Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium.
Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium.
Musculoskelet Sci Pract. 2021 Jun;53:102368. doi: 10.1016/j.msksp.2021.102368. Epub 2021 Mar 19.
The effects of inflammation and ankylosis on spinal kinematics of patients with axial spondyloarthritis (axSpA) are poorly understood. Furthermore, existence of (mal)adaptive movement profiles within axSpA, and differences between movement profiles in sensation of pain or fear of movement has never been investigated.
To investigate differences in range of motion in six spinal regions and the hips between inflammatory and ankylosed patients with axSpA, and to increase insight in different movement profiles of patients with axSpA and their association with pain and fear.
Observational, cross-sectional.
Three-dimensional motion analysis was performed in 20 patients with axSpA and 23 healthy controls during range of motion tasks in all three planes. We compared patients with inflammatory (n = 8) and ankylosed (n = 12) axSpA, and controls. Patients were also classified into Flexion or Lordotic profile. Questionnaires regarding pain and fear of movement were conducted.
RESULTS/FINDINGS: Both inflammatory and ankylosed axSpA patients have limited spinal ROM and reduced movement speed compared to healthy controls. Patients with a Lordotic profile showed significantly less ROM in lumbar regions and experienced more pain during forward bending than patients with a Flexion profile.
Both inflammation and ankylosis contribute to spinal mobility impairment, and axSpA patients with a lordotic profile experienced more pain. This profile may be a maladaptive movement strategy to prevent further pain increase. Suggesting that pain and fear of movement, might be better variables to specify patients' spinal mobility limitations for individual physical therapy and rehabilitation patient profiling.
炎症和强直对强直性脊柱炎（axSpA）患者脊柱运动学的影响知之甚少。此外，axSpA 患者中是否存在（不良）适应性运动模式，以及疼痛或运动恐惧感觉之间的运动模式差异从未被研究过。
研究炎症和强直 axSpA 患者六个脊柱区域和髋关节的活动范围差异，并深入了解 axSpA 患者的不同运动模式及其与疼痛和恐惧的关系。
观察性、横断面研究。
在三个平面的活动范围任务中，对 20 例 axSpA 患者和 23 例健康对照者进行三维运动分析。我们比较了炎症（n=8）和强直（n=12）axSpA 患者与对照组之间的差异。患者还分为屈曲或前凸型。进行了有关疼痛和运动恐惧的问卷调查。
结果/发现：炎症和强直 axSpA 患者的脊柱活动范围均有限，运动速度较健康对照组降低。前凸型患者的腰椎活动范围明显较小，前屈时疼痛程度高于屈曲型患者。
炎症和强直均导致脊柱活动受限，前凸型 axSpA 患者疼痛更明显。这种模式可能是一种适应性不良的运动策略，以防止疼痛进一步增加。这表明疼痛和运动恐惧可能是更好的变量，可用于确定患者的脊柱活动受限，以进行个体化的物理治疗和康复患者分析。
