Pulmonary function in ankylosing spondylitis
Pulmonary dysfunction in AS patients is common, but is is unclear if reduced spinal mobility and associated chest wall immobility OR direct inflammation of the lung parenchyma are responsible for increased fatigue and reduced capacity.
This study explores the relationship between spinal mobility (measured by the Bath Ankylosing Spondylitis Scales), radiographic changes in the spine (mSASSS), pulmonary function (FEV1 and FVC), pain, fatigue, and QOL in patient with AS.
Spinal mobility assessment indeed has a predictive value for respiratory capacity, with clinical implications (maintaining spinal mobility to prevent structural changes).
However, QoL and fatigue were only related to perceived physical condition and pain, suggesting that we need to focus more on pain management and moderate physical exercise as factors influencing work capacity.
Ankylosing spondylitis (AS) is a chronic inflammatory disease with progressive features, the primary affecting sites of which are the joints of the pelvis and the axial skeleton. It has been reported that AS affects approximately 0.1% of the population. In addition, AS may affect peripheral joints, the skin, eyes, or bowel, and also increase the risk of cardiovascular or pulmonary manifestation. More than 50% of patients with AS complain of fatigue, with causative factors unclear. 36 patients were recruited and were evaluated on: • QoL (SF-36 • spinal mobility (BASMI) • radiographic changes (mSASSS) • disease activity and functional capacity (BASDAI/BSAFI) • fatigue (MAF) • pulmonary function (FEV1 and FVC)
Reduced pulmonary function can be predicted by reduced spinal mobility. However, pulmonary function in AS shows a restrictive pattern, suggesting small airway involvement, and pulmonary function is not exclusively caused by chest wall immobility. Maintaining a good physical activity level and adequate pain management are more important than spinal mobility in the day-to-day work capacity of patients with AS.
Do you include general aerobic exercise in your interventions for people with AS, and if yes, what and how?
> From: Cho et al., Ann Rehabil Med 37 (2015) 675-682. All rights reserved to Korean Academy of Rehabilitation Medicine. Click here for the Pubmed summary.