GS1 gs -0.015 Tc 0.132 Tw 2.208 0 Td [(Ciprian et al. evaluated the ef)18(fect of balne)]TJ 0 Tc 0 Tw (-)Tj -0.015 Tc 0.124 Tw -2.208 -1.3 Td [(otherapy in )55(AS patients treated with )18(TNF inhibi)]TJ 0 Tc 0 Tw (-)Tj -0.015 Tc 0.073 Tw T* [(tors, )0.5(and found )0.5(a )0.5(greater )0.5(improvement )0.5(in )0.5(functio)]TJ 0 Tc 0 Tw (-)Tj -0.015 Tc 0.133 Tw T* [(nal status \(measured by BASFI\), disease activity)-15( )]TJ /C2_0 1 Tf 0.015 Tw T* [<005500480047005800460057004C005200510003>-44.5<000B005000480044005600580055004800470003>-44.6<0045005C0003>-44.5<00250024003600270024002C000C000F0003>-44.5<005500440051004A00480003>-44.6<005200490003>-44.5<005000520057004C>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj -0.015 Tc 0.01 Tw T* [(on increase \(measured by BASMI\), pain reduction)-15( )]TJ 0.155 Tw T* [(\(measured by )18.5(V)128.7(AS\) and )0.5(functional improvement)-14.8( )]TJ 0.065 Tw T* [(\(measured by HAQ\) in a combination of )18.1(TNF in)]TJ 0 Tc 0 Tw (-)Tj -0.015 Tc 0.145 Tw T* [(hibitor )0.6(therapy )0.6(and )0.6(balneotherapy )0.6(than )0.6(when )0.6(the)-14.8( )]TJ -0.006 Tw T* [(TNF inhibitors were used alone. )17.7(The improvement)-14.8( )]TJ 0 Tw T* (was maintained after 3 and 6 months \(97\).)Tj 0 Tc 0.212 Tw 0 -1.583 TD [(Only )0.5(a )0.7(small )1(number )0.8(of )0.5(studies )0.7(evaluated )1.5(the )]TJ 0.322 Tw 0 -1.3 TD [(ef)18.2(fects of balneotherapy )0.5(and hydrotherapy in )]TJ 0.409 Tw T* [(other )0.8(SpA)55( )0.5(enti)0.5(ties. )0.8(Mustur et )0.6(al. )0.8(conducted )]TJ 0.103 Tw T* [(4-week spa rehabilitation )1.1(study in patients )0.6(with )]TJ /C2_0 1 Tf 0 Tw T* [<003300560024>54.7<0003>-92.2<0044005100470003>-92.1<0046005200510046004F00580047004800470003>-91.6<0057004B004400570003>-91.7<005600580046004B0003>-92.2<00440003>-92.1<005300550052004A0055004400500003>-91.9<0056004C004A0051004C00BF>]TJ /TT0 1 Tf (-)Tj -0.003 Tw T* [(cantly )0.8(reduced )0.5(disease )0.5(activity )1.1(parameters )0.9(\(num)]TJ 0 Tw (-)Tj -0.045 Tw T* [(ber )0.5(of pain )0.7(and swollen )0.5(joints, )0.7(level )0.9(of pain, )0.6(dura)]TJ 0 Tw (-)Tj 0.046 Tw T* [(tion )0.5(of morning )0.5(stif)18.3(fness, and composite )0.7(disease )]TJ /C2_0 1 Tf 0 Tw T* <004400460057004C0059004C0057005C0003004C005100470048005B00030027002400360015001B000C0003000B001C001B000C0011>Tj ET 0 0 0 0 k /GS0 gs 70.866 41.686 28.346 12.874 re f endstream endobj 23 0 obj <>stream q /GS0 gs /Fm0 Do Q BT 0 0 0 1 k /GS1 gs /TT0 1 Tf 11 0 0 11 502.2697 44.9321 Tm (217)Tj -0.01 Tc 0.046 Tw 10 0 0 10 85.0394 735.7435 Tm (As postural stability is deteriorating with the pro)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.083 Tw 0 -1.3 TD [(gression of axSpA/AS, exercises for balance and)-10( )]TJ 0.2 Tw T* [(posture should be included in the rehabilitation)-10( )]TJ /C2_0 1 Tf 0.01 Tw T* [<005300550052004A00550044005000110003>-143.5<00270048005000520051004C0057004C00560003>-143.5<004800570003>-143.5<0044004F00110003>-143.5<0047004800500052005100560057005500440057004800470003>-143.5<005300520056004C0057004C00590048>-9.8<0003>]TJ /TT0 1 Tf 0.216 Tw T* [(ef)18(fects of the supervised rehabilitation program)-9.8( )]TJ 0.055 Tw T* (and home-based rehabilitation program on balan)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.038 Tw T* (ce and postural stability \(68\). In the study by Gu)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.081 Tw T* [(nay et al. balance and postural stability exercises)-10.1( )]TJ 0.1 Tw T* [(in addition to a spa-based rehabilitation program)-9.9( )]TJ -0.058 Tw T* [(increased the duration of maintaining balance \(69\).)-10( )]TJ 0 Tc 0.071 Tw 0 -1.583 TD [(For )55.2(AS patients, )0.9(special )0.8(exercise )0.8(programs such )]TJ 0.066 Tw 0 -1.3 TD [(as the Global Posture Reeducati)0.9(on method have )]TJ 0.118 Tw T* [(been developed. )18.6(This method )0.6(is based on exer)]TJ 0 Tw 19.226 0 Td (-)Tj 0.065 Tw -19.226 -1.3 Td [(cises for shortened )0.6(muscular )0.6(chains, )0.6(such as the )]TJ 0.108 Tw T* [(posterior )0.5(chain, )0.7(anterior )0.8(diaphra)0.5(gmal )0.6(chain, )0.7(an)]TJ 0 Tw (-)Tj 0.169 Tw T* [(teromedial )1.5(pelvic )0.7(chain )0.9(and )0.6(the )0.7(scapular )0.8(chain )]TJ 0.022 Tw T* [(\(70, )0.5(71\). Some )0.6(studies )0.7(have )0.7(shown that )0.9(this )0.7(type )]TJ T* [(of exercise )0.6(is better )0.9(than )0.7(a )0.5(conventional )1.1(exercise )]TJ 0.019 Tw T* [(in outcomes such as forced )0.5(vital)0.6( capacity)65.9(, forced )]TJ 0.045 Tw T* [(expiratory )0.6(volume in one second and peak expi)]TJ 0 Tw (-)Tj /C2_0 1 Tf T* <00550044005700520055005C000300C00052005A0003000B001A00140010001A0016000C0011>Tj 0 -1.583 TD [<00240048005500520045004C00460003>-66.5<0048005B004800550046004C00560048>0.6<00560003>-67<0044005500480003>-66.5<005900480055005C0003>-66.7<004500480051004800BF0046004C0044004F0003>-66<004C00510003>-66.6<005300440057004C00480051005700560003>]TJ /TT0 1 Tf 0.088 Tw 0 -1.3 TD [(with )55.2(AS. One type of aerobic exercise )0.5(often re)]TJ 0 Tw (-)Tj 0.024 Tw T* [(commended )0.9(to )55.6(AS patients )0.8(is swimming, )0.9(though )]TJ 0.02 Tw T* [(evidence )1(of its overall )0.9(ef)18.2(fectiven)0.8(ess is limited. )56.4(A)55( )]TJ /C2_0 1 Tf 0 Tw T* [<0056005700580047005C0003>-56.6<0045005C0003>-56.5<002E00440055004400530052004F004400570003>-56<004800570003>-56.2<0044004F00110003>-56.3<0056004B0052005A004800470003>-56.7<0056004C004A0051004C00BF00460044005100570003>-56.1<004C0050>]TJ /TT0 1 Tf (-)Tj 0.108 Tw T* [(provement )0.8(in exercise )0.8(tolerance)0.9( and pulmonary )]TJ 0.163 Tw T* [(capacity )1.4(by )0.5(combining )1.2(swimming )0.5(and )0.7(walking )]TJ 0.06 Tw T* [(\(74\). In the )0.7(study of Jennings et )0.7(al. )0.6(aerobic )1(trai)]TJ 0 Tw (-)Tj -0.026 Tw T* [(ning )0.5(led )0.7(to )0.6(improvements )1.1(in )0.6(aerobic )0.7(capacity )1.3(and )]TJ 0.084 Tw T* (maximum walking distance but did not have an )Tj 0.211 Tw T* [(impact )0.7(on functional )0.6(capacity)65.9(, mobility)65.8(, disea)]TJ 0 Tw (-)Tj 0.089 Tw T* [(se activity)65.8(, quality )0.7(of life )0.5(and blood lipid )0.6(levels )]TJ 0.034 Tw T* [(\(75\). )55.6(Although )0.5(morbidity )1.1(and )0.5(mortality )1.4(of cardi)]TJ 0 Tw (-)Tj -0.04 Tw T* [(ovascular )0.6(diseases in SpA)54.8( patients )0.8(are )0.5(increasing, )]TJ /C2_0 1 Tf 0 Tw T* [<004500480051004800BF005700560003>-148.2<005200490003>-148.4<00440048005500520045004C00460003>-147.7<0048005B004800550046004C005600480003>-147.8<004C00510003>-148.2<0057004B00480003>-148<005500480047005800460057004C005200510003>-147.8<005200490003>]TJ /TT0 1 Tf 0.021 Tw T* [(cardiovascular )1.4(risk )0.5(have )0.8(not )0.7(yet )0.8(been )0.8(adequately )]TJ 0 Tw T* (studied in this population \(76\).)Tj 0.058 Tw 0 -1.583 TD [(Pilates, )18.9(T)69.9(ai-chi, )38.1(Y)99.9(oga )0.5(and simila)0.7(r techniques )0.9(are )]TJ -0.026 Tw 0 -1.3 TD [(becoming increasingly attractive )0.9(for various con)]TJ 0 Tw (-)Tj 0.073 Tw 0 -1.3 TD [(ditions, )0.9(SpA)54.8( )0.6(included. )56(Altan )0.8(et )0.9(al. )0.8(evaluated )1.5(the )]TJ -0.007 Tw T* [(ef)18.2(fect )0.5(of Pilates )0.5(exercise )0.6(in patients )0.7(with )55.4(AS, and )]TJ 0.147 Tw T* [(the )0.8(results )0.7(showed )0.6(an )0.6(increase )1.1(in )0.6(functionality)66.1(, )]TJ -0.003 Tw T* (measured by BASFI \(77\). Rosu et al. demonstra)Tj 0 Tw 19.226 0 Td (-)Tj /C2_0 1 Tf -19.226 -1.3 Td [<0057004800470003>-66<0057004B00480003>-66<004500480051004800BF005700560003>-66.2<005200490003>-66.3<00500058004F0057004C0050005200470044004F0003>-65.2<0048005B004800550046004C005600480003>-65.9<005300550052004A0055004400500003>]TJ /TT0 1 Tf 0.322 Tw T* [(combining )0.9(Pilates, )0.7(McKenzie, )0.7(and Heckscher )]TJ /C2_0 1 Tf 0 Tw T* [<005700480046004B0051004C00540058004800560003>-0.7<005A004C0057004B0003>-1.2<0056004C004A0051004C00BF00460044005100570003>-0.9<004C00500053005500520059004800500048005100570003>-0.7<004C00510003>-1.2<00530044004C0051000F0003>]TJ T* [<004F005800500045004400550003>-234<00560053004C005100480003>-234.3<005000520045004C004F004C0057005C0003>-233.6<000B005000520047004C00BF004800470003>-234.5<00360046004B00520045004800550003>-234.3<0057004800560057000F0003>]TJ T* [<00BF0051004A004800550057004C00530056001000C00052005200550003>19.9<0047004C005600570044005100460048000C000F0003>20.5<0025002400360029002C000F0003>19.5<00250024003600270024002C000F0003>19.2<00250024>]TJ /TT0 1 Tf (-)Tj 0.014 Tw T* [(SMI and )0.5(chest )0.7(expansion )0.6(\(78\). )18.4(There )0.8(is only )0.6(one )]TJ /C2_0 1 Tf 0 Tw 21.543 64.55 Td [<0056005700580047005C0003>-73.4<0057004B004400570003>-73.1<004C00510059004800560057004C004A00440057004800470003>-72.7<0057004B00480003>-73.1<0048004900BF004600440046005C0003>-73.3<005200490003>-55.4<0037>70<0044004C00100046004B004C0003>-72.8<004C00510003>]TJ /TT0 1 Tf 0.2 Tw T* [(SpA)54.9( conditions, )0.6(and the results suggested that )]TJ -0.026 Tw T* [(this type of exercise can decrease )0.5(disease activity )]TJ /C2_0 1 Tf 0 Tw T* [<0044005100470003>47<004C0050005300550052005900480003>47.4<00C00048005B004C0045004C004F004C0057005C0003>47.7<004C00510003>47.1<005300440057004C00480051005700560003>47.5<005A004C0057004B0003>102.2<00240036000F0003>46.6<0044004F0057004B0052>]TJ /TT0 1 Tf 19.226 0 Td (-)Tj -0.031 Tw -19.226 -1.3 Td [(ugh the )0.7(possibility )0.9(of the )0.7(placebo )1(ef)18.2(fect )0.8(could )0.7(not )]TJ -0.011 Tw T* [(be discounted \(79\). )36.6(Y)99.9(oga seems to be ef)18.2(fective in )]TJ /C2_0 1 Tf 0 Tw T* [<0047004800460055004800440056004C0051004A0003>-107<00530044004C00510003>-107.3<0044005100470003>-107.5<004C005100C000440050005000440057004C>1<005200510003>-107.6<005A004B004C004F00480003>-107.3<004C00510046005500480044>]TJ /TT0 1 Tf 19.226 0 Td (-)Tj -0.045 Tw -19.226 -1.3 Td [(sing QoL)37.1( in patients with RA)55( \(80\), but despite the )]TJ 0.048 Tw T* [(increasing acceptance )1.1(and its use as an ef)18.2(fective )]TJ 0.052 Tw T* [(mind-body techn)0.5(ique, there are no studies about )]TJ 0 Tw T* [(its ef)18.4(fect in patients with SpA)56.3( \(81\).)]TJ 0.171 Tw 0 -1.583 TD [(As the treatmen)1(t of )55.1(AS with )18.1(TNF-)]TJ /C2_1 1 Tf 0 Tw <0044>Tj /TT0 1 Tf 0.171 Tw ( inhibitors )Tj 0.073 Tw 0 -1.3 TD [(is becoming )1(more )0.6(widespread, )0.6(a )0.5(number )0.6(of stu)]TJ 0 Tw (-)Tj 0.191 Tw T* [(dies )0.6(analysed )0.6(the )0.6(ef)18.2(fect )0.9(of )0.5(the combination )1.4(of )]TJ 0 Tw T* (TNF-)Tj /C2_1 1 Tf <0044>Tj /TT0 1 Tf 0.031 Tw [( inhibitors and therapeuti)1(c exercises. Me)]TJ 0 Tw (-)Tj 0.094 Tw T* [(ta-analysis )1(has shown that )0.8(this )0.5(combination )1.3(has )]TJ 0.21 Tw T* (improved outcomes measuring disease activity )Tj /C2_0 1 Tf 0 Tw T* <000B00250024003600270024002C000C00030044005100470003005500440051004A00480003005200490003005000520057004C005200510003000B0025002400360030002C000C0003000B001B0015000C0011>Tj /TT0 1 Tf -0.01 Tc 0.148 Tw 0 -1.583 TD [(The ef)18.1(fects of rehabilitation modalities, therape)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.178 Tw 0 -1.3 TD [(utic exercise included, in PsA, as well as other)-10( )]TJ /C2_0 1 Tf 0.01 Tw T* [<00360053002400100056000F0003>-245.9<004B0044005900480003>-245.9<0051005200570003>-245.9<00450048004800510003>-245.9<00560058004900BF0046004C004800510057004F005C0003>-245.9<004800590044004F005800440057004800470003>-246<00560052>-10<0003>]TJ /TT0 1 Tf 0.422 Tw T* [(far)55.1(. Nevertheless, the international society of)-10( )]TJ 0.105 Tw T* [(experts on psoriasis and PsA)55( \(Group for Resear)]TJ 0 Tc 0 Tw 19.226 0 Td (-)Tj -0.01 Tc 0.091 Tw -19.226 -1.3 Td [(ch and )55.4(Assessment of Psoriatic and Psoriatic )55.4(Ar)]TJ 0 Tc 0 Tw 19.226 0 Td (-)Tj -0.01 Tc 0.141 Tw -19.226 -1.3 Td [(thritis - GRAPP)91.6(A\) considers rehabilitation to be)-9.9( )]TJ 0.232 Tw T* [(an important component of treatment for these)-9.8( )]TJ 0.133 Tw T* [(patients \(21\). )0.5(Physical )0.5(therapy has )0.5(been particu)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.026 Tw T* [(larly ef)18.1(fective in the axial form of the disease and)-10( )]TJ 0.067 Tw T* [(in the treatment of enthesitis \(83\). )55.1(A)55.1( recent study)-10( )]TJ 0.077 Tw T* [(by Roger)20.1(-Silva et al. observed positive ef)18(fects of)-10( )]TJ 0.063 Tw T* [(resistance training in PsA)55( patients in the sense of)-10( )]TJ -0.002 Tw T* [(improvement in functional capacity and quality of)-10( )]TJ 0.04 Tw T* [(life, as well as in the reduction of disease activity)-10( )]TJ /C2_0 1 Tf 0.01 Tw T* [<000B005000480044005600580055004800470003>-120.6<0045005C0003>-120.6<00250024003600270024002C000C000F0003>-120.6<0044004F0057004B00520058004A004B0003>-120.5<005100520003>-120.6<0056004C004A0051004C00BF0046004400510057>-9.8<0003>]TJ /TT0 1 Tf 0 Tw T* [(increase in muscle strength was observed \(84\).)-10( )]TJ -0.015 Tc 0.056 Tw 0 -1.583 TD [(Adherence is one of the most important factors in)-15( )]TJ -0.085 Tw 0 -1.3 TD [(the success of the therapeutic exercise. )55.5(According to)-15( )]TJ 0.046 Tw T* [(some studies, adherence for supervised short-term)-14.8( )]TJ 0.034 Tw T* [(programs \(1-12 months\) was found to be 68-93%,)-15( )]TJ /C2_0 1 Tf 0.015 Tw 0 -1.3 TD [<005A004B004C004F00480003>-21.2<004F00520051004A001000570048005500500003>-21.3<00440047004B0048005500480051004600480003>-21.2<0055004800540058004C0055004C0051004A0003>-21.2<0056004C004A0051004C00BF00460044005100570003>-21.2<004F004C>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj -0.015 Tc 0.114 Tw 0 -1.3 TD [(festyle changes was 25-50% \(85, 86\). )54.9(Adherence)-14.8( )]TJ 0.122 Tw T* [(was better if exercise technique and purpose had)-15( )]TJ 0.015 Tw T* [(been )0.5(clearly )0.5(explained )0.5(and )0.5(if )0.5(they )0.5(could )0.5(be perfor)]TJ 0 Tc 0 Tw 19.226 0 Td (-)Tj -0.015 Tc 0.112 Tw -19.226 -1.3 Td [(med in a safe environment under the supervision)-15( )]TJ 0.034 Tw T* [(of a physiotherapist. 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Spinal mobilization )1.4(exerci)]TJ 0 Tw 19.226 0 Td (-)Tj 0.033 Tw -19.226 -1.3 Td [(ses can )0.6(be )0.5(performed )0.9(from )0.6(a )0.5(supine, )0.6(crawling )0.9(or )]TJ 0.068 Tw T* [(seated position. Chest mobilizat)1.1(ion is especially )]TJ 0.032 Tw T* [(important )1(in patients )0.8(with )55.4(AS, and )]TJ /CS0 cs 0.129 0.129 0.129 scn /GS0 gs [(in addition )0.8(to )]TJ 0.052 Tw T* [(breathing exerci)0.6(ses, activities )0.7(such as singing or )]TJ 0.108 Tw T* [(playing a wind instrument )0.6(are also encouraged. )]TJ 0.027 Tw T* [(Studies evaluating )1.1(the ef)18.3(fect )0.5(of therapeutic )1.2(exer)]TJ 0 Tw 19.226 0 Td (-)Tj 0.044 Tw -19.226 -1.3 Td [(cises on pulmonary function in patients with )54.9(AS )]TJ 0.131 Tw T* [(have )0.8(shown positive )1(results )0.6(in )0.6(multiple )1.5(pulmo)]TJ 0 Tw (-)Tj 0.113 Tw T* [(nary function )0.6(outcomes, )0.6(includi)0.6(ng chest )0.5(expan)]TJ 0 Tw (-)Tj 0.432 Tw T* [(sion, maximal )0.5(inspiratory pressure, maximal )]TJ 0.041 Tw T* [(expiratory )0.6(pressure and overall )0.6(pulmonary )0.5(func)]TJ 0 Tw (-)Tj 0.109 Tw T* [(tion )0.6(\(63\). )55.4(A)55.1( study by Basakci )0.7(Calik )0.8(et )0.6(al. )0.6(inve)]TJ 0 Tw (-)Tj -0.005 Tw T* [(stigated the ef)18.3(fects of inspiratory muscle training )]TJ 0.029 Tw T* [(and showed that )0.7(this type )0.5(of exercise )0.8(in addition )]TJ 0.211 Tw T* [(to conventional )0.8(exercises )0.5(increased )0.7(inspiratory )]TJ -0.02 Tw T* [(muscle strength, functional )0.7(exercise capacity )0.9(and )]TJ 0 Tw T* [(positively af)18.9(fected disease activity \(64\). )]TJ 0 0 0 1 k /GS1 gs 0.274 Tw 0 -1.583 TD [(Strengthening )0.5(exercises are also an important )]TJ 0.005 Tw 0 -1.3 TD [(part of SpA)55( rehabilitation )1(because the disease le)]TJ 0 Tw (-)Tj 0.022 Tw T* [(ads to loss )-0.6(of muscle strength due to both inacti)]TJ 0 Tw 19.226 0 Td (-)Tj /C2_0 1 Tf -19.226 -1.3 Td [<0059004C0057005C0003>-4.7<0044005100470003>-5<0057004B00480003>-4.8<004C005100C00044005000500044005700520055005C0003>-4.4<00530055005200460048005600560003>-5.4<004C005700560048004F00490003>-4.5<000B00190018000F0003>-5.1<00190019000C00110003>]TJ /CS0 cs 0.129 0.129 0.129 scn /GS0 gs /TT0 1 Tf 0.229 Tw T* [(In axSpA/AS patients )0.6(special )0.7(attention )1(should )]TJ 0.116 Tw T* (be given to the strengthening of the antigravity )Tj 0.163 Tw T* [(muscles - spine extensors and gluteal )0.5(muscles, )]TJ /C2_0 1 Tf 0 Tw T* [<0044004F0057004B00520058004A004B0003>-102.7<004F00440057004800550044004F0003>-102.2<0057005500580051004E0003>-103.1<00C00048005B0052005500560003>-103.3<0044005100470003>-103<0057005500580051004E0003>-103.1<005500520057004400570052005500560003>]TJ /TT0 1 Tf -0.034 Tw T* [(should not be neglected )0.7(\(50, 61\). Caution is requ)]TJ 0 Tw (-)Tj 0.064 Tw T* [(ired )0.8(in )0.7(the )0.7(mobilization )1.8(of )0.5(the )0.8(joints )0.9(with )0.7(active )]TJ /C2_0 1 Tf 0 Tw T* [<004C005100C000440050005000440057004C005200510003>-84.2<005200550003>-85.1<004C00510003>-85<00500052005500480003>-84.8<005000480046004B00440051004C00460044004F004F005C0003>-83.8<004C005000530044004C0055004800470003>]TJ /TT0 1 Tf 0.205 Tw T* [(joints when gentle )0.5(active )0.5(assisted exercises )]TJ 0 0 0 1 k /GS1 gs 0 Tw (or )Tj /CS0 cs 0.129 0.129 0.129 scn /GS0 gs 0.061 Tw T* [(isometric )0.6(exercises can be used because of their )]TJ 0 Tw T* [(minimal ef)19.2(fect on joint load \(67\).)]TJ ET 0 0 0 0 k 70.866 41.686 28.346 12.874 re f endstream endobj 88 0 obj <>stream q /GS0 gs /Fm0 Do Q BT 0 0 0 1 k /GS1 gs /TT0 1 Tf 11 0 0 11 502.2697 44.9321 Tm (215)Tj /C2_0 1 Tf -0.01 Tc 0.01 Tw 10 0 0 10 85.0394 735.2711 Tm [<00560057005500520051004A0003>-277<00480059004C004700480051004600480003>-277.1<005200510003>-277<0057004B00480003>-277<0048004900BF004600440046005C0003>-277<0044005100470003>-277.1<004F00520051004A00100057004800550050>-9.8<0003>]TJ /TT0 1 Tf 0.079 Tw 0 -1.3 TD [(ef)18(fectiveness of joint protection programs, which)-10( )]TJ -0.015 Tw T* (should be done under the supervision of an adequ)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.36 Tw T* [(ate professional, mostly occupational therapist)-9.8( )]TJ 0.046 Tw T* [(\(33, 34\). Maintaining proper posture is especially)-9.9( )]TJ -0.015 Tw T* [(important for patients with )55.2(AS/axSpA. In the initi)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.002 Tw T* [(al stage of the disease, lumbar lordosis is reduced,)-10( )]TJ 0.058 Tw T* [(followed by the increase of the thoracic kyphosis)-10.2( )]TJ 0.141 Tw T* [(and the reduction of the cervical lordosis, while)-9.9( )]TJ 0.112 Tw T* (in the later stage of the disease, a hip contractu)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.093 Tw T* [(re can occur)40.1(, which, in order to maintain the ba)]TJ 0 Tc 0 Tw (-)Tj /C2_0 1 Tf -0.01 Tc 0.01 Tw T* [<004F0044005100460048000F0003>-82.7<0055004800560058004F005700560003>-82.7<004C00510003>-82.7<00460052005000530048005100560044005700520055005C0003>-82.8<004E0051004800480003>-82.7<00C00048005B004C0052005100110003>-64.7<0037004B004C0056>-10.2<0003>]TJ /TT0 1 Tf 0.097 Tw T* [(type of posture is called \223skier)-37.1(\222)55.2(s stance\224. In bio)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.06 Tw T* [(mechanical sense, it is rather inef)18.1(fective in main)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.113 Tw T* [(taining proper balance because even in the early)-9.9( )]TJ -0.042 Tw T* [(stage of the disease it shifts the gravitational centre)-9.8( )]TJ 0.085 Tw T* [(forward \(35\). )18.3(Therefore, patients should be advi)]TJ 0 Tc 0 Tw (-)Tj /C2_0 1 Tf -0.01 Tc 0.01 Tw T* [<0056004800470003>-16<0051005200570003>-16<005700520003>-16.1<00560053005200510057004400510048005200580056004F005C0003>-16<005600570044005100470003>-16<000B005200550003>-16<0056004C0057000C0003>-16<004C00510003>-16.1<00440003>-16.1<00C00048005B004C00520051>-10<0003>]TJ /TT0 1 Tf 0.115 Tw T* (posture, even though it reduces pain. Implemen)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.054 Tw T* [(ting er)18.1(gonomic rules at home, workplace and du)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.067 Tw T* [(ring )0.5(recreational )0.5(activities )0.6(will )0.5(improve )0.5(the )0.6(long-)]TJ -0.023 Tw T* [(term functional outcome of the disease. In order to)-10( )]TJ -0.028 Tw T* [(minimize long-term consequences, regular change)-9.8( )]TJ 0.132 Tw T* [(of body position, stretching and postural control)-9.9( )]TJ 0.172 Tw T* [(are recommended. )18.2(When working in an upright)-9.8( )]TJ -0.016 Tw T* [(position, the working surface should be at a height)-9.8( )]TJ -0.002 Tw T* [(that allows working without bending. )55.2(A)55( chair sho)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.025 Tw T* [(uld provide support for the entire spine, including)-10( )]TJ 0.072 Tw T* (the neck, while the hips and knees should be po)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.013 Tw T* [(sitioned at 90 degrees, foot pads should be used if)-10( )]TJ /C2_0 1 Tf 0.01 Tw T* [<00490048004800570003>-47.6<004700520003>-47.6<0051005200570003>-47.6<0055004800440046004B0003>-47.6<0057004B00480003>-47.6<00C0005200520055>40<000F0003>-47.6<005A004B004C004F00480003>-47.5<004400550050005500480056005700560003>-47.6<004B0048004F00530003>-47.6<00570052>-10<0003>]TJ /TT0 1 Tf -0.009 Tw T* (reduce the strain on the cervical muscles. For peo)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc -0.043 Tw T* [(ple who spend more time working at the computer)40(,)-10( )]TJ -0.008 Tw T* [(a simple adaptation of the height of the screen and)-10( )]TJ /C2_0 1 Tf 0.01 Tw T* [<0057004B00480003>-135<0046004B0044004C00550003>-135<0046004400510003>-135<00500044004E00480003>-135<00440003>-135<0056004C004A0051004C00BF00460044005100570003>-135<0047004C0049>18.1<00490048005500480051004600480003>-135<000B00160017000C0011>-10<0003>]TJ /TT0 1 Tf 0.077 Tw T* [(Car seats should support the neck and spine, and)-10( )]TJ 0.118 Tw T* [(headrest should be at least 7 cm higher than the)-9.8( )]TJ 0.204 Tw T* [(eye )0.6(level. )0.6(Specially )0.6(designed )0.6(rear )0.6(view )0.6(mirrors)-10.1( )]TJ /C2_0 1 Tf 0.01 Tw T* <0046004400510003004C005100460055004800440056004800030057004B0048000300BF0048004F004700030052004900030059004C0056004C005200510003000B00160019000C0011>Tj /TT0 1 Tf 0.009 Tw 0 -1.583 TD [(Since the lack of ener)18.1(gy and fatigue are important)-9.9( )]TJ /C2_0 1 Tf 0.01 Tw 0 -1.3 TD [<0056005C0050005300570052005000560003>-280.3<005200490003>-280.3<004C005100C00044005000500044005700520055005C0003>-280.2<0055004B00480058005000440057004C00460003>-280.3<0047004C005600480044005600480056000F>-10<0003>]TJ /TT0 1 Tf 0.066 Tw T* (patients should be advised on resting, and the re)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.079 Tw T* [(sting position should prevent the development of)-10( )]TJ 0.121 Tw T* [(the contractures. Patients with )54.8(AS/axSpA)55( are re)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc -0.01 Tw T* [(commended to lie supine but should have a pillow)-10.1( )]TJ 0.101 Tw T* (under the head, which should be as small as po)Tj 0 Tc 0 Tw (-)Tj /C2_0 1 Tf -0.01 Tc 0.01 Tw T* [<00560056004C0045004F004800110003>-93.9<002B004C00530003>-93.9<00C00048005B004C005200510003>-93.9<0046005200510057005500440046005700580055004800560003>-93.9<0046004400510003>-93.8<004500480003>-93.9<005300550048005900480051005700480047>-10<0003>]TJ /TT0 1 Tf 0.028 Tw T* [(by laying prone twice a day for 20-30 minutes or)40(,)-10( )]TJ 0.002 Tw T* [(when lying supine, by suspending the leg over the)-9.8( )]TJ 0 Tw T* (edge of the bed, thus stretching the hips \(37\).)Tj /C2_1 1 Tf 0 Tc 21.543 63.964 Td <0037002B0028003500240033002800380037002C002600030028003B002800350026002C003600280003>Tj /TT0 1 Tf 0.076 Tw 0 -1.867 TD [(Therapeutic )1.4(exercise )1(is the )0.6(most )0.5(important )1.2(non-)]TJ 0.349 Tw 0 -1.3 TD [(pharmacological )1.1(intervention )0.6(in patients with )]TJ 0.016 Tw T* [(SpA, having )0.7(a )0.7(preventive )1.2(and )0.6(therapeutic )1.4(purpo)]TJ 0 Tw (-)Tj 0.1 Tw T* [(se. General )0.9(positive )0.8(ef)18.2(fects )0.7(of exercise )0.9(are )0.7(well )]TJ 0.239 Tw T* (known, and they include reducing the risk of )Tj 0.13 Tw T* [(cardiovascular )1.1(and metabolic )1.3(diseases \(38, 39\), )]TJ 0.064 Tw T* [(maintaining )0.9(cognitive )0.6(functions \(40\),)]TJ /TT1 1 Tf 0 Tw ( )Tj /TT0 1 Tf 15.393 0 Td (improving )Tj -0.041 Tw -15.393 -1.3 Td [(strength, mobility)65.8(, balance )0.6(and coordination )0.7(\(41\), )]TJ 0.208 Tw T* [(reducing )0.7(the )0.6(risk of fall )0.8(\(42\), increasing )0.8(bone )]TJ 0.094 Tw T* [(density \(43\), and improving )0.6(mental )0.9(health )0.7(\(44\). )]TJ 0.049 Tw T* [(Therapeutic )1.5(exercise )1(can )0.8(be )0.5(performed )0.9(in )0.6(health )]TJ 0.168 Tw T* [(facilities )1.4(or at )0.7(home, )0.6(individua)0.7(lly )0.6(or in )0.5(groups )]TJ 0 Tw T* [(and it can be land-based or water)21.7(-based. )]TJ -0.01 Tc 0.059 Tw 0 -1.583 TD (In the past two decades, new insights have emer)Tj 0 Tc 0 Tw 19.226 0 Td (-)Tj -0.01 Tc 0.13 Tw -19.226 -1.3 Td [(ged regarding the role of therapeutic exercise in)-10( )]TJ /C2_0 1 Tf 0.01 Tw 0 -1.3 TD [<004C005100C00044005000500044005700520055005C0003>-216.7<0055004B00480058005000440057004C00460003>-216.7<0047004C005600480044005600480056000F0003>-216.7<0057004B00480055004800490052005500480003>-216.7<00500052>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj -0.01 Tc 0.01 Tw T* [(difying the present paradigm. Studies have shown)-10( )]TJ /C2_0 1 Tf T* [<0057004B004400570003>-166<0048005B004800550046004C005600480003>-166<004B004400560003>-166<00440003>-166<0056004C004A0051004C00BF00460044005100570003>-166<004400510057004C0010004C005100C00044005000500044005700520055005C>-10<0003>]TJ /TT0 1 Tf 0.087 Tw T* [(ef)18(fect. )17.8(The contraction of the muscle, which acts)-10.1( )]TJ 0.203 Tw T* [(as a secretory or)18(gan, stimulates the production,)-10( )]TJ 0.112 Tw T* [(excretion, and expression of cytokines and other)-10( )]TJ 0.491 Tw T* [(peptides, called myokines, derived from the)-9.8( )]TJ /C2_0 1 Tf 0.01 Tw T* [<0050005800560046004F00480003>-154.3<00BF004500550048005600110003>-154.3<002C0051005700480055004F00480058004E004C00510003>-154.3<00B10003>-154.3<00190003>-154.3<000B002C002F00100019000C0003>-154.3<0057004B004400570003>-154.3<00460052005000480056>-10.2<0003>]TJ T* [<00490055005200500003>-179.6<0057004B00480003>-179.5<00560044005000480003>-179.6<004900440050004C004F005C0003>-179.5<004400560003>-179.6<005300550052004C005100C00044005000500044005700520055005C0003>-179.6<002C002F00100019000F>-10<0003>]TJ /TT0 1 Tf 0.141 Tw T* [(is considered to be the most important myokine)-9.9( )]TJ 0.109 Tw T* [(\(45\). It inhibits the production of tumor)20(-necrosis)-10.1( )]TJ /C2_0 1 Tf 0.01 Tw T* [<0049004400460057005200550003>8.2<00B10003>8.3<0044004F0053004B00440003>8.2<000B0037003100290010>]TJ /C2_2 1 Tf 0 Tc 0 Tw <0044>Tj /TT0 1 Tf -0.01 Tc -0.008 Tw 8.698 0 Td (\) and stimulates the produc)Tj 0 Tc 0 Tw (-)Tj /C2_0 1 Tf -0.01 Tc 0.01 Tw -8.698 -1.3 Td [<0057004C005200510003>-56.9<005200490003>-57<004400510057004C0010004C005100C00044005000500044005700520055005C0003>-57<0046005C00570052004E004C0051004800560003>-56.9<002C002F001000140003>-57<00550048004600480053005700520055>-10<0003>]TJ /TT0 1 Tf 0.041 Tw T* [(antagonist and IL-10 \(45-47\). )18.3(Therefore, contrary)-10( )]TJ -0.015 Tw T* (to the previous belief that exercise is contraindica)Tj 0 Tc 0 Tw (-)Tj /C2_0 1 Tf -0.01 Tc 0.01 Tw T* [<0057004800470003>23.8<004C00510003>23.7<0057004B00480003>23.7<004400460058005700480003>23.7<0053004B0044005600480003>23.8<005200490003>23.7<004C005100C000440050005000440057004C00520051000F0003>23.7<0057004B0048005500440053004800580057004C0046>-9.9<0003>]TJ /TT0 1 Tf 0.067 Tw T* [(exercise is now viewed as a potential remedy for)-10( )]TJ /C2_0 1 Tf 0.01 Tw T* [<005300440057004C00480051005700560003>-299.4<005A004C0057004B0003>-299.4<004C005100C00044005000500044005700520055005C0003>-299.5<0055004B00480058005000440057004C00460003>-299.4<0047004C0056004800440056004800560011>-10<0003>]TJ /TT0 1 Tf 0.044 Tw T* [(This can also explain some of the positive ef)18(fects)-10.1( )]TJ 0 Tw T* (of exercise in other chronic diseases \(48\).)Tj -0.017 Tc 0.127 Tw 0 -1.583 TD (Therapeutic exercise should be prescribed indivi)Tj 0 Tc 0 Tw (-)Tj -0.017 Tc 0.134 Tw 0 -1.3 TD [(dually for each patient, depending on the current)-16.9( )]TJ 0.058 Tw T* [(disease activity and functional status. Generally)65(, it)-16.8( )]TJ -0.016 Tw T* [(is important to start such a program at low levels of)-17( )]TJ -0.08 Tw T* [(load, gradually)65(, increasing its intensity and duration.)-17( )]TJ /C2_0 1 Tf 0.017 Tw T* [<0024004F0057004B00520058004A004B0003>-35.2<0057004B00480003>-35.2<004500480051004800BF0046004C0044004F0003>-35.2<00480049>18.1<004900480046005700560003>-35.2<005200490003>-35.2<0053004B005C0056004C00460044004F0003>-35.2<004400460057004C0059004C0057005C>-17<0003>]TJ T* [<0044005100470003>39.9<0048005B004800550046004C005600480003>40<0044005500480003>40<005A0048004F004F0010004E00510052005A0051000F0003>40<005100520003>40<0056005300480046004C00BF00460003>40<004A0058004C00470048004F004C005100480056>-17.2<0003>]TJ /TT0 1 Tf 0.103 Tw T* [(on the required type and dosage for patients with)-17( )]TJ 0.061 Tw T* [(arthritis were )0.5(available until )0.5(2018., when )0.5(EULAR)-16.9( )]TJ -0.026 Tw T* [(published recommendations for physical activity in)-17( )]TJ /C2_0 1 Tf 0.017 Tw T* [<0053004800520053004F00480003>-29.4<005A004C0057004B0003>-29.4<004C005100C00044005000500044005700520055005C0003>-29.4<004400550057004B0055004C0057004C00560003>-29.4<0044005100470003>-29.4<00520056005700480052004400550057004B0055004C>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj -0.017 Tc 0.01 Tw T* [(tis. Given the evidence of its ef)18(fectiveness, feasibi)]TJ 0 Tc 0 Tw (-)Tj -0.017 Tc 0.033 Tw T* [(lity and safety)64.9(, physical activity is advocated as an)-17( )]TJ -0.005 Tw T* [(integral )0.5(part )0.5(of standard care throughout )0.5(the course)-16.8( )]TJ /TT1 1 Tf 0 Tc 0 Tw 0.34 70.57 Td (Grazio et al.)Tj /TT0 1 Tf 5.248 0 Td ( Rehabilitation in spondyloarthritis)Tj ET 0 0 0 0 k /GS0 gs 496.346 41.752 28.346 12.874 re f endstream endobj 87 0 obj <>stream q /GS0 gs /Fm0 Do Q BT 0 0 0 1 k /GS1 gs /TT0 1 Tf 11 0 0 11 76.7894 44.9321 Tm (214)Tj -0.01 Tc 0.022 Tw 10 0 0 10 99.2126 735.7435 Tm [(progression )0.5(and )0.5(preservation )0.5(and )0.5(improvement of)-10( )]TJ 0.103 Tw 0 -1.3 TD (functionality and social participation \(19, 20\).)Tj /TT1 1 Tf 0 Tc 0 Tw ( )Tj /TT0 1 Tf -0.01 Tc 0.01 Tw 18.736 0 Td [(In)-10( )]TJ 0.019 Tw -18.736 -1.3 Td [(accordance )0.5(with )0.5(these )0.5(goals, )0.5(adequate )0.5(assessment)-9.8( )]TJ 0.205 Tw T* (and regular patient follow-up are required, ide)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.069 Tw T* [(ally within a multidisciplinary team. )18.2(The number)-10( )]TJ 0.07 Tw T* [(of team members can be expanded or reduced as)-10.1( )]TJ 0.041 Tw T* (needed, but it usually consists of physicians \(spe)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.366 Tw T* [(cialist in physical and rehabilitation medicine)-9.8( )]TJ 0.126 Tw T* [(and, if necessary)64.9(, other specialties\), physiothera)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc -0.002 Tw T* [(pists, occupational therapists, nurses, occasionally)-10( )]TJ 0.233 Tw T* [(accompanied by orthopaedic technicians, social)-9.8( )]TJ -0.036 Tw T* [(workers, and clinical psychologists. )17.6(This approach)-10( )]TJ 0.236 Tw T* [(in the rehabilitation of chronic illness, such as)-10.1( )]TJ 0.166 Tw T* [(SpA, encourages the patient to participate more)-9.8( )]TJ 0.007 Tw T* [(actively in the treatment and to take responsibility)-10( )]TJ -0.013 Tw T* (for the decisions related to his/her condition. Non-)Tj -0.03 Tw T* [(pharmacological non-sur)18.1(gical interventions, as the)-9.9( )]TJ 0.25 Tw T* [(mainstream of rehabilitation, are recognized as)-10.2( )]TJ 0.016 Tw T* [(extremely important in patients with SpA)55( \(21,22\).)-10( )]TJ 0.004 Tw T* [(In )0.5(that )0.5(regard, )0.5(therapeutic )0.5(exercises have a )0.5(crucial)-9.8( )]TJ -0.031 Tw T* [(role, especially in patients with axial SpA)55( \(axSpA\))-10( )]TJ 0.086 Tw T* (\(21,22\). Other methods used in a non-pharmaco)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.27 Tw T* [(logical non-sur)18.1(gical approach for patients with)-10( )]TJ -0.012 Tw T* [(SpA)55( usually include education of patients and the)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.099 Tw T* [(ir families, occupational therapy)65(, use of dif)18(ferent)-9.8( )]TJ 0.088 Tw T* [(physical modalities and in some instances use of)-10( )]TJ 0 Tw T* (orthoses and walking aids \(22\).)Tj /C2_0 1 Tf 0 Tc 0 -2.25 TD [<00280027003800260024>54.8<0037002C00320031>]TJ /TT0 1 Tf -0.027 Tw 0 -1.867 TD [(Patient education)0.8( is included in the domain of se)]TJ 0 Tw (-)Tj 0.006 Tw 0 -1.3 TD [(lf-help, along with social learnin)0.6(g and cognitive-)]TJ 0 Tw T* (behavioural therapy \(22\).)Tj -0.01 Tc 0.103 Tw 0 -1.583 TD [(Educational programs include informing patients)-10.2( )]TJ 0.089 Tw 0 -1.3 TD [(and their families about nature and course of the)-9.9( )]TJ 0.021 Tw T* (disease, possibilities of self-treatment, conservati)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.116 Tw T* [(ve and operational treatment and the importance)-9.8( )]TJ 0.24 Tw T* [(of modifying habits and professional activities,)-10( )]TJ 0.254 Tw T* [(including the use of aids. Studies have shown)-10( )]TJ /C2_1 1 Tf 0.01 Tw T* [<0057004B00480003>-126.6<0048004900BF004600440046005C0003>-126.6<005200490003>-126.7<004800470058004600440057004C005200510003>-126.7<004C00510003>-126.7<004C00500053005500520059004C0051004A0003>-126.6<0057004B00480003>-126.7<0049005800510046>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj -0.01 Tc 0.047 Tw T* [(tionality of patients with )55(AS, and better results of)-10( )]TJ 0.065 Tw T* [(educational programs can be achieved if they are)-9.9( )]TJ 0.099 Tw T* (applied at an early stage of the disease \(23\). Le)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.107 Tw T* [(vel of patient involvement in decision-making is)-10.1( )]TJ 0.094 Tw T* [(important, as it was shown in patients with PsA,)-10( )]TJ 0.05 Tw T* [(where the low level of their involvement resulted)-10( )]TJ 0.095 Tw T* (in lower satisfaction with the treatment \(24\). Pa)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.168 Tw T* [(tients should realize, accept and implement that)-9.8( )]TJ 0.154 Tw T* [(investing time and ener)18.1(gy in these non-pharma)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc 0.202 Tw T* [(cological interventions results in a reduction of)-10( )]TJ 0.113 Tw T* [(disability and improvement of the quality of life)-9.8( )]TJ 0.047 Tw 21.543 64.201 Td [(\(25\). )0.6(Possibilities )0.6(of )0.6(sport )0.5(and )0.5(recreational )0.6(activi)]TJ 0 Tc 0 Tw (-)Tj -0.01 Tc -0.032 Tw T* [(ties that can contribute to the improvement of their)-10( )]TJ -0.02 Tw T* [(functional )0.6(status )0.5(should )0.5(be )0.5(communicated )0.5(to )0.6(these)-9.8( )]TJ 0.012 Tw T* [(patients, too. For example, backstroke swimming,)-10( )]TJ 0.018 Tw T* [(skiing, basketball, badminton or volleyball can be)-9.8( )]TJ 0.067 Tw T* [(recommended for patients with )55(AS/axSpA, while)-9.8( )]TJ 0.15 Tw T* (sports and recreational activities that are increa)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.087 Tw T* [(sing the load on pectoral muscles and worsening)-9.9( )]TJ 0.423 Tw T* [(thoracic spine kyphosis, such as breaststroke)-9.9( )]TJ 0.051 Tw T* [(swimming, cycling, rowing, hockey)65(, high or long)-10( )]TJ 0 Tw T* [(jump and contact sports \(e.g. boxing\) cannot \(26\).)-9.9( )]TJ 0 Tc 0.077 Tw 0 -1.583 TD [(Apart from the individual )0.7(face to face approach )]TJ -0.026 Tw 0 -1.3 TD [(patients )1.1(can )0.8(get )0.7(information )1.1(through )0.6(support )0.5(gro)]TJ 0 Tw (-)Tj -0.009 Tw T* [(ups, printed )0.8(materials )1.2(\(e.g. booklets, )0.7(magazines\), )]TJ 0.103 Tw T* [(websites, lectures )0.6(or public )0.5(campaigns. )55.7(A)55( study )]TJ /C2_1 1 Tf 0 Tw T* [<005A004B004C0046004B0003>-195.9<004800590044004F005800440057004800470003>-195.1<0057004B00480003>-195.7<0053005500520053005200550057004C005200510003>-195.7<005200490003>-196.1<0056005300480046004C00BF00460003>-195.7<00440047>]TJ /TT0 1 Tf (-)Tj 0.105 Tw T* [(vice )0.6(given to )55.4(AS patients )0.8(showed that )0.5(the most )]TJ -0.026 Tw T* [(valuable )1.1(for them )0.8(were those )0.5(about )0.6(the )0.6(importan)]TJ 0 Tw 19.226 0 Td (-)Tj 0.097 Tw -19.226 -1.3 Td [(ce )0.6(of daily )0.6(exercise )0.8(routine )0.8(\(69%\), followed )0.6(by )]TJ 0.113 Tw T* [(the )0.5(advice )0.7(about )0.5(the )0.6(importance )1.1(of maintaining )]TJ 0.238 Tw T* [(mobility )1.1(\(55%\). Other advice )0.9(perceived )0.9(to be )]TJ 0.013 Tw T* (important referred to sleeping on a hard mattress )Tj 0.071 Tw T* [(\(53%\), avoiding the use of lar)18.4(ge pillows \(42%\), )]TJ 0.163 Tw T* [(maintaining )1.3(good posture \(38%\) and participa)]TJ 0 Tw 19.226 0 Td (-)Tj -19.226 -1.3 Td (ting in sports activities \(36%\) \(27\). )Tj -0.012 Tw 0 -1.583 TD [(Among )0.6(other )0.8(advice, )1.2(smoking )0.7(cessation )1(is )0.6(frequ)]TJ 0 Tw (-)Tj 0.069 Tw 0 -1.3 TD [(ently )0.8(recommended, )1.3(especially )1.3(for patients )1(with )]TJ 0.095 Tw T* [(AS, as )0.5(it )0.7(was shown that )1(smoking )0.7(increases )1(di)]TJ 0 Tw (-)Tj /C2_1 1 Tf T* [<005600480044005600480003>-192.1<004400460057004C0059004C0057005C>65.9<000F0003>-192.3<004C005100C00044005000500044005700520055005C0003>-191.5<004400460057004C0059004C0057005C0003>-191.6<0059004C0056004C0045004F00480003>-191.7<005200510003>]TJ /TT0 1 Tf 0.072 Tw T* [(magnetic )1.3(resonance )0.8(imaging )1(and )0.5(spondylophyte )]TJ /C2_1 1 Tf 0 Tw T* [<004900520055005000440057004C005200510003>-304.9<000B0015001B000F0015001C000C00110003>-305.6<0027004800560053004C005700480003>-305.3<0057004B00440057000F0003>-305.1<0057004B00480003>-305.2<00480049>18.2<00490048004600570003>-305.1<005200490003>]TJ /TT0 1 Tf -0.027 Tw T* [(smoking )0.6(cessatio)0.5(n on signs and )0.6(symptoms )0.6(in )55.7(AS/)]TJ 0 Tw T* [(axSpA)55( has not been proven.)]TJ 0.207 Tw 0 -1.583 TD (Interventions based on social learning through )Tj 0.116 Tw 0 -1.3 TD [(the observation )0.5(of other patients\222)74.9( behaviour )0.5(are )]TJ 0.02 Tw T* [(also included, )0.9(and for this purpose, problem-sol)]TJ 0 Tw 19.226 0 Td (-)Tj 0.057 Tw -19.226 -1.3 Td [(ving and goal-achieving )1(techniques )0.6(such as bio)]TJ 0 Tw (-)Tj 0.045 Tw T* [(feedback, )1.1(relaxation, )1.4(cognitive )1.2(restructuring )1.1(and )]TJ 0.086 Tw T* [(encouragement )1.4(of social )0.8(partici)0.8(pation )0.7(are )0.6(appli)]TJ 0 Tw (-)Tj 0.089 Tw 0 -1.3 TD [(ed )0.7(\(22\). )0.6(One )0.5(should )0.6(always )0.7(consider )0.8(a )0.8(question )]TJ 0.371 Tw 0 -1.3 TD [(of ef)18.2(fect-size )0.9(and cost-ef)18.3(fectiv)0.7(eness of these )]TJ /C2_1 1 Tf 0 Tw T* [<004C00510057004800550059004800510057004C0052005100560003>-84.3<004C00510003>-85<00440003>-85<0056005300480046004C00BF00460003>-84.9<005600520046004C00520010004800460052005100520050004C00460003>-84.2<004800510059004C>]TJ /TT0 1 Tf (-)Tj T* (ronment \(30-32\). )Tj /C2_0 1 Tf 0 -2.25 TD <002D0032002C0031003700030033003500320037002800260037002C00320031000F00030033003200360037003800350028000300240031002700030035002800360037>Tj /TT0 1 Tf -0.01 Tc 0.01 Tw 0 -1.867 TD [(Certain positions and motions in SpA)55( patients can)-10( )]TJ 0.06 Tw 0 -1.3 TD [(increase the risk of experiencing pain and further)-10( )]TJ 0.132 Tw T* [(damage. Joint protection is based on learning to)-10( )]TJ 0.108 Tw T* [(position a joint in the least painful way with the)-9.9( )]TJ /C2_1 1 Tf 0.01 Tw T* [<005600500044004F004F0048005600570003>-64.2<00490058005100460057004C005200510044004F0003>-64.1<0047004800BF0046004C005700110003>-64.2<0036005700580047004C004800560003>-64.1<004B0044005900480003>-64.1<0053005500520059004C004700480047>-10<0003>]TJ ET 0 0 0 0 k /GS0 gs 70.866 41.686 28.346 12.874 re f endstream endobj 85 0 obj <>stream q /GS0 gs /Fm0 Do Q BT 0 0 0 1 k /GS1 gs /TT0 1 Tf 11 0 0 11 502.2697 44.9321 Tm (213)Tj /C2_0 1 Tf 10 0 0 10 85.0945 735.0795 Tm <002C00310037003500320027003800260037002C003200310003>Tj /TT0 1 Tf 0.005 Tc 0.328 Tw 0 -1.867 TD (Spondyloarthritides \(formerly )Tj /TT1 1 Tf -0.005 Tw [(spondyloarthr)37(o)]TJ 0 Tc 0 Tw (-)Tj 0.005 Tc -0.005 Tw 0 -1.3 TD (pathies\))Tj /TT0 1 Tf 0.196 Tw ( \(abbreviation SpA\) is a group of he)Tj 0 Tc 0 Tw (-)Tj /C2_1 1 Tf 0.005 Tc -0.005 Tw T* [<0057004800550052004A0048005100480052005800560003>-369.8<004C005100C00044005000500044005700520055005C0003>-369.8<0055004B00480058005000440057004C00460003>-369.8<0047004C005600480044005600480056>4.9<0003>]TJ /TT0 1 Tf 0.335 Tw T* (sharing similar genetic, clinical and radiolo)Tj 0 Tc 0 Tw (-)Tj 0.005 Tc 0.228 Tw T* [(gical features. )18(The group includes ankylosing)5( )]TJ 0.069 Tw T* (spondylitis \(AS\), psoriatic arthritis \(PsA\), reac)Tj 0 Tc 0 Tw (-)Tj 0.005 Tc 0.04 Tw T* [(tive arthritis, enteropathic or arthritis associated)5( )]TJ /C2_1 1 Tf -0.005 Tw T* [<005A004C0057004B0003>-191<004C005100C00044005000500044005700520055005C0003>-191<00450052005A0048004F0003>-191<0047004C005600480044005600480003>-191<0044005100470003>-191<005800510047004C0049>18.1<00490048>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj 0.005 Tc 0.036 Tw T* [(rentiated spondyloarthritis \(1\). )18.2(The most promi)]TJ 0 Tc 0 Tw (-)Tj 0.005 Tc -0.037 Tw T* (nent common features in these entities are: nega)Tj 0 Tc 0 Tw (-)Tj 0.005 Tc 0.041 Tw T* [(tive rheumatoid factor)40(, familial aggregation and)5( )]TJ 0.127 Tw T* [(high prevalence of HLA)55( B-27 antigen, clinical)5.2( )]TJ 0.047 Tw T* [(features which include the involvement of axial)5.2( )]TJ -0.048 Tw T* (skeleton \(spine and sacroiliac joints\) or asymme)Tj 0 Tc 0 Tw (-)Tj 0.005 Tc 0.153 Tw T* [(trical )0.5(and oligoarticular af)18(fection of )0.5(peripheral)5.2( )]TJ 0.26 Tw T* [(joints, enthesitis, dactylitis and extra-articular)5( )]TJ 0.016 Tw T* (manifestations such as uveitis, psoriasis, and in)Tj 0 Tc 0 Tw (-)Tj /C2_1 1 Tf 0.005 Tc -0.005 Tw T* [<00C00044005000500044005700520055005C0003>49.9<00450052005A0048004F0003>50<0047004C0056004800440056004800110003>50<002700480053004800510047004C0051004A0003>50<005200510003>50<0057004B00480003>50<0046004F004C>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj 0.005 Tc 0.045 Tw T* [(nical and radiographic characteristics, SpA)55( may)5( )]TJ /C2_1 1 Tf -0.005 Tw T* [<004500480003>-183<0046004F004400560056004C00BF004800470003>-183<0048004C0057004B004800550003>-183<004400560003>-182.9<0044005B004C0044004F0003>-182.9<005200550003>-183<005300480055004C0053004B004800550044004F000F0003>-183<004400510047>5<0003>]TJ T* [<00510048005A004800550003>-129.6<0046004F004400560056004C00BF004600440057004C005200510003>-129.6<00460055004C005700480055004C00440003>-129.6<004B0044005900480003>-129.6<0048005B0053004400510047004800470003>-129.6<0057004B0048>5.2<0003>]TJ /TT0 1 Tf 0.085 Tw T* [(spectrum by including early \(non-radiographic\))5( )]TJ 0.187 Tw T* [(forms of axial disease detectable on magnetic)5.1( )]TJ 0.104 Tw T* [(resonance imaging \(MRI\) \(2, 3\). Prevalence of)5( )]TJ 0.089 Tw T* [(SpA)55( in the world population ranges from 0.2%)5( )]TJ -0.027 Tw T* [(to 1.61%, bearing in mind that some of the dif)18.1(fe)]TJ 0 Tc 0 Tw (-)Tj /C2_1 1 Tf 0.005 Tc -0.005 Tw T* [<0055004800510046004800560003>6.3<0050004C004A004B00570003>6.3<004500480003>6.3<0057004B00480003>6.3<0055004800560058004F00570003>6.3<005200490003>6.3<0057004B00480003>6.3<0047004C0049>18<0049004800550048005100570003>6.3<0047004800BF0051004C>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj 0.005 Tc T* (tion and methodology used in these studies \(4\).)Tj 0 Tc 0.075 Tw 0 -1.583 TD [(Patients with SpA)55( have reduced)0.5( physical ability )]TJ 0.071 Tw 0 -1.3 TD [(and )0.5(quality )1.1(of life )0.8(\(QoL\) \(5\). For instance, )1(self-)]TJ 0.022 Tw T* [(care and mobility )0.6(are impaired )0.6(in more than half )]TJ 0.017 Tw T* [(of patients )0.8(with )55.7(AS \(6\). )18.4(W)80.2(orking )0.5(capacity )1.3(is also )]TJ 0.065 Tw T* [(reduced in these patients, )0.7(resulting in an increa)]TJ 0 Tw 19.226 0 Td (-)Tj 0.085 Tw -19.226 -1.3 Td [(sed economic )1.2(burden )0.6(on the )0.7(patient )1.3(and )0.5(the )0.8(he)]TJ 0 Tw (-)Tj /C2_1 1 Tf T* [<0044004F0057004B0003>26<0056005C00560057004800500003>25.7<000B001A000C00110003>25.5<002700480053004800510047004C0051004A0003>26<005200510003>25.5<0057004B00480003>25.7<0056005700580047005C>64.9<000F0003>25.5<005A00520055004E004C0051004A0003>]TJ /TT0 1 Tf 0.103 Tw T* [(incapacity )0.7(for patients with )54.9(AS )-0.8(ranged between )]TJ 0 Tw T* (3% and 50% \(8,9\). )Tj 0.01 Tc -0.001 Tw 0 -1.583 TD (In PsA, alongside physical impairment, the pre)Tj 0 Tc 0 Tw (-)Tj 0.01 Tc 0.062 Tw 0 -1.3 TD [(sence of psoriasis carries a great psychological)10.2( )]TJ 0.115 Tw T* [(and social burden, too. )18.3(The disease negatively)10( )]TJ 0.051 Tw T* [(af)18.1(fects the quality of life and leads to an incre)]TJ 0 Tc 0 Tw (-)Tj 0.01 Tc 0.36 Tw T* (ased incidence of sleep disorders, exhausti)Tj 0 Tc 0 Tw (-)Tj 0.01 Tc 0.143 Tw T* [(on, )0.5(stress, )0.5(and )0.6(depression, )0.5(creating )0.5(a )0.5(negative)10.1( )]TJ 0.1 Tw T* [(body image and leading to a decrease in work)9.9( )]TJ 0.057 Tw T* [(productivity \(10\). It was shown that the risk of)10( )]TJ /C2_1 1 Tf -0.01 Tw T* [<0047004800530055004800560056004C005200510003>-57.5<004C00560003>-57.4<0056004C004A0051004C00BF0046004400510057004F005C0003>-57.5<004C005100460055004800440056004800470003>-57.5<004C00510003>-57.4<005300440057004C0048005100570056>9.9<0003>]TJ /TT0 1 Tf 0.035 Tw T* [(with )55.4(AS and PsA)55( \(1)37.1(1, 12\). In one study)64.9(, factors)9.8( )]TJ -0.029 Tw T* [(associated with deterioration or improvement of)9.9( )]TJ 0.203 Tw T* [(self-reported depression were fatigue, general)10.2( )]TJ 0.085 Tw 21.538 64.9 Td (health, QoL, level of functioning, disease acti)Tj 0 Tc 0 Tw (-)Tj /C2_1 1 Tf 0.01 Tc -0.01 Tw T* [<0059004C0057005C0003004400510047000300560048004F004900100048004900BF004600440046005C0003000B00140016000C0011>10<0003>]TJ /TT0 1 Tf -0.005 Tc 0.103 Tw 0 -1.583 TD (The prerequisite of an adequate plan for rehabi)Tj 0 Tc 0 Tw (-)Tj -0.005 Tc 0.034 Tw 0 -1.3 TD [(litation interventions is an evaluation of a patient)-4.8( )]TJ 0.19 Tw T* [(in regard to the disease activity and functional)-4.9( )]TJ 0.166 Tw T* (ability \(biomedical aspect\) as well as the biop)Tj 0 Tc 0 Tw (-)Tj -0.005 Tc 0.083 Tw T* [(sychosocial aspect \(biometric evaluation\). In the)-4.8( )]TJ 0.01 Tw T* (last 20 years, validated questionnaires for measu)Tj 0 Tc 0 Tw (-)Tj -0.005 Tc 0.134 Tw T* [(ring disease activity and functional ability were)-4.9( )]TJ -0.011 Tw T* [(designed for )55.5(AS and PsA. )18.4(These instruments con)]TJ 0 Tc 0 Tw (-)Tj -0.005 Tc 0.04 Tw T* (sist of questions reported by the patients themse)Tj 0 Tc 0 Tw (-)Tj -0.005 Tc 0.176 Tw T* [(lves \(Patient Reported Outcomes - PRO-s\) and)-5( )]TJ 0.074 Tw T* [(some are combining PRO-s with some objective)-4.8( )]TJ 0.224 Tw T* [(measures, e.g. CRP)110.7(. Some of the most known)-5( )]TJ 0.075 Tw T* [(examples for )55.6(AS are Bath )55.6(Ankylosing Spondyli)]TJ 0 Tc 0 Tw (-)Tj -0.005 Tc 0.156 Tw T* [(tis Functional Index \(BASFI\), Bath )55.4(Ankylosing)-5( )]TJ /C2_1 1 Tf 0.005 Tw T* [<00360053005200510047005C004F004C0057004C00560003>-29.4<0027004C005600480044005600480003>25.8<002400460057004C0059004C0057005C0003>-29.3<002C005100470048005B0003>-29.4<000B00250024003600270024002C000C0003>-29.4<00520055>-5<0003>]TJ T* [<00240051004E005C004F00520056004C0051004A0003>-236.7<00360053005200510047005C004F004C0057004C00560003>-236.6<0027004C005600480044005600480003>-181.5<002400460057004C0059004C0057005C0003>-236.6<00360046005200550048>-4.9<0003>]TJ T* [<000B00240036002700240036000C000F0003>31.4<005A004B004C004F00480003>31.4<0048005B004400500053004F004800560003>31.3<005200490003>31.4<004C00510056005700550058005000480051005700560003>31.4<0047004800590048004F0052>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj -0.005 Tc 0.07 Tw T* [(ped for PsA)55( are )]TJ /CS0 cs 0 0 0 scn /GS0 gs /C2_1 1 Tf 0.005 Tw [<0033005600520055004C00440057004C00460003>-70.4<0027004C005600480044005600480003>-15.2<002400460057004C0059004C0057005C0003>-70.4<002C005100470048005B>-5.1<0003>]TJ T* [<000B0026003300270024002C000C000F0003>-137<0027004C005600480044005600480003>-81.7<002400460057004C0059004C0057005C0003>-137<004C00510003>-136.9<0033005600520055004C00440057004C00460003>-81.8<002400550057004B0055004C0057004C0056>-5.2<0003>]TJ T* [<000B00270024003300360024000C000F0003>51<0044005100470003>50.9<0033005600520055004C00440057004C00460003>106.1<002400550057004B0055004C0057004C00560003>50.9<0027004C005600480044005600480003>106.1<002400460057004C0059004C0057005C>-5<0003>]TJ T* [<003600460052005500480003>-3<000B0033>91.7<00240036002700240036000C0003>-3<000B00140017000F0003>-3<00140018000C0011>]TJ 0 0 0 1 k /GS1 gs /TT0 1 Tf 0.003 Tw [( It is worth mentioning)-5.1( )]TJ 0.006 Tw T* [(that )0.5(due )0.5(to )0.5(its )0.5(heterogeneity)64.9(, )0.5(tools )0.5(for )0.6(PsA)55( )0.5(are )0.5(not)-4.8( )]TJ 0.005 Tw T* [(generally accepted and various instruments are in)-5( )]TJ 0.015 Tw T* (use, most commonly those \223borrowed\224 from rhe)Tj 0 Tc 0 Tw (-)Tj -0.005 Tc T* [(umatoid arthritis \(RA\) and )55.1(AS \(15\).)]TJ -0.01 Tc 0.014 Tw 0 -1.583 TD (From the point of view of physical and rehabilita)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.046 Tw 0 -1.3 TD [(tion medicine, main health issues of SpA)55( patients)-10.1( )]TJ /C2_1 1 Tf 0.01 Tw T* [<0044005500480003>-132.9<004800510046005200500053004400560056004800470003>-132.9<0045005C0003>-132.9<0057004B00480003>-132.9<002C0051005700480055005100440057004C005200510044004F0003>-132.9<0026004F004400560056004C00BF00460044>]TJ /TT0 1 Tf 0 Tc 0 Tw (-)Tj /C2_1 1 Tf -0.01 Tc 0.01 Tw T* [<0057004C005200510003>-61<005200490003>-61<00290058005100460057004C00520051004C0051004A000F0003>-61<0027004C005600440045004C004F004C0057005C>64.9<000F0003>-61<0044005100470003>-61<002B00480044004F0057004B0003>-61<000B002C00260029000C000F>-10<0003>]TJ /TT0 1 Tf 0.152 Tw T* [(which is based on the biopsychosocial principle)-9.8( )]TJ -0.045 Tw T* [(\(16, 17\). )55.4(As a universal conceptual framework ICF)-10.2( )]TJ 0.107 Tw T* (covers the whole spectrum of issues in the mus)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.13 Tw T* [(culoskeletal )0.5(diseases )0.5(and )0.5(is )0.5(useful )0.5(for )0.5(structured)-10( )]TJ /C2_1 1 Tf 0.01 Tw T* [<004C0047004800510057004C00BF004600440057004C005200510003>13.9<005200490003>13.8<0047004C005600440045004C004F004C0057005C0003>13.8<004C00510003>13.9<00440003>13.9<0053004400550057004C00460058004F004400550003>13.8<0046005200510047004C0057004C00520051>-10<0003>]TJ /TT0 1 Tf -0.046 Tw T* [(and for the particular patient, as the diagnosis itself)-10( )]TJ 0.121 Tw T* [(does not reveal what the patient can do, what is)-10.2( )]TJ 0.069 Tw T* (his/her prognosis or what are the costs of rehabi)Tj 0 Tc 0 Tw (-)Tj -0.01 Tc 0.102 Tw T* [(litation. 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