Dr. Narendra H.S

Flexion, extension, lateral flexion and rotation of the cervical, thoracic and lumbar spines can become limited in a person with AS owing to bony changes,fibrosis and calcification of ligaments and muscle tension. Therefore,exercises should be designed to improve these movements.

Mobility exercise should put a joint through the full range of available movement.

 A variety of equipment can be used to make the exercises more interesting, such as a gymnastic ball. When exercising in supine, support the patient’s head with the minimum number of pillows-just enough to prevent the head from tilting back. 

The physiotherapist should always be prepared to modify an exercise. 

A.MOBILISING  EXERCISES

Lumbar and thoracic spine flexion and extension Hold the rail with both hands straight out in front and the elbow extended.Stand two paces back facing the pool rail and with the buttocks back as far as possible. The feet should be slightly apart.

1.      Push the hips forward towards the wall (into the extension) and then back out to the starting position. Keep elbows and knees straight.

2.      With the same starting position as above, bring one foot up towards the wall with an extended knee. Leading with the heel and keeping the knee straight, take the heel backwards as high as possible. Repeat on the other side.

B.THORACIC AND CERVICAL ROTATION

1.      Use the same starting position as above but with legs astride. Bend theleft elbow and twist to the left to look under the elbow. Repeat to the otherside.

2.      Face the wall and rest the arms on the bar. Bend the knees to 90 degrees and keep the trunk, pelvis and thighs against the wall. Keep the knees together. Fix shoulders by holding on the pool rail with hands and forearms.Swing both the knees up to the right as far as possible until the outside to the left thigh is on the wall. Repeat to the other side.

C.FUN AND GAMES

Take care to match patients equally and ensure safety in the pool at all times.

1.      Race each other across pool forwards, backwards and sideways.

2.      Two opponents face each other prone with a ring or a woggle held at arms length between them. Using any swimming kick, the winner is the person who pushes the ring over to the partner’s side.

3.      As a race, pass a large ring over the body starting at either the head or feet.

4.      Sit with a woggle between the legs. Use the legs in a cycling action to race across pool