In Ankylosing Spondylitis (AS), thoracic range of motion is often greatly limited. The objective of the study was to describe the effects of 12 weeks of Glossopharyngeal Insufflation (GI) training in patients with AS. Dynamic spirometry included vital capacity, forced expiratory volume, and peak expiratory flow. Thoracic and lumbar range of motion was assessed by tragus-to-wall distance, modified Schober test, and tape measure. Disease activity, activity limitation, and health perception were assessed using the BAS-Indices, and tension in the thoracic region during GI was assessed using the Borg CR-10 scale. Adherence to training was recorded in an activity log, along with any remarks on the training. Ten patients were recruited and six male patients fulfilled the study protocol. Three patients were able to learn GI by exceeding their maximal vital capacity with 5% using GI. A significant increase in thoracic range of motion both on costae IV and at the level of the xiphoid process was seen. Thus, patients with AS can practice GI, it is safe if maximal exertion is avoided, and patients with some mobility in the chest can increase their lung function substantially by performing GI during 12 weeks. 1. Introduction Ankylosing Spondylitis (AS) is a chronic inflammatory disease of multifactorial impact to the patient. Pain, stiffness, and fatigue are common symptoms affecting the patient’s function, activity, and participation in society [1, 2]. Inflammation mainly affects the spinal joints, which may lead to imbalance in the costotransverse joints with pain and greatly limited thoracic mobility as a result. Due to this, respiratory function can be affected, most often described as restrictive ventilatory impairment [3], indicating that the lung tissue is unaffected, and instead the thorax has reduced ability to expand due to weak respiratory muscles, inflammatory pain, or reduced mobility [4, 5]. This can lead to reduced ventilation, impaired coughing function, secretion stagnation, and even more limited thoracic range of motion, which in turn can lead to serious respiratory complications. Glossopharyngeal Insufflation (GI) training has been used since the 1950s by patients with reduced lung volume [6]. It is an alternative technique of breathing which maintains adequate ventilation and improves cough function when respiratory muscles are weak [7]. It is also used by breath-hold divers to help them increase lung volume above their normal total lung capacity (TLC) and thereby increase diving performance [8]. This breathing technique is performed by using the
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