Respiratory muscle strength but not BASFI score relates to diminished chest expansion in ankylosing spondylitis

Abstract

Pulmonary function is altered in ankylosing spondylitis (AS) owing mainly to the restriction of chest wall involvement (limited chest expansion). The objective of this study was to investigate the relationship between chest expansion, respiratory muscle strength (MIP, MEP) maximum voluntary ventilation (MVV), and BASFI score in patients with AS. Twenty-three male patients with definite AS and 21 age-matched healthy male controls were recruited for the study. Patients with AS were assessed for functional status by BASFI. Measurement of chest expansion and lumbar spinal flexion (modified Schober) method was performed in all subjects. Pulmonary function tests were performed by spirometry. Respiratory muscle strength was evaluated by a mouth-pressure meter (MPM). Body mass index (kg/m(2)) was recorded in all individuals. Chest expansion and modified Schober measurement were significantly lower in AS patients (p<0.05). Pulmonary function tests revealed restrictive lung disease. The mean BASFI score suggested good functional capacity in the AS group. The respiratory muscle strength and MVV were also lower in AS (p<0.05). The chest expansion was correlated with MIP and MEP values (r=0.491; p=0.02, r=0.436; p=0.05). Chest expansion was also correlated negatively with disease duration (r=-0.502; p=0.03). In addition, there was no correlation between chest expansion and BASFI score (r=-0.076; p=0.773). This study demonstrates that functional status (BASFI) is not influenced by the limitation of chest wall movement. It may be as a result of the maintenance of moderate physical activity during active life in patients with AS.

The Pulmonary Involvement in Rheumatic Diseases: Pulmonary Effects of Ankylosing Spondylitis and Its Impact on Functionality and Quality of Life

“…We do not have a reasonable explanation for this significant difference between the two studies. On the other hand, in accordance with our results, there are some studies in the literature (El Maghraoui et al 2004;Sahin et al 2004) that show restrictive PFT pattern in AS patients.…”

“…Sahin et al (2004) stated that there was a significant negative correlation between functionality and pulmonary muscle strength, but they did not find a significant relation between BASFI and the chest expansion. They also concluded that chest expansion did not affect the functionality.…”

Reference Values for Chest Expansion among Adult Residents in Ile-Ife

“…Professionals such as Physiotherapists, doctors, osteopathic physicians and other health care professionals commonly use Chest excursion measurements to evaluate the effect that restrictive pulmonary diseases, such as Ankylosing spondylitis, idiopathic scoliosis, muscular dystrophy, spinal cord injuries, and obstructive diseases such as chronic obstructive pulmonary diseases, have on chest wall range of motion [2,3] Chest excursion is also an indicator of respiratory muscle function in patients with rheumatological disease [4].…”

Treatment of ankylosing spondylitis with biologics and targeted physical therapy

“…Pulmonary function abnormalities are due mainly to the restriction of chest wall movement [21]. Restrictive lung disease occurs in kyphoscoliosis and AS due to decreased functional residual capacity, inspiratory capacity, lung compliance, and airway conductance.…”

“…Restrictive lung disease occurs in kyphoscoliosis and AS due to decreased functional residual capacity, inspiratory capacity, lung compliance, and airway conductance. Some patients reported an inability to expand the chest upon inspiration [13,21,22]. The normal chest expansion is 5 cm or greater; however, it is age-and sex-dependent.…”