Spinal Mobility, Vertebral Squaring, Pulmonary Function, Pain, Fatigue, and Quality of Life in Patients With Ankylosing Spondylitis

Abstract

ObjectiveTo investigate the relationships between spinal mobility, pulmonary function, structural change of the spine, pain, fatigue, and quality of life (QOL) in patients with ankylosing spondylitis (AS).MethodsThirty-six patients with AS were recruited. Their spinal mobility was examined through seven physical tests: modified Schober test, lateral bending, chest expansion, occiput to wall, finger to ground, bimalleolar distance, and range of motion (ROM) of the spine. Pulmonary Function Test (PFT) was performed using a spirometer, and vertebral squaring was evaluated through the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). QOL, disease activity, functional capacity, and fatigue were evaluated by SF-36 Health Survey (SF-36), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Multidimensional Assessment of Fatigue (MAF) scale, respectively. Perceived physical condition and degree of pain were assessed using 10 cm visual analogue scale.ResultsParticipants showed reduced spinal mobility, which was negatively correlated with mSASSS. PFT results showed reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and increased FEV1/FVC. Reduced FEV1 and FVC showed positive correlations with reduced spinal mobility and a negative relationship with mSASSS. Perceived physical condition and degree of pain were both significantly related to the SF-36, BASDAI, BASFI, and MAF scores.ConclusionThis study shows that both reduced spinal mobility and radiographic changes in the vertebral body may have a predictive value for pulmonary impairment in patients with AS. Likewise, pain and perceived physical condition may play an important role in the QOL, functional capacity, and fatigue level of these patients.

Surgical Stabilization of a Cervical Fracture in a Patient with Ankylosing Spondylitis in the Sitting Position

“…However, surgery for spinal fractures associated with AS is complex and replete with risk due to multiple factors [4,5]. Patients with AS often have greater comorbidities, such as hyperkyphosis-related reduction in pulmonary function [12][13][14]. Increased risk of spinal cord injury due to instability of the fracture necessitates careful consideration of transfers and operative positioning [3,15,16].…”

Evaluation of Pulmonary Functions and Aerobic Capacity in Patients with Ankylosing Spondylitis and Rheumatoid Arthritis

“…A study that examined disease activity, quality of life, fatigue, pain and physical condition reported that low physical condition and high levels of pain result in reduced quality of life; high disease activity, reduced functionality and increased fatigue. 34 It can be mentioned that patients with high disease activity feel more pain and fatigue and therefore show less functionality leading to reduced exercise capacity.…”

Role of HLA-B27 in the pathogenesis of ankylosing spondylitis

“…Peripheral arthritis and enthesopathy have been reported to be present in a large group of AS patients (1). In addition, specific organ involvement including anterior uveitis, psoriasis and chronic inflammatory bowel disease, may simultaneously occur in AS, accompanied by an increased risk of cardiovascular or pulmonary complications (1,2). Chronic inflammation in the attachment of tendons, ligaments and joint capsules to bone leads to alterations in joint architecture, with new bone formations and joint fusions (3).…”