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

Osman Hakan GÜNDÜZ1, Emel Ece ÖZCAN-EKŞİ2, Esra GİRAY1, İlker YAĞCI1

1Department of Physical Medicine and Rehabilitation, Medical Faculty of Marmara University, İstanbul, Turkey
2Department of Physical Medicine and Rehabilitation, Antalya Ataturk State Hospital, Antalya, Turkey

Keywords: Ankylosing spondylitis; dynamic balance; posture; static balance

Abstract

Objectives: 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.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Acknowledgments

We would like to thank Firat Ulutatar, MD, for taking photographs.