Skip to main content
SpringerLink
Log in

Correlation Among Disease Activity, Musculoskeletal Function, and Quality of Life in Patients with Ankylosing Spondylitis with Mild to Moderate Radiographic Signs

  • Original Article
  • Published:
Journal of Medical and Biological Engineering Aims and scope Submit manuscript

Abstract

Purpose

To examine the relationship among disease activity, musculoskeletal function, and quality of life (QOL) in ankylosing spondylitis (AS) with mild to moderate radiographic signs. For understanding how muscle strength and function associations QOL in AS with different radiographic signs.

Methods

Fifty-one adults with AS according to their radiographic signs were divided into a sacroiliitis (mild) or a syndesmophytes (moderate) group. Twenty-three healthy adults were enrolled as normal controls. Disease activity were measured with Bath AS Disease Activity Index (BASDAI) and informative marker of laboratory data. Bath AS Functional Index (BASFI), musculoskeletal function, and the Metrology Index (BASMI) were used to measure muscle function. QOL was assessed using the 36-Item Short-Form Health Survey (SF-36).

Results

Significant differences were observed in BASFI, BASMI, grip strength, and the acceleration pattern in the sit-to-stand (STS) between the AS and the control group. However, no significant difference in QOL was present. Spinal mobility, shoulder proprioception, and immunoglobulin A level differed between the two AS subgroups. Disease activity was significantly correlated with QOL. Grip strength was significantly correlated with QOL subscales, pain, lumbar side flexion, and cervical rotation range; chest expansion was correlated with QOL subscales and cervical rotation. The 2-minute step test scores were significantly correlated with social functioning and prednisolone use.

Conclusion

The patient had well managed in disease activity with fair QOL. The spinal mobility and proprioception of patients with syndesmophytes were seriously affected. The muscle strength and STS motion pattern were adversely affected by the disease even on the sacroiliitis AS.

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

Similar content being viewed by others

References

  1. van der Heijde, D., Dougados, M., Davis, J., Weisman, M. H., Maksymowych, W., Braun, J., et al. (2005). Assessment in ankylosing spondylitis international working group/spondylitis association of america recommendations for conducting clinical trials in ankylosing spondylitis. Arthritis and Rheumatology, 52, 386–394.

    Article  Google Scholar 

  2. Qian, B. P., Jiang, J., Qiu, Y., Wang, B., Yu, Y., & Zhu, Z. Z. (2014). The presence of a negative sacral slope in patients with ankylosing spondylitis with severe thoracolumbar kyphosis. The Journal of Bone and Joint Surgery American Volume, 96, e188.

    Article  PubMed  Google Scholar 

  3. Song, Y., Xie, X., Chen, Y., Wang, Y., Yang, H., Nie, A., et al. (2021). Effects of wechat-based educational intervention on depression and quality of life in patients with ankylosing spondylitis: a randomized controlled trail. Arthritis Research and Therapy, 23, 72.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Huang, J. C., Qian, B. P., Qiu, Y., Wang, B., Yu, Y., Zhu, Z. Z., et al. (2017). Quality of life and correlation with clinical and radiographic variables in patients with ankylosing spondylitis: a retrospective case series study. BMC Musculoskeletal Disorders, 18, 352.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kim, S. C., Lee, Y. G., Park, S. B., Kim, T. H., & Lee, K. H. (2017). Muscle mass, strength, mobility, quality of life, and disease severity in ankylosing spondylitis patients: a preliminary study. Annals of Rehabilitation Medicine, 41, 990–997.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sallam, R. A., & Elbahnasawy, A. S. (2020). Health related quality of life (HRQoL) in ankylosing spondylitis patients: relation to clinical features, disease activity and radiographic damage. The Egyptian Rheumatologist, 42, 287–290.

    Article  Google Scholar 

  7. An, H. J., Tizaoui, K., Terrazzino, S., Cargnin, S., Lee, K. H., Nam, S. W., et al. (2020). Sarcopenia in autoimmune and rheumatic diseases: a comprehensive review. International Journal of Molecular Sciences, 21, 5678.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kwon, J. W., Lee, B. H., Sung, S., Lee, S. B., Park, M. S., Cho, J. H., et al. (2020). Hand grip strength as a surrogate marker for postoperative changes in spinopelvic alignment in patients with lumbar spinal stenosis. Scientific Reports, 10, 13432.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kasapoğlu, A. M., Altan, L., Görükmez, O., Güner, A., & Ayar, K. (2020). The relationship between CRP gene polymorphism (rs2794521, rs3091244), ASDAS-CRP and ASDAS-ESR in ankylosing spondylitis. Modern Rheumatology, 30, 715–720.

    Article  Google Scholar 

  10. Liew, J. W., Gianfrancesco, M. A., Heckbert, S. R., & Gensler, L. S. (2022). Relationship between body mass index, disease activity, and exercise in ankylosing spondylitis. Arthritis Care and Research, 74, 1287–1293.

    Article  PubMed  Google Scholar 

  11. Schneeberger, E. E., Citera, G., De Leon, D. P., Szumski, A. E., Kwok, K., Cutri, M., et al. (2022). Simplified ankylosing spondylitis disease activity score (SASDAS) versus ASDAS: a post hoc analysis of a randomized controlled trial. The Journal of Rheumatology, 49, 1100–1108.

    Article  CAS  PubMed  Google Scholar 

  12. Zhang, G., Tian, Z., & Xue, Q. (2022). Comparison of clinical and pathological features of secondary IgA nephropathy of ankylosing spondylitis and primary IgA nephropathy. Clinical Nephrology, 97, 273–280.

    Article  CAS  PubMed  Google Scholar 

  13. Calin, A., Garrett, S., Whitelock, H., Kennedy, L. G., O’hea, J., Mallorie, P., et al. (1994). A new approach to defining functional ability in ankylosing spondylitis: the development of the bath ankylosing spondylitis functional index. The Journal of Rheumatology, 21, 2281–2285.

    CAS  PubMed  Google Scholar 

  14. Chang, S. T., Lai, K. L., Kuo, F. C., & Kao, Y. S. (2018). Cross-correlation between spine and hip joint kinematics differs in healthy individuals and subgroups of ankylosing spondylitis patients during trunk lateral flexion. Musculoskeletal Science and Practice, 38, 8–14.

    Article  PubMed  Google Scholar 

  15. Kuo, F. C., Chiang, K. L., & Kao, Y. S. (2019). Structural damage and motion rhythm of the spine and hip during trunk lateral bending in ankylosing spondylitis patients with mild to moderate radiographic signs. Clinical Biomechanics, 63, 112–118.

    Article  PubMed  Google Scholar 

  16. Aguila Maldonado, R., Ruta, S., Valuntas, M. L., & Garcia, M. (2017). Ultrasonography assessment of heel entheses in patients with spondyloarthritis: a comparative study with magnetic resonance imaging and conventional radiography. Clinical Rheumatology, 36, 1811–1817.

    Article  PubMed  Google Scholar 

  17. Barone, M., Viggiani, M. T., Anelli, M. G., Fanizzi, R., Lorusso, O., Lopalco, G., et al. (2018). Sarcopenia in patients with rheumatic diseases: prevalence and associated risk factors. Journal of Clinical Medicine, 7, 504.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chen, L. K., Woo, J., Assantachai, P., Auyeung, T. W., Chou, M. Y., Iijima, K., et al. (2020). Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. Journal of the American Medical Directors Association, 21, 300–307.

    Article  PubMed  Google Scholar 

  19. Marcora, S., Casanova, F., Williams, E., Jones, J., Elamanchi, R., & Lemmey, A. (2006). Preliminary evidence for cachexia in patients with well-established ankylosing spondylitis. Rheumatology, 45, 1385–1388.

    Article  CAS  PubMed  Google Scholar 

  20. Mateos-Angulo, A., Galán-Mercant, A., & Cuesta-Vargas, A. I. (2020). Muscle thickness contribution to sit-to-stand ability in institutionalized older adults. Aging Clinical and Experimental Research, 32, 1477–1483.

    Article  CAS  PubMed  Google Scholar 

  21. Bohannon, R. W., & Crouch, R. H. (2019). Two-minute step test of exercise capacity: systematic review of procedures, performance, and clinimetric properties. Journal of Geriatric Physical Therapy, 42, 105–112.

    Article  PubMed  Google Scholar 

  22. Mackay, K., Mack, C., Brophy, S., & Calin, A. (1998). The bath ankylosing spondylitis radiology index (BASRI): a new, validated approach to disease assessment. Arthritis and Rheumatism, 41, 2263–2270.

    Article  CAS  PubMed  Google Scholar 

  23. Baraliakos, X., Listing, J., Rudwaleit, M., Haibel, H., Brandt, J., Sieper, J., et al. (2007). Progression of radiographic damage in patients with ankylosing spondylitis: defining the central role of syndesmophytes. Annals of the Rheumatic Diseases, 66, 910–915.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Garrett, S., Jenkinson, T., Kennedy, L. G., Whitelock, H., Gaisford, P., & Calin, A. (1994). A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index. The Journal of Rheumatology, 21, 2286–2291.

    CAS  PubMed  Google Scholar 

  25. Yang, X., Fan, D., Xia, Q., Wang, M., Zhang, X., Li, X., et al. (2016). The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis. Quality of Life Research, 25, 2711–2723.

    Article  PubMed  Google Scholar 

  26. Song, Y., Xie, X., Chen, Y., Wang, Y., Yang, H., Nie, A., et al. (2021). The effects of WeChat-based educational intervention in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Research and Therapy, 23, 1–9.

    Google Scholar 

  27. Lu, J. R., Tseng, H. M., & Tsai, Y. J. (2003). Assessment of health-related quality of life in taiwan (I): development and psychometric testing of SF-36 taiwan version. Taiwan Journal of Public Health, 22, 501–511.

    Google Scholar 

  28. Ramiro, S., Landewe, R. B., van der Heijde, D., Stolwijk, C., Dougados, M., van den Bosch, F., et al. (2015). Hierarchy of impairment of spinal mobility measures in ankylosing spondylitis: twelve-year data. Arthritis Care and Research, 67, 1571–1577.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of General Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

    Chen-I Kao

  2. Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan

    Ben-Yi Liau

  3. Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

    Kuo-Lung Lai

  4. Department of Physical Therapy, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, 433304, Taichung, Taiwan

    Fang-Chuan Kuo

Authors
  1. Chen-I Kao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ben-Yi Liau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kuo-Lung Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fang-Chuan Kuo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fang-Chuan Kuo.

Ethics declarations

Competing interests

The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical Approval

The Institutional Review Board of Taichung Veterans General Hospital Ethics Committee(s) approved this study. All participants gave written informed consent before data collection began. IRB TCVGH No: CE16133A.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kao, CI., Liau, BY., Lai, KL. et al. Correlation Among Disease Activity, Musculoskeletal Function, and Quality of Life in Patients with Ankylosing Spondylitis with Mild to Moderate Radiographic Signs. J. Med. Biol. Eng. 43, 147–155 (2023). https://doi.org/10.1007/s40846-023-00780-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40846-023-00780-5

Search

Navigation