Importance of posture assessment in ankylosing spondylitis. Preliminary study
University of Medicine and Pharmacy Grigore T. Popa Iaşi, School of Medicine.
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
The aim of this study is to perform a screening of patients diagnosed with ankylosing spondylitis (AS) in order to evaluate the static spinal disorders and correlate the results with the main clinical and functional parameters that characterize this disease.
Ninety-five patients diagnosed with AS according to the 1994 New York criteria were screened, and 68 of them (all males) presenting static spinal disorders and on physical therapy programs in different outpatient physical therapy units throughout 2011 entered the study.
The distribution of the patients according to static spinal disorders was almost even. There were no statistically significant differences in mean age and disease duration (p>0.05). The assessment oflumbosacral pain in the morning (VAS1) and daytime lumbosacral pain (VAS2) showed a higher scores in patients suffering from kyphoscoliosis than in those with scoliosis (p=0.020), (p=0.000), or kyphosis. Ott and modified Schöber index, and chest expansion, had higher mean values in patients with scoliosis compared with the other postural disorders (p<0.001). Statistically higher mean BASFI values were recorded in patients with kyphoscoliosis (p=0.038), while the mean BASMI values were lower in scoliosis patients (p<0.001). As to the quality of life of AS patients, HAQ-DI index recorded significantly lower mean values for kyphoscoliosis compared with other postural disorders (p<0.001).
Our study suggests that posture assessment and implicitly the correction of possible misalignments should be part of the kinetic physical therapy program. Rigorous observing of postural recommendations can prevent the respiratory system complications.
Available from: Aleksandra Rapała
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ABSTRACT: BACKGROUND: The available literature is lacking in reports on the quantitative analysis of posture in patients with lumbar stenosis. OBJECTIVE: The aim of this study was to analyze body posture in patients with lumbar spinal canal stenosis. METHODS: The study involved 100 people: 49 persons with severe lumbar spine stenosis and 51 control subjects without any history of back pain. All participatants were evaluated by a photogrammetric method. RESULTS: Photogrammetric measurements showed statistically significant differences in the shape of the anterior-posterior curvatures of the spine. In the study group thoracic kyphosis was significantly greater (p = 0.043), and the depth of lumbar lordosis was significantly smaller (p = 0.038). The inclination of the thoracolumbar segment was also significantly lower (p = 0.013). CONCLUSIONS: 1. Measurements of body posture indicate a deepening of thoracic kyphosis and flattening of lumbar lordosis in lumbar stenosis patients. 2. Flattening of physiological lordosis seems to be caused by enlargment of the space of the spinal canal and dural sac in this position.
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To review the evidence on the rehabilitation treatment of ankylosing spondylitis (AS) through exercise and education and to analyze the most appropriate content.
We carried out a systematic review of controlled trials, systematic reviews, meta-analyses and clinical practice guidelines in MEDLINE, SCOPUS, Web of Knowledge, Cochrane Library, and PEDro published from January 2008 to December 2013.
14 articles were selected.
All studies, as well as review articles, that investigated the efficacy of therapeutic exercise demonstrated benefits in the various functional parameters of the disease. Supervised group exercises are preferred, whether in or out of water, or even at home as a supplement or alternative. Factors that should be considered are patients’ motivations, desires, expectations, and fatigue. Rehabilitation programs have been demonstrated to be cost-effective.
Rehabilitation is effective in the treatment of AS.
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