الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that predominantly affects the sacroiliac joints and spine, and even other joints leading to structural damage and functional impairments with a consequential decrease in quality of life. It is one of the prototypes of spondyloarthritis. With advanced disease, the ossification of the vertebral ligaments leads to fusion of the vertebral bodies and subsequent loss of spinal flexibility (Nava, 2019).
Pulmonary disease can develop as a result of restrictive changes caused by the musculoskeletal disease and changes in the lungs themselves, including interstitial, nodular, and parenchymal abnormalities (Rezaie et al., 2018).
Pulmonary Rehabilitation (PR) is an integral part of medical therapy and plays a fundamental role at the level of tissues and musculoskeletal system; it intervenes in the different phases and at different stages of the disease (Nava, 2019).
This study included 30 patients diagnosed as radiographic axial SPA recruited from outpatient clinic and inpatient department of Physical medicine, Rheumatology and Rehabilitation of Ain Shams University Hospitals.
All patients underwent pulmonary rehabilitation programme (3 times per week for 8 weeks) and were exposed to a detailed history, clinical & pulmonary function testing. Disease activity evaluated by Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP),Evaluation of function by using Bath Ankylosing Spondylitis Functional index (BASFI), 6-Minute walk test (6MWT), The Modified Borg Dyspnoea Scale (MBS) & Timed Up and Go (TUG) Test. All function and clinical scores were done at baseline and repeated after completing pulmonary rehabilitation programme.
All data were collected, tabulated and statistically analyzed revealing that 20 out of studied patients with respiratory affection, 20 of them with restrictive pattern and one of them with obstructive pattern. 9(30.0%) with mild affection, 7 (23.3%) with moderate affection and 4 (13.3%) of patients with severe affection
With comparison between pre & post interventional of pulmonary rehabilitation there was significant statistical improvement in all clinical and functional parameters including disease activity (ASDAS-CRP) and functional (BASFI,MBS, TUG and 6MWT) parameters.
Regarding pulmonary function tests including (FVC,FEV1, FEV1/FVC and PEF), it was statistically significant improvement at baseline & at end of exercise except FEV1/FVC.
CONCLUSION
• Our findings support the ASAS/EULAR recommendations of non-pharmacological therapy (including education, exercise and physiotherapy) as an management of AS important part of the management of AS.
• Regular exercise therapy is an effective, low-priced, easy applicable therapy in decreasing symptoms, improving quality of life and pulmonary functions in AS patients so, it should be essentially included in the treatment of patients with AS.
• Improved respiratory function, disease activity and overall functional activity are possible outcomes of pulmonary rehabilitation programs in combination with other rehabilitation interventions.