Research Article Effects of Glossopharyngeal Insufflation in Ankylosing Spondylitis: A Pilot Study Nina Brodin, 1,2 Peter Lindholm, 3,4 Claudia Lennartsson, 1,5 and Malin Nygren-Bonnier 1,5 1 Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, B3, Huddinge, 14183 Stockholm, Sweden 2 Department of Orthopaedics, Division of Physiotherapy, Danderyd Hospital, 182 88 Stockholm, Sweden 3 Department of Radiology, Karolinska University Hospital, 171 76 Stockholm, Sweden 4 Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden 5 Department of Physical herapy, Karolinska University Hospital, 141 86 Stockholm, Sweden Correspondence should be addressed to Nina Brodin; nina.brodin@ki.se Received 13 August 2014; Revised 12 November 2014; Accepted 12 November 2014; Published 23 November 2014 Academic Editor: Ruben Burgos-Vargas Copyright © 2014 Nina Brodin et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In Ankylosing Spondylitis (AS), thoracic range of motion is oten greatly limited. he objective of the study was to describe the efects of 12 weeks of Glossopharyngeal Insulation (GI) training in patients with AS. Dynamic spirometry included vital capacity, forced expiratory volume, and peak expiratory low. horacic and lumbar range of motion was assessed by tragus-to-wall distance, modiied 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 fulilled the study protocol. hree patients were able to learn GI by exceeding their maximal vital capacity with 5% using GI. A signiicant increase in thoracic range of motion both on costae IV ( = 0.04) and at the level of the xiphoid process ( = 0.04) was seen. hus, 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 inlammatory dis- ease of multifactorial impact to the patient. Pain, stifness, and fatigue are common symptoms afecting the patient’s func- tion, activity, and participation in society [1, 2]. Inlammation mainly afects 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 afected, most oten described as restrictive ventilatory impairment [3], indicating that the lung tissue is unafected, and instead the thorax has reduced ability to expand due to weak respiratory muscles, inlammatory pain, or reduced mobility [4, 5]. his 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 Insulation (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]. his breathing technique is performed by using the glossopharyngeal muscles to insulate boluses of air into the lungs [9]. he mechanics of GI are described in previous studies [9, 10]. A study by Collier et al. [10] showed that the resistive work during GI is rather small. More efort is required to expand the thorax than the lungs. Previous studies in healthy persons and persons with cervical spinal cord injury have shown that lung function and thoracic range of motion can improve with Hindawi Publishing Corporation International Journal of Rheumatology Volume 2014, Article ID 594708, 6 pages http://dx.doi.org/10.1155/2014/594708