Evaluating the strength of spinal and proximal girdle muscles in patients with axial spondyloarthritis: Correlation with activity, disability, and functionality

Abstract

Aim: To compare the muscle strength of muscle groups in axial spondyloarthritis (axSpA) patients with the muscle powers of healthy volunteers and to examine the relationship of muscle strengths with disease activity, functionality, and disability.Method: One hundred males (50 axSpA, 50 healthy) were included in the study. Bath Disease Activity Index (BASDAI), Functional Index (BASFI), and Health Assessment Questionnaire-Disability Index (HAQ-DI) scores were recorded. The maximum (max) and mean cervical flexion, extension, lateral flexion (CF, CE, CLF), truncal flexion, extension (TF, TE), root joint flexion, extension, abduction, internal and external rotation (SF, SE, SAB, SIR and SER for the shoulder; HF, HE, HAB, HIR and HER for the hip) muscle strengths of the patients in both groups were measured by a handheld dynamometer. Total muscle strength (CT, TT, ST, HT) was found according to the sum of the max and mean values for each region.Results: All muscle strengths were lower in the axSpA group compared to the healthy volunteers. The symptom duration was found to have a weak-moderate negative correlation with CT, TT, ST, HT and all individual muscle strengths except for the TE, CF, HIR, and HER. BASDAI and HAQ-DI had weak-moderate negative correlations with HIR and HER. BASFI had a weak-moderate negative correlation with cervical measurements, TE, TF, SF, SER, SIR, and hip measurements. Conclusion:All muscle strengths were lower in patients compared to healthy volunteers. Strengthening specific muscle groups for the desired goal can be a reasonable strategy. The study is prospectively registered and available at www.clini caltr ials.gov (NCT04435860).

Causal Relationships Between Total Physical Activity and Ankylosing Spondylitis: A Mendelian Randomization Study

“…Previously, it has been reported that, regardless of disease activity, the amount of vigorous and moderate exercise in people with ankylosing spine is significantly lower than normal ( 44 ). Less exercise may be due to the fact that the disease (AS) can cause stiffness in the joints ( 45 ) and reduction in muscle strength of the whole body ( 46 ), rather than a decrease in moderate-to-vigorous PA or vigorous PA and hence making the disease (AS) more likely to occur. Usually, higher PA is linked to other healthy lifestyle factors, including lower prevalence of obesity and smoking ( 47 ).…”

T2 mapping and fat quantification of lumbar paraspinal muscle in ankylosing spondylitis: a case control study

“…The exact mechanisms responsible for the decrease in muscle volume and increase in fatty infiltration in AS patients are not well understood. However, several theories have been proposed, including (1) systemic inflammation causing the overexpression of TNF-α and other proinflammatory cytokines (interleukins 6, 1, 17, and 23), which have been reported to be involved in myofibril protein catabolism; (2) local inflammation at the site of attachment of ligaments or tendons to bone (enthesitis) or facet joint arthritis; (3) biomechanical stress; and (4) denervation or/and neuroinflammation of the spinal cord and nerve roots [ 8 , 14 , 16 , 20 – 22 , 40 – 43 ]. Other factors that have a bidirectional role (i.e., can be both a cause and consequence of vicious cycle initiation) of paraspinal muscle degeneration in AS include lower back pain, facet joint or spinal stiffness, inactivity, and fatigue [ 9 , 11 , 32 , 33 , 39 , 44 ].…”