Long‐Term Spinal Mobility in Ankylosing Spondylitis: A Repeated Cross‐Sectional Study

Sundström, Björn; Ljung, Lotta; Hörnberg, Kristina; Wållberg‐Jonsson, Solveig

doi:10.1002/acr.23929

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…Also, although a randomization was used to assign the patients to each group, the inhomogeneity of gender within the groups could have influenced the present outcomes. In addition, impairment of spinal mobility is known to be dependent on the course of the disease in AS (Sundstrom et al, 2019). Thus, a better control of gender homogeneity and disease duration by stratification should be taken into account for providing data consistency in future studies.…”

Section: Limitationsmentioning

confidence: 99%

Effects of non-manipulative osteopathic management in addition to physical therapy and rehabilitation on clinical outcomes of ankylosing spondylitis patients: A preliminary randomized clinical trial

Seiler

Vermeylen

Poortmans

et al. 2020

Journal of Bodywork and Movement Therapies

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Introduction: Ankylosing Spondylitis (AS) is reported to impair quality of life, physical and functional ability of patients. Rehabilitation and physical therapy is usually proposed to improve AS patient clinical conditions. Besides, an osteopathic management has not been extensively studied in the field of inflammatory diseases. ¼ Objective: To investigate the effects of osteopathic approach in addition to conventional rehabilitation management on clinical and functional outcomes among patients with AS. Equipment and methods: Eighteen patients with AS were recruited to participate to a physical therapy and rehabilitation (PTR) program over an 18-week period. They were randomly allocated into two groups to complete PTR only or PTR combined with osteopathic management without manipulative techniques (OSTEO group). Thoracolumbar maximal isometric strength (for flexion, extension, lateroflexion, and axial rotation) and flexibility, functional index, pain intensity and quality of life (self-assessment questionnaires) were assessed before and after the protocol. Results: Significant improvements were observed for the OSTEO group in strength, flexibility, disease activity and pain compared to the PTR group. However the difference between groups did not reach statistical significance for all the post-intervention measures. No significant correlation was found between functional, disability data or pain intensity and disease duration for both groups. Conclusion: The results suggest that osteopathic management in addition to a physical therapy and rehabilitation program may be beneficial for individuals who suffer from AS. Further investigations are required using larger sample sizes to confirm these preliminary results.

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Section: Limitationsmentioning

confidence: 99%

Effects of non-manipulative osteopathic management in addition to physical therapy and rehabilitation on clinical outcomes of ankylosing spondylitis patients: A preliminary randomized clinical trial

Seiler

Vermeylen

Poortmans

et al. 2020

Journal of Bodywork and Movement Therapies

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“…These changes in postural control and balance can negatively affect patients' participation in daily life and increase their risk of falling. Sundström et at also reported that spinal mobility decreases with increasing disease severity and age [15]. Kuo et al…”

Section: Discussionmentioning

confidence: 93%

How does Spinal Mobility Affect Balance and Postural Control in Patients with Ankylosing Spondylitis? A Cross-Sectional Study

Balim

Ünver

Sevik

et al. 2022

Aktuelle Rheumatologie

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Purpose Alterations in spinal mobility lead to impaired postural control and balance, an increased risk of falls and a decrease in quality of life. The purposes of this study were to investigate the relationship between spinal mobility, postural control and balance and to compare spinal mobility and balance with a view to disease severity in patients with ankylosing spondylitis (AS). Methods 137 patients with AS were divided into 2 groups by tragus-to-wall distance (TWD): (Group I=mild AS, n=51), (Group II=moderate AS, n=86). Balance was assessed with the Single-Leg Balance Test, the Timed Up and Go Test (TUG) and the Berg Balance Scale (BBS). Spinal mobility was measured by BASMI Index [TWD, cervical rotation (CR), Modified Schober Test (MST), lumbar lateral flexion (LLF), intermalleolar distance (IMD) and thoracic expansion (TE)] and was compared between the groups. The association with balance was investigated. Results Spinal mobility and BBS scores in Group II were worse than in Group I (p<0.05). Static balance and TUG of the groups were similar (p>0.05). Dynamic balance was weakly correlated with MST, LLF and IMM and moderately correlated with CR, TE and BASMI. Static balance was weakly correlated with spinal mobility (p<0.05). There was no correlation between TWD and any balance domains (p>0.05). Conclusions In patients with AS, spinal mobility and dynamic balance worsen as the disease progresses, whereas static balance does not change. Such changes in mobility and balance can negatively affect patients’ participation in daily life and increase their risk of falls. Therefore, detailed evaluation of balance, balance training and fall prevention approaches need to be implemented in the rehabilitation programs of patients with AS.

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“…As part of the treatment routine, the patients are also offered rehabilitation when needed, and during these periods, measurements are performed at enrollment and on completion of rehabilitation. At the department, 232 patients with a verified diagnosis of AS according to the modified New York criteria (20) and with a known time point of onset of AS symptoms were identified by examining medical records as previously described (17). In these 232 individuals, at least 1 visit with spinal mobility measurements was registered between February 1980 to June 2016.…”

Section: Methodsmentioning

confidence: 99%

“…The effect of age on spinal mobility is considerable, and using regression models, Ramiro et al developed reference centile charts of the progressive age‐related decline in spinal mobility among individuals without spinal impairment (16). We have previously compared these norm data with those of a large AS study population to describe characteristics over a disease span of 40 years using repeated cross‐sectional analyses (17), and also to define predictors of abnormal spinal mobility (18). Based on the assumption of a linear development of spinal mobility impairment at a group level in AS, we can further understand the content of our data through extended analyses of linear regression models.…”

Section: Introductionmentioning

confidence: 99%

Individual Regression Modeling of Spinal Mobility Measurements in Long‐Term Ankylosing Spondylitis: In‐Depth Analyses With Comparison to Norm Data

Hörnberg

Ljung

Södergren

et al. 2022

Arthritis Care & Research

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Objective. Normal age-related decline and temporary restrictions in mobility complicate the understanding of spinal mobility deterioration over time in patients with ankylosing spondylitis (AS). In this study, we aimed to determine whether spinal mobility deterioration occurred linearly in patients with AS. We also aimed to compare patterns of change with corresponding age-related normal values and analyze variations in temporary fluctuations in mobility measurements over time.Methods. We included 111 men and 30 women (median age 20.9 years at symptom onset), who were followed for a median of 34 years since symptom onset. This inclusion resulted in 9,697 spinal mobility measurements for analysis. Individual linear regression models for development of lateral spinal flexion (LSF), the 10-cm Schober test (ST10), chest expansion (CE), and cervical rotation (CR) were analyzed and compared with normal age-related decline over time.Results. The median values for the constants of all measurements were significantly lower than the norm data. However, LSF, ST10, and CE followed a yearly linear decline comparable to the norm data, whereas CR declined approximately twice as fast as expected from the norm data (beta median −0.62 [25th-75th percentile −1.16, −0.22] and −0.35 [25th-75th percentile −0.35, −0.35], respectively). Temporary fluctuations in LSF and CE were significantly higher during the early phase of the disease, with decreasing residuals over time.Conclusion. Based on median constants of our data, mobility restrictions related to AS seem to mainly occur during the first years of disease, indicating a narrow window of opportunity for prevention.

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Long‐Term Spinal Mobility in Ankylosing Spondylitis: A Repeated Cross‐Sectional Study

Cited by 6 publications

References 16 publications

Effects of non-manipulative osteopathic management in addition to physical therapy and rehabilitation on clinical outcomes of ankylosing spondylitis patients: A preliminary randomized clinical trial

Effects of non-manipulative osteopathic management in addition to physical therapy and rehabilitation on clinical outcomes of ankylosing spondylitis patients: A preliminary randomized clinical trial

How does Spinal Mobility Affect Balance and Postural Control in Patients with Ankylosing Spondylitis? A Cross-Sectional Study

Individual Regression Modeling of Spinal Mobility Measurements in Long‐Term Ankylosing Spondylitis: In‐Depth Analyses With Comparison to Norm Data

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