Purpose of the study: Ankylosing spondylitis (AS) is a chronic disease that affects the spine and joints, causing pain, stiffness, fatigue, and reduced quality of life. Exercise is known to help reduce pain and improve function in individuals with AS. However, the most effective type and method of exercise are not fully known. This study aims to compare the effects of different telerehabilitation methods-synchronous (live video) and asynchronous (pre-recorded video)-on disease activity, physical function, mobility, fatigue, quality of life, kinesiophobia (fear of movement), and pain levels in individuals with AS. Study design and methods: This is a randomized controlled experimental study. Participants will be randomly assigned to one of three groups: Synchronous telerehabilitation: Exercise sessions via live video, 3 times per week for 8 weeks. Asynchronous telerehabilitation: Exercise sessions via pre-recorded videos, 3 times per week for 8 weeks. Control group: Exercise instructions provided in a brochure. All groups will perform exercises for approximately 40-50 minutes per session, focusing on flexibility, strength, posture, balance, coordination, and functional movements. Participants will be evaluated before the intervention (week 0) and after 8 weeks for disease activity, physical function, mobility, fatigue, quality of life, kinesiophobia, and pain during rest, movement, and sleep. Participants: The study will include adults aged 18-65 years diagnosed with AS at least one year prior, able to use a smartphone, and willing to participate. Individuals who are pregnant, have serious comorbidities, recent surgery, or conditions affecting mobility will be excluded. Expected benefits: The study will identify which telerehabilitation method is more effective for individuals with AS. telerehabilitation may provide easier access to treatment, improve adherence to exercise programs, and contribute to better disease management and quality of life.
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Change in cervical rotation (degrees) from baseline to 8 weeks
Timeframe: 8 weeks
Change from baseline in Tampa Scale of Kinesiophobia (TSK)
Timeframe: 8 weeks
Change from baseline in Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL)
Timeframe: 8 weeks
Change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI)
Timeframe: 8 weeks
Change from baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
Timeframe: 8 weeks
Change in Visual Analog Scale (VAS) pain score at rest from baseline after 8 weeks
Timeframe: 8 weeks
Change in Visual Analog Scale (VAS) pain score during movement from baseline after 8 weeks
Timeframe: 8 weeks
Change in Visual Analog Scale (VAS) pain score during sleep from baseline after 8 weeks
Timeframe: 8 weeks
Change in tragus-to-wall distance (cm) from baseline to 8 weeks
Timeframe: 8 weeks
Change in lumbar side flexion (cm) from baseline to 8 weeks
Timeframe: 8 weeks
Change in lumbar flexion (Modified Schober's test, cm) from baseline to 8 weeks
Timeframe: 8 weeks
Change in intermalleolar distance (cm) from baseline to 8 weeks
Timeframe: 8 weeks