Skip to main content
SpringerLink
Log in

Impaired gait in ankylosing spondylitis

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. The spine becomes rigid from the occiput to the sacrum, leading to a stooped position. This study aims at evaluating AS subjects gait alterations. Twenty-four subjects were evaluated: 12 normal and 12 pathologic in stabilized anti-TNF-alpha treatment (mean age 49.42 (10.47), 25.44 (3.19) and mean body mass index 55.75 (3.19), 23.73 (2.7), respectively). Physical examination and gait analysis were performed. A motion capture system synchronized with two force plates was used. Three-dimensional kinematics and kinetics of trunk, pelvis, hip, knee and ankle were determined during gait. A trend towards reduction was found in gait velocity and stride length. Gait analysis results showed statistically significant alterations in the sagittal plane at each joint for AS patients (P < 0.049). Hip and knee joint extension moments showed a statistically significant reduction (P < 0.044). At the ankle joint, a decreased plantarflexion was assessed (P < 0.048) together with the absence of the heel rocker. Gait analysis, through gait alterations identification, allowed planning-specific rehabilitation intervention aimed to prevent patients’ stiffness together with improve balance and avoid muscles’ fatigue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Aydog E, Depedibi R, Bal A, Ekşioglu E, Unlu E, Çakci A (2006) Dynamic postural balance in ankylosing spondylitis patients. Rheumatology 45:445–448

    Article  PubMed  CAS  Google Scholar 

  2. Barkham N, Kong KO, Tennant A et al (2005) The unmet need for anti-tumour necrosis factor (anti-TNF) therapy in ankylosing spondylitis. Rheumatology 44:1277–1281

    Article  PubMed  CAS  Google Scholar 

  3. Bot SDM, Caspers M, Van Royen BJ, Toussaint HM, Kingma I (1999) Biomechanical analysis of posture in patients with spinal kyphosis due to ankylosing spondylitis: a pilot study. Rheumatology 38:441–443

    Article  PubMed  CAS  Google Scholar 

  4. Braun J, Bollow M, Remlinger G, Eggens U, Rudwaleit M, Distler A et al (1998) Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum 41:58–67

    Article  PubMed  CAS  Google Scholar 

  5. Braun J, Brandt J, Listing J et al (2002) Treatment of active ankylosing spondylitis with infliximab—a double-blind placebo controlled multicenter trial. Lancet 359:1187–1193

    Article  PubMed  CAS  Google Scholar 

  6. Braun J, Brandt J, Listing J, Rudwaleit M, Sieper J (2003) Biologic therapies in the spondyloarthritis: new opportunities, new challenges. Curr Opin Rheumatol 15(4):394–407

    Article  PubMed  CAS  Google Scholar 

  7. Calin A, Garrett S, Whitelock H, Gail Kennedy L, O’Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath ankylosing spondylitis functional Index. J Rheumatol 21(12):2281–2285

    PubMed  CAS  Google Scholar 

  8. Cappozzo A, Catani F, Della Croce U, Leardini A (1995) Position and orientation in space of bones during movement, anatomical frame definition and determination. Clin Biomech 10:171–178

    Article  Google Scholar 

  9. Cutti AG, Ferrari A, Garofalo P, Raggi M, Cappello A, Ferrari A (2009) ‘Outwalk’: a protocol for clinical gait analysis based on inertial and magnetic sensors. Med Biol Eng Comput 48(1):17–25

    Article  PubMed  Google Scholar 

  10. De Filippis LG, Balestrieri A, Furfari P, Caliri A, Africa A, Bagnato G (2006) Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis. Reumatismo 58:132–137

    PubMed  Google Scholar 

  11. Della Croce U, Leardini A, Chiari L, Cappozzo A (2005) Human movement analysis using stereophotogrammetry: Part 4: assessment of anatomical landmark misplacement and its effects on joint kinematics. Gait Posture 21(2):226–237

    Article  PubMed  Google Scholar 

  12. Ferrari A, Cutti AG, Garofalo P, Raggi M, Heijboer M, Cappello A, Davalli A (2010) First in vivo assessment of “Outwalk”: a novel protocol for clinical gait analysis based on inertial and magnetic sensors. Med Biol Eng Comput 48(1):1–15

    Article  PubMed  Google Scholar 

  13. Gage JR (1994) The role of gait analysis in the treatment of cerebral palsy. J Pediatr Orthop 14(6):701–702

    Article  PubMed  CAS  Google Scholar 

  14. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21(12):2286–2291

    PubMed  CAS  Google Scholar 

  15. Greene BR, McGrath D, O’Neill R, O’Donovan KJ, Burns A, Caulfield B (2010) An adaptive gyroscope-based algorithm for temporal gait analysis. Med Biol Eng Comput 48(12):1251–1260

    Article  PubMed  Google Scholar 

  16. Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105(2):136–144

    Article  PubMed  CAS  Google Scholar 

  17. Helliwell PS, Smeathers JE, Wright V (1989) Shock absorption by the spinal column in normals and in ankylosing spondylitis. Proc Inst Mech Eng Part H 203:187–190

    Article  CAS  Google Scholar 

  18. Jenkinson TR, Mallorie PA, Whitelock HC, Gail Kennedy L, Garrett SL, Calin A (1994) Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS metrology index. J Rheumatol 21(9):1694–1698

    PubMed  CAS  Google Scholar 

  19. Khan MA (2002) Update on spondyloarthropathies. Ann Intern Med 136:896–907

    PubMed  Google Scholar 

  20. Leardini A, Sawacha Z, Paolini G, Nativo R, Ingrosso S, Benedetti MG (2007) A new anatomical based protocol for gait analysis in children. Gait Posture 26:560–571

    Article  PubMed  Google Scholar 

  21. Maynard V, Bakheit AMO, Oldham J, Freeman J (2003) Intra-rater and interrater reliability of gait measurements with CODA mpx30 motion analysis system. Gait Posture 17(1):59–67

    Article  PubMed  CAS  Google Scholar 

  22. Murray HC, Elliott C, Barton SE, Murray A (2000) Do patients with ankylosing spondylitis have poorer balance than normal subjects? Rheumatology 39:497–500

    Article  PubMed  CAS  Google Scholar 

  23. Perry J (1992) Gait analysis, normal and pathological function. McGraw-Hill, New York, pp 435–436

    Google Scholar 

  24. Picerno P, Cereatti A, Cappozzo A (2008) Joint kinematics estimate using wearable inertial and magnetic sensing modules. Gait Posture 28(4):588–595

    Article  PubMed  Google Scholar 

  25. Sawacha Z, Guarneri G, Cristoferi G, Guiotto A, Avogaro A, Cobelli C (2009) Diabetic gait and posture abnormalities: a biomechanical investigation through three dimensional gait analysis. Clin Biomech 24:722–728

    Article  Google Scholar 

  26. Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A (2002) Ankylosing spondylitis: an overview. Ann Rheum Dis 61(Suppl 3):iii8–iii18

    PubMed  Google Scholar 

  27. Swinkels A, Dolan P (2004) Spinal position sense and disease progression in ankylosing spondylitis—a longitudinal study. Spine 29(11):1240–1245

    Article  PubMed  Google Scholar 

  28. Turan Y, Duruöz MT, Bal S, Guvenc A, Cerrahoglu L, Gurgan A (2007) Assessment of fatigue in patients with ankylosing spondylitis. Rheumatol Int 27(9):847–852

    Article  PubMed  Google Scholar 

  29. van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27:361–368

    Article  PubMed  Google Scholar 

  30. Zebouni L, Helliwell PS, Howe A, Wright V (1992) Gait analysis in ankylosing spondylitis. Ann Rheum Dis 51:898–899

    Article  PubMed  CAS  Google Scholar 

  31. Zochling J, van der Heijde D, Burgos-Vargas R, Collantes E, Davis JC, Dijkmans B Jr, Dougados M, Géher P, Inman RD, Khan MA, Kvien TK, Leirisalo-Repo M, Olivieri I, Pavelka K, Sieper J, Stucki G, Sturrock RD, van der Linden S, Wendling D, Böhm H, van Royen BJ, Braun J (2006) ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 65:442–452

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank the contribution of Roberta Guglielmin and Mariangela Sambini for their help in collecting the clinical data on AS patients.

Author information

Authors and Affiliations

  1. Department of Information Engineering, University of Padova, Via Gradenigo 6/B, 35131, Padua, Italy

    Silvia Del Din, Zimi Sawacha, Annamaria Guiotto & Claudio Cobelli

  2. Department of Rehabilitation Medicine, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy

    Elena Carraro, Lara Bonaldo & Stefano Masiero

Authors
  1. Silvia Del Din
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elena Carraro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zimi Sawacha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Annamaria Guiotto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lara Bonaldo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stefano Masiero
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Claudio Cobelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claudio Cobelli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Del Din, S., Carraro, E., Sawacha, Z. et al. Impaired gait in ankylosing spondylitis. Med Biol Eng Comput 49, 801–809 (2011). https://doi.org/10.1007/s11517-010-0731-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-010-0731-x

Keywords

Search

Navigation