Background Ankylosing spondylitis (AS) is a major chronic rheumatic disease that predominantly affects axial joints, determining a rigid spine from the occiput to the sacrum. The disease can lead to permanent spinal deformity and postural disorder during the later stages. Changes in axial mobility may lead to impaired postural control, with altered postural control being associated with increased fall risk and lower quality of life. The population with AS has been rarely studied regarding postural control, both dynamic and static.
Objectives The aim was to investigate the relationship between spinal mobility and static and dynamic balance of patients with mild to moderate AS.
Methods The study included 137 (74 male and 63 female) patients with a mean age of 51.19±10.72 (20–78) years who were diagnosed with AS according to the modified New York criteria. Patients were divided into two groups as tragus to the wall distance (TWD) <15 cm (Group I = mild AS, n=51) and TWD ≥15 (Group II = moderate AS, n=84). The mean duration of disease in Group I was 17.83±11.3 (1 - 50) years and the mean duration of disease in Group II was 20.78±9.67 (2 - 43) years. Spinal mobility measurements [TWD, cervical rotation (CR), modified Schober test (MST), lumbar lateral flexion (LLF), intermalleolar distance (IMM), thoracic expansion (TE) tests] were compared with static and dynamic balance tests in the groups. Static balance was assessed with one-foot standing with eyes open and closed. Dynamic balance was assessed with timed up and go test and Berg balance scale.
Results A statistically significant difference was found between spinal mobility measurements and Berg balance scale scores between the groups. Spinal mobility values of Group II were worse than Group I (p<0.05). Berg balance scale scores were better in Group I than Group II (p=0.028). No statistically significant difference was found between the two groups in terms of static balance and timed up and go test (p>0.05). There was a weak and significant correlation between spinal mobility measurements [CR, MST, LLF, IMM, and TE] and static and dynamic balance in the positive direction (r=0.177–0.284, p<0.05). There was no significant correlation between TWD and static and dynamic balance (p>0.05).
Conclusions In patients with AS, as the severity of the disease progresses, spinal mobility and dynamic balance worsen; however, the static balance does not change. These changes in the posture and balance can negatively affect patients' participation levels in daily life and increase their risk of falling. For this reason, we think that detailed evaluation of balance, balance training and fall preventing approaches should be included in the rehabilitation programs for the patients with AS.
Demontis A, et al. Rheumatol Int. 2016;36(3):333–9.
Çınar E, et al. Eur J Rheumatol. 2016;3(1):5–9.
Disclosure of Interest None declared