surgery. 70% of patients with NFN, 71% of patients withspinal canal stenosis, 73% of patients with anterior listhesis,49% of patients with a history of surgery and 41% of patientswith DDD experienced more than 70% relief from the injec-tion. 46 patients (21%) failed conservative treatments andunderwent cervical spine surgery.Conclusions: Fluoroscopically guided CTFEI are moreeffective in patients with spinal canal stenosis, NFN. andanterior listhesis than patients with DDD and history ofcervical spine surgery. CTFEIs appear to be an effectivenonsurgical treatment option for patients with neck and/orradicular arm pain.

Poster 113Effects of Aerobic Exercise Program inPatients With Ankylosing Spondylitis StabilizedWith Anti-TNF-Alpha Therapy.Paolo Di Benedetto, MD (Physical Medicine andRehabilitation, Udine, Italy); Salvatore De Vita,MD; Nicoletta Franzolini, MD; Sandra Lombardi,MD; Stefania Sacco; Novella Scalia, MD.

Disclosures: P. Di Benedetto, None.Objective: To determine effects of an aerobic exerciseprogram on disease activity and disability in 5 patients withankylosing spondylitis (AS) stabilized with anti-TNF-alphatherapy.Design: Consecutive patients.Setting: Aerobic exercise program.Participants: Five patients with AS treated with infliximabfor at least 12 months and with persistent response to thebiologic treatment (expressed as at least 50% improvement ofthe Bath Ankylosing Spondylitis Disease Activity -BASDAI).Interventions: The exercise regimen was performed twiceweekly for 6 weeks (T0-T1). After that the patient was trainedto repeat the exercises individually at home 3 times weeklyfor next 4 months (T1-T2). Rehabilitation program includeda warm-up followed by 30 minutes of mobilization exercisesand respiratory exercises. The second phase was composed of25 minutes of aerobic exercises on a static bicycle, achieving0.75 of maximal cardiac frequency standardized by age.Third phase was characterized by 10 minutes stretching andrespiratory exercises.Main Outcome Measures: The primary outcome mea-sure was an improvement of BASDAI. Secondary outcomemeasures included an improvement in the Bath AnkylosingSpondylitis Functional Index (BASFI) and VAS pain.Results: A significant improvement of BASDAI (T1) com-pared with BASDAI (T0) was observed in all patients. Thisresult was maintained in 3/5 of patients at T2. A persistentimprovement of BASFI was noticed in 3/5 patients at T1 andT2. VAS pain was reduced in 4/5 patients at T1 and in 3/5patients at T2.Conclusions: Aerobic exercise program improves atshort-term disease activity and disability in patients with AS

stabilized with anti-TNF-alpha therapy. The lack of mainte-nance of the results at long term can be explained as thefailure of compliance in practicing individually exercises athome. Therefore, it is necessary to have a periodic physio-therapeutic evaluation to control the correct performance ofexercises and the maintenance of patient’s compliance.

Poster 114: CancelledFactors Associated With Posterior TibialTendon Pathology on SonographicAssessment.Nitin B. Jain, MD, MSPH (Spaulding RehabilitationHospital/ Harvard Medical School, Boston, MA);Thomas Grant, MD; Imran Omar, MD.

Disclosures: N. B. Jain, None.Objective: Posterior tibial tendon (PTT) pathology (tendi-nopathy or tear) has been most often reported at its inser-tional site (inframalleolar) or at the medial malleolus (retro-malleolar). We assessed the frequency of PTT pathology inthe supramalleolar region using ultrasound. We also assessedfactors associated with the location (supramalleolar, retro-malleolar, and inframalleolar) of PTT pathology.Design: Cross-sectional analysis.Setting: University hospital.Participants: Patients with medial ankle pain.Interventions: Sonographic assessment was performed us-ing a 12.5 MHz linear array transducer on a commerciallyavailable ultrasound unit (ATL HDI-5000, Bothell, WA) andinterpreted by 2 musculoskeletal radiologists.Main Outcome Measures: PTT pathology.Results: Of the 217 patients, 33.2% had grade 1 PTT pa-thology, 14.3% had grade 2 pathology, and 2.8% had grade 3pathology. When stratified by location, 29.0% of patientshad inframalleolar abnormalities, 11.5% had retromalleolarpathology, and 11 (5.1%) patients had supramalleolar pa-thology. Four patients had PTT subluxation/ dislocation. Agewas significantly associated with PTT pathology (P�.02). Ahigher proportion of patients with supramalleolar (81.8%)and retromalleolar (72.0%) PTT pathology were females ascompared with those with inframalleolar (57.1%) PTT pa-thology. A higher proportion of those with supramalleolarand retromalleolar PTT pathology had grade 2 tears as com-pared with those with inframalleolar PTT pathology (36.4%for supramalleolar, 44.0% for retromalleolar, and 22.2% forinframalleolar).Conclusions: We present one of the largest studies on PTTpathology. Our data demonstrate that PTT pathology canoccur in the supramalleolar area, a region that is often notassessed on imaging. Patients with supramalleolar PTT pa-thology had more severe grades of tear, had increased prev-alence of tenosynovitis and were more often females. It isessential to recognize, supramalleolar PTT pathology so thatconsequences of chronic untreated PTT tendinopathy/tear,such as medial arch collapse can be prevented. We also

S55PM&R Vol. 2, Iss. 9S, 2010