Biomechanical analysis of posture in patients with spinal kyphosis due to ankylosing spondylitis: a pilot study.

Abstract

The results suggest that the hip joints are at least no longer involved in balance control. This may imply that conservative therapy should focus on the prevention of restriction of the hip joints.

Postural Control and Balance in Ankylosing Spondylitis

“…Bot et al determined that AS patients had great difficulty extending their hips when standing and this changed the centre of gravity towards the anterior leading to increased impaired balance. In the biomechanical analyses applied in that study, it was shown that the impaired balance which could occur from thoracic kyphosis was compensated for with hip extension, knee flexion and ankle plantar flexion and the most effective of these was ankle plantar flexion [29].…”

“…The anatomic changes which occur with the development of vertebral ankylosis in AS may result in kyphosis and lead to decreased movement in the spine [29]. It has been reported that the changes occurring in axial mobility lead to impaired postural control, loss of balance and even increased risk of falls [13].…”

Postural deformities: potential morbidities to cause balance problems in patients with ankylosing spondylitis?

“…The chronic nature of the disease, slow progression of postural deformities, and possibly compensatory mechanisms against postural instability may explain this paradox. Because hip extension is generally limited due to disease involvement in late stage AS, compensation for the increased thoracic kyphosis is mainly performed by ankle dorsiflexion and knee flexion as suggested by Bot et al (8). These authors also emphasized the importance of early surgical hip interventions as a way to combat increased workload on the knees and ankles.…”

“…Besides, these postural changes may be expected to cause balance problems in advanced stages. In literature, there is conflicting data regarding this topic, and this may be because of the usage of different methods in previous studies, evaluating balance and postural stability in AS (2,(5)(6)(7)(8). Therefore, we aimed to assess the impact of AS-related postural deformities on balance.…”

Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis

“…Stiffness and pain in the cervical spine generally occur in the early stages of the disease and tend to develop after some years. The involvement of other joints, such as the hips may cause flexion contractures eventually leading to characteristic, rigid gait with flexion with knee to maintain erect posture ( Figure 1) [6,[10][11][12]. Therefore, the long-term follow-up of AS patients needs to include repetitive assessments of inflammation, pain, structural changes and deterioration of function [13,14].…”