Risk of Falls in Patients With Ankylosing Spondylitis

Dursun, Nigar; Sarkaya, Selda; Özdolap, Şenay; Dursun, Erbil; Zateri, Çoşkun; Altan, Lale; Birtane, Murat; Akgün, Kenan; Revzani, Aylin; Aktaş, İlknur; Taştekin, Nurettin; Çeliker, Reyhan

doi:10.1097/rhu.0000000000000216

Cited by 34 publications

(54 citation statements)

References 37 publications

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“…It has been reported that restricted mobility of the lumbar spine, hip, knee, and ankle involvement impaired postural control and increased the risk of fall. 14,15 Falls were suggested as the most common causes of spinal fractures which resulted in higher morbidity and mortality in subjects with AS when compared to those without AS. 6 Thus, postural assessment is crucial to predict and prevent balance disorders and falls in AS patients.…”

Section: Discussionmentioning

confidence: 99%

What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

et al. 2017

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Objectives:This study aims to compare ankylosing spondylitis (AS) patients with healthy subjects in terms of posture and balance, and to identify the factors correlated with balance in AS. Patients and methods: Thirty patients (17 males, 13 females; mean age 41.7±7.7 years; range 31 to 57 years) with AS and 33 healthy subjects (18 males, 15 females; mean age 41.3±7.0 years; range 26 to 56 years) were included in the study. Participants were assessed in terms of posture and balance. Posture was assessed using tragus-wall distance, modified Schober's test, and chest expansion. Balance was assessed using device-assisted balance tests. Pain (visual analog scale) and disease activity (Bath Ankylosing Spondylitis Disease Activity Index) were assessed only in AS patients. Results: Ankylosing spondylitis patients walked more slowly when compared to healthy subjects (p=0.002). As the modified Schober's test was restricted, AS patients had greater step width in tandem walk and higher sway velocity on foam base (r=-0.418 p=0.022; r=-0.473 p=0.008). Neither Bath Ankylosing Spondylitis Disease Activity Index nor visual analog scale was correlated with balance. Conclusion: Static and dynamic balance are impaired in AS patients when compared to healthy subjects. Restricted mobility of the spine and advanced kyphosis impaired balance, while pain and disease activity had no correlations with balance.

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Section: Discussionmentioning

confidence: 99%

What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

et al. 2017

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“…The balance impairment and risk factors for falls in patients with AS were previously reported. 15 However, to our knowledge, none of the previous studies focused on the association between the SSA and balance in patients with AS. Therefore, in this study, we aimed to identify the relationship between balance and SSA in AS and compare patients with or without lumbopelvic mismatch in terms of balance.…”

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confidence: 95%

“…14 Fall prevention is important, since falls increased the morbidity and mortality in patients with AS. 15,16 Risk factors for falls and impaired balance should be understood to prevent falls in patients with AS. Also, assessment of the association between sagittal spinopelvic parameters and balance may provide better surgical plans and outcomes.…”

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confidence: 99%

A Preliminary Study on the Correlation Between Spinopelvic Parameters and Balance in Ankylosing Spondylitis

et al. 2019

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Objectives:This study aims to identify the relationship between balance and sagittal spinopelvic alignment (SSA) in ankylosing spondylitis (AS) and compare patients with or without lumbopelvic mismatch in terms of balance. Patients and methods: We enrolled 41 patients (22 males, 19 females; mean age 41.3±8.9 years; range 21 to 57 years) into the study. SSA was evaluated measuring thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence on lateral standing X-rays of the whole spine including the femoral heads. Patients were grouped according to presence of lumbopelvic mismatch (lumbar lordosis-pelvic incidence >10 o ). Clinical parameters including age, body mass index, pain (Visual Analog Scale), disease activity (Bath Ankylosing Spondylitis Disease Activity Index), and disease duration were recorded. Posture was evaluated measuring tragus-to-wall distance, modified Schober's test and chest expansion. A computerized pressure plate system (NeuroCom Balance Master®) was used for evaluating static and dynamic balance. Correlations between SSA parameters and balance were analyzed. Patients with or without lumbopelvic mismatch were compared in terms of balance. Results: Patients took shorter steps, as thoracic kyphosis increased and sacral slope decreased (r= -0.391, p=0.012; r=0.344, p=0.028). Patients with lumbopelvic mismatch had significantly higher sway velocity on firm base with eyes closed and on foam base when the eyes open and closed . They also walked more slowly compared to patients without lumbopelvic mismatch (p>0.05). Conclusion: Lumbopelvic mismatch impaired both static and dynamic balance, while increased thoracic kyphosis and decreased sacral slope impaired only the dynamic balance in patients with AS. Further studies with larger sample size and longer follow-ups need to be conducted to identify the mechanism of spinal deformities and balance disorders in patients with AS.

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“…2 Various results have been reported related to postural stability in patients with AS. 1,3,20,21 Dursun et al 5 observed that the number of falls experienced by patients with AS was significantly correlated with BASFI and BASMI, whereas there was no significant relationship between BASDAI and the number of falls. As BASFI and BASMI reflect the chronic damage associated with the disease, they may be accepted as more important risk factors when compared with BASDAI.…”

Section: Reported a Low Lumbarmentioning

confidence: 99%

“…With an increased risk of falls, it is easy to develop fractures of the rigid spine. 5 A combination of non-pharmacological and pharmacological treatments is considered to be the ideal treatment for patients with AS. Non-pharmacological treatment includes patient education and regular exercise.…”

mentioning

confidence: 99%

Analysis of Spinal Posture With Three-Dimensional Ultrasonic System in Patients With Ankylosing Spondylitis

Kurtoğlu

Tuna

et al. 2019

Arch Rheumatol

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Objectives: This study aims to investigate the relationship between postural changes detected in ankylosing spondylitis (AS) vertebrae and clinical and demographic characteristics of patients using a three-dimensional ultrasonic system. Patients and methods: A total of 44 AS patients (36 males, 8 females; mean age 39.1±9.8 years; range, 18 to 63 years) and 44 healthy volunteers (36 males, 8 females; mean age 38.4±9.4 years; range, 18 to 65 years) were included. Clinical, demographic, and laboratory data were recorded. Spinal posture analysis was performed using a Zebris CMS20 three-dimensional ultrasonic system. Results: Thoracic kyphosis angle was significantly higher in the AS group (45.4±12.8°) than in the control group (36.9±7.7°) (p=0.001). Lumbar lordosis angle was significantly lower in the AS group (20.7±10.6°) than in the control group (28±8.2°) (p=0.002). There were no significant differences in total trunk inclination or sacral angles (p>0.05). Increase in thoracolumbar length at maximum spinal flexion and decrease in thoracolumbar length at maximum spinal extension were significantly lower in the AS group (p<0.05). A negative correlation was found between the thoracic kyphosis angle and length increase in spine flexure as well as chest expansion. Thoracic kyphosis angle had a statistically significantly positive correlation with age at onset of symptoms and tragus-wall distance (p<0.05). Conclusion: Significant changes were observed in spinal posture in patients with AS. In addition, significant correlations were found between dynamic postural changes and spinal mobility. We think that postural evaluation and follow-up should be carried out with other parameters. Awareness of AS patients about postural changes should be increased, and proper exercise treatment should be applied.

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Risk of Falls in Patients With Ankylosing Spondylitis

Cited by 34 publications

References 37 publications

What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity?

A Preliminary Study on the Correlation Between Spinopelvic Parameters and Balance in Ankylosing Spondylitis

Analysis of Spinal Posture With Three-Dimensional Ultrasonic System in Patients With Ankylosing Spondylitis

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