Abstract
Axial spondyloarthritis (axSpA) is a chronic inflammatory disease predominantly affecting the axial skeleton. axSpA includes radiographic (i.e., ankylosing spondylitis (AS)) and non-radiographic forms (nr-axSpA). Although recent studies have reported that patients with AS have impaired gait, axSpA’s consequences on gait remain unknown. The present review’s objectives were to identify: 1) how gait is assessed in patients with axSpA, and 2) what the gait characteristics are of patients with axSpA.
This systematic review’s protocol was registered in the Prospero database (CRD42020128509). Three databases were systematically searched using keywords related to axSpA and gait. Two independent reviewers selected the articles and extracted the data.
The search revealed two hundred titles and abstracts, and two articles were finally included in this review, comprising a total of 132 patients with axSpA. One of the included studies used the 6 m maximum gait velocity test (axSpA: 2.2 ± 0.5 m/s), and the other used the six-minute walk test (axSpA: 414 ± 106 m). Neither study involved a control group to compare gait.
Only two published studies assessed the gait performance of patients with axSpA using clinical tests. Furthermore, neither of them compared gait performance to healthy controls or differentiated gait between the AS and nr-axSpA forms of axSPA. The present literature review highlights the need for future research to learn more about how gait is impaired in different types of patients with axSpA.
Keywords: Axial spondyloarthritis, spondyloarthritis, gait, walk, locomotion, six-minute walk test.
Graphical Abstract
[1]
Sieper J, Rudwaleit M, Baraliakos X, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis 2009; 68(Suppl. 2): ii1-ii44.
[http://dx.doi.org/10.1136/ard.2008.104018] [PMID: 19433414]
[http://dx.doi.org/10.1136/ard.2008.104018] [PMID: 19433414]
[2]
Proft F, Poddubnyy D. Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria. Ther Adv Musculoskelet Dis 2018; 10(5-6): 129-39.
[http://dx.doi.org/10.1177/1759720X18773726] [PMID: 29942364]
[http://dx.doi.org/10.1177/1759720X18773726] [PMID: 29942364]
[3]
Dincer U, Cakar E, Kiralp MZ, Dursun H. Diagnosis delay in patients with ankylosing spondylitis: possible reasons and proposals for new diagnostic criteria. Clin Rheumatol 2008; 27(4): 457-62.
[http://dx.doi.org/10.1007/s10067-007-0727-6] [PMID: 17899306]
[http://dx.doi.org/10.1007/s10067-007-0727-6] [PMID: 17899306]
[4]
Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford) 2014; 53(4): 650-7.
[http://dx.doi.org/10.1093/rheumatology/ket387] [PMID: 24324212]
[http://dx.doi.org/10.1093/rheumatology/ket387] [PMID: 24324212]
[5]
Bohn R, Cooney M, Deodhar A, Curtis JR, Golembesky A. Incidence and prevalence of axial spondyloarthritis: methodologic challenges and gaps in the literature. Clin Exp Rheumatol 2018; 36(2): 263-74.
[PMID: 29148402]
[PMID: 29148402]
[6]
Danve A, Deodhar A. Axial spondyloarthritis in the USA: diagnostic challenges and missed opportunities. Clin Rheumatol 2019; 38(3): 625-34.
[http://dx.doi.org/10.1007/s10067-018-4397-3] [PMID: 30588555]
[http://dx.doi.org/10.1007/s10067-018-4397-3] [PMID: 30588555]
[7]
Rudwaleit M, Sieper J. Referral strategies for early diagnosis of axial spondyloarthritis. Nat Rev Rheumatol 2012; 8(5): 262-8.
[http://dx.doi.org/10.1038/nrrheum.2012.39] [PMID: 22487797]
[http://dx.doi.org/10.1038/nrrheum.2012.39] [PMID: 22487797]
[8]
Sieper J, Hu X, Black CM, Grootscholten K, van den Broek RWM, Kachroo S. Systematic review of clinical, humanistic, and economic outcome comparisons between radiographic and non-radiographic axial spondyloarthritis. Semin Arthritis Rheum 2017; 46(6): 746-53.
[http://dx.doi.org/10.1016/j.semarthrit.2016.09.002] [PMID: 27855973]
[http://dx.doi.org/10.1016/j.semarthrit.2016.09.002] [PMID: 27855973]
[9]
Hebeisen M, Micheroli R, Scherer A, et al. Spinal radiographic progression in axial spondyloarthritis and the impact of classification as nonradiographic versus radiographic disease: Data from the Swiss Clinical Quality Management cohort. PLoS One 2020; 15(3): e0230268.
[http://dx.doi.org/10.1371/journal.pone.0230268] [PMID: 32196530]
[http://dx.doi.org/10.1371/journal.pone.0230268] [PMID: 32196530]
[10]
Soulard J, Vaillant J, Agier C-T, Vuillerme N. Gait characteristics in patients with ankylosing spondylitis: a systematic review. Clin Exp Rheumatol 2021; 39: 173-186. https://www.clinexprheumatol.org/article.asp?a=15409
[11]
Poddubnyy D, Rudwaleit M, Haibel H, et al. Effect of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Ann Rheum Dis 2012; 71(10): 1616-22.
[http://dx.doi.org/10.1136/annrheumdis-2011-201252] [PMID: 22459541]
[http://dx.doi.org/10.1136/annrheumdis-2011-201252] [PMID: 22459541]
[12]
Poddubnyy D. Axial spondyloarthritis: is there a treatment of choice? Ther Adv Musculoskelet Dis 2013; 5(1): 45-54.
[http://dx.doi.org/10.1177/1759720X12468658] [PMID: 23514983]
[http://dx.doi.org/10.1177/1759720X12468658] [PMID: 23514983]
[13]
Poddubnyy D, Listing J, Haibel H, Knüppel S, Rudwaleit M, Sieper J. Functional relevance of radiographic spinal progression in axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Rheumatology (Oxford) 2018; 57(4): 703-11.
[http://dx.doi.org/10.1093/rheumatology/kex475] [PMID: 29373733]
[http://dx.doi.org/10.1093/rheumatology/kex475] [PMID: 29373733]
[14]
Packham J. Optimizing outcomes for ankylosing spondylitis and axial spondyloarthritis patients: a holistic approach to care. Rheumatology (Oxford) 2018; 57(6): vi29-34.
[http://dx.doi.org/10.1093/rheumatology/key200] [PMID: 30445484]
[http://dx.doi.org/10.1093/rheumatology/key200] [PMID: 30445484]
[15]
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6(7): e1000097.
[http://dx.doi.org/10.1371/journal.pmed.1000097] [PMID: 19621072]
[http://dx.doi.org/10.1371/journal.pmed.1000097] [PMID: 19621072]
[16]
Verhoeven F, Guillot X, Prati C, et al. Aerobic exercise for axial spondyloarthritis - its effects on disease activity and function as compared to standard physiotherapy: A systematic review and meta-analysis. Int J Rheum Dis 2019; 22(2): 234-41.
[http://dx.doi.org/10.1111/1756-185X.13385] [PMID: 30187695]
[http://dx.doi.org/10.1111/1756-185X.13385] [PMID: 30187695]
[17]
Boyer KA, Johnson RT, Banks JJ, Jewell C, Hafer JF. Systematic review and meta-analysis of gait mechanics in young and older adults. Exp Gerontol 2017; 95: 63-70.
[http://dx.doi.org/10.1016/j.exger.2017.05.005] [PMID: 28499954]
[http://dx.doi.org/10.1016/j.exger.2017.05.005] [PMID: 28499954]
[18]
Eppeland SG, Diamantopoulos AP, Soldal DM, Haugeberg G. Short term in-patient rehabilitation in axial spondyloarthritis - the results of a 2-week program performed in daily clinical practice. BMC Res Notes 2013; 6: 185.
[http://dx.doi.org/10.1186/1756-0500-6-185] [PMID: 23651526]
[http://dx.doi.org/10.1186/1756-0500-6-185] [PMID: 23651526]
[19]
Coulter EH, McDonald MT, Cameron S, Siebert S, Paul L. Physical activity and sedentary behaviour and their associations with clinical measures in axial spondyloarthritis. Rheumatol Int 2020; 40(3): 375-81.
[http://dx.doi.org/10.1007/s00296-019-04494-3] [PMID: 31848736]
[http://dx.doi.org/10.1007/s00296-019-04494-3] [PMID: 31848736]
[20]
Wang J, Mannen EM, Siddicky SF, Lee JM, Latt LD. Gait alterations in posterior tibial tendonitis: A systematic review and meta-analysis. Gait Posture 2020; 76: 28-38.
[http://dx.doi.org/10.1016/j.gaitpost.2019.11.002] [PMID: 31715431]
[http://dx.doi.org/10.1016/j.gaitpost.2019.11.002] [PMID: 31715431]
[21]
Zebouni L, Helliwell PS, Howe A, Wright V. Gait analysis in ankylosing spondylitis. Ann Rheum Dis 1992; 51(7): 898-9.
[http://dx.doi.org/10.1136/ard.51.7.898] [PMID: 1632666]
[http://dx.doi.org/10.1136/ard.51.7.898] [PMID: 1632666]
[22]
Zhang G, Li J, Xia Z, Xu W. The gait deviations of ankylosing spondylitis with hip involvement. Clin Rheumatol 2019; 38(4): 1163-75.
[http://dx.doi.org/10.1007/s10067-018-4401-y] [PMID: 30607653]
[http://dx.doi.org/10.1007/s10067-018-4401-y] [PMID: 30607653]
[23]
Mangone M, Scettri P, Paoloni M, Procaccianti R, Spadaro A, Santilli V. Pelvis-shoulder coordination during level walking in patients with ankylosing spondylitis. Gait Posture 2011; 34(1): 1-5.
[http://dx.doi.org/10.1016/j.gaitpost.2011.02.002] [PMID: 21377366]
[http://dx.doi.org/10.1016/j.gaitpost.2011.02.002] [PMID: 21377366]
[24]
Del Din S, Carraro E, Sawacha Z, et al. Impaired gait in ankylosing spondylitis. Med Biol Eng Comput 2011; 49(7): 801-9.
[http://dx.doi.org/10.1007/s11517-010-0731-x] [PMID: 21229328]
[http://dx.doi.org/10.1007/s11517-010-0731-x] [PMID: 21229328]
[25]
Kim HJ, Park I, Lee HJ, Lee O. The reliability and validity of gait speed with different walking pace and distances against general health, physical function, and chronic disease in aged adults. J Exerc Nutrition Biochem 2016; 20(3): 46-50.
[http://dx.doi.org/10.20463/jenb.2016.09.20.3.7] [PMID: 27757387]
[http://dx.doi.org/10.20463/jenb.2016.09.20.3.7] [PMID: 27757387]
[26]
Barkham N, Coates LC, Keen H, et al. Double-blind placebo-controlled trial of etanercept in the prevention of work disability in ankylosing spondylitis. Ann Rheum Dis 2010; 69(11): 1926-8.
[http://dx.doi.org/10.1136/ard.2009.121327] [PMID: 20511615]
[http://dx.doi.org/10.1136/ard.2009.121327] [PMID: 20511615]
[27]
Beauchet O, Allali G, Sekhon H, et al. Guidelines for assessment of gait and reference values for spatiotemporal gait parameters in older adults: the biomathics and canadian gait consortiums initiative. Front Hum Neurosci 2017; 11: 353.
[http://dx.doi.org/10.3389/fnhum.2017.00353] [PMID: 28824393]
[http://dx.doi.org/10.3389/fnhum.2017.00353] [PMID: 28824393]
[28]
Çınar E, Akkoç Y, Karapolat H, Durusoy R, Keser G. Postural deformities: potential morbidities to cause balance problems in patients with ankylosing spondylitis? Eur J Rheumatol 2016; 3(1): 5-9.
[http://dx.doi.org/10.5152/eurjrheum.2015.15104] [PMID: 27708961]
[http://dx.doi.org/10.5152/eurjrheum.2015.15104] [PMID: 27708961]
[29]
Paul L, Coulter EH, Cameron S, et al. Web-based physiotherapy for people with axial spondyloarthritis (WEBPASS) - a study protocol. BMC Musculoskelet Disord 2016; 17(1): 360.
[http://dx.doi.org/10.1186/s12891-016-1218-1] [PMID: 27553492]
[http://dx.doi.org/10.1186/s12891-016-1218-1] [PMID: 27553492]
[30]
Balke B. A simple field test for the assessment of physical fitness. Rep Civ Aeromed Res Inst 1963.
[31]
Focht BC, Rejeski WJ, Ambrosius WT, Katula JA, Messier SP. Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum 2005; 53(5): 659-65.
[http://dx.doi.org/10.1002/art.21466] [PMID: 16208674]
[http://dx.doi.org/10.1002/art.21466] [PMID: 16208674]
[32]
Deodhar AA, Kumthekar A, Dubreuil M. Minimal disease activity in axial spondyloarthritis: the need of the hour and a proposal for development. Curr Opin Rheumatol 2017; 29(4): 293-7.
[http://dx.doi.org/10.1097/BOR.0000000000000387] [PMID: 28376060]
[http://dx.doi.org/10.1097/BOR.0000000000000387] [PMID: 28376060]
[33]
ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166(1): 111-7.
[http://dx.doi.org/10.1164/ajrccm.166.1.at1102] [PMID: 12091180]
[http://dx.doi.org/10.1164/ajrccm.166.1.at1102] [PMID: 12091180]
[34]
Lee G, Pollo F. Technology Overview: The Gait Analysis Laboratory. J Clin Eng 2001; 26
[http://dx.doi.org/10.1097/00004669-200126020-00010]
[http://dx.doi.org/10.1097/00004669-200126020-00010]
[35]
Iosa M, Picerno P, Paolucci S, Morone G. Wearable inertial sensors for human movement analysis. Expert Rev Med Devices 2016; 13(7): 641-59.
[http://dx.doi.org/10.1080/17434440.2016.1198694] [PMID: 27309490]
[http://dx.doi.org/10.1080/17434440.2016.1198694] [PMID: 27309490]
[36]
Storm FA, Cesareo A, Reni G, Biffi E. Wearable inertial sensors to assess gait during the 6-minute walk test: a systematic review. Sensors (Basel) 2020; 20(9): E2660.
[http://dx.doi.org/10.3390/s20092660] [PMID: 32384806]
[http://dx.doi.org/10.3390/s20092660] [PMID: 32384806]
[37]
Vervoort D, Vuillerme N, Kosse N, Hortobágyi T, Lamoth CJ. Multivariate analyses and classification of inertial sensor data to identify aging effects on the timed-up-and-go test. PLoS One 2016; 11(6): e0155984.
[http://dx.doi.org/10.1371/journal.pone.0155984] [PMID: 27271994]
[http://dx.doi.org/10.1371/journal.pone.0155984] [PMID: 27271994]
[38]
Esser P, Collett J, Maynard K, et al. Single sensor gait analysis to detect diabetic peripheral neuropathy: a proof of principle study. Diabetes Metab J 2018; 42(1): 82-6.
[http://dx.doi.org/10.4093/dmj.2018.42.1.82] [PMID: 29504308]
[http://dx.doi.org/10.4093/dmj.2018.42.1.82] [PMID: 29504308]
[39]
Lewallen S, Courtright P. Epidemiology in practice: case-control studies. Community Eye Health 1998; 11(28): 57-8.
[PMID: 17492047]
[PMID: 17492047]
[40]
Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing 1997; 26(1): 15-9.
[http://dx.doi.org/10.1093/ageing/26.1.15] [PMID: 9143432]
[http://dx.doi.org/10.1093/ageing/26.1.15] [PMID: 9143432]
[41]
Brambila-Tapia AJL, Rocha-Muñoz AD, Gonzalez-Lopez L, et al. Pulmonary function in ankylosing spondylitis: association with clinical variables. Rheumatol Int 2013; 33(9): 2351-8.
[http://dx.doi.org/10.1007/s00296-013-2723-2] [PMID: 23543327]
[http://dx.doi.org/10.1007/s00296-013-2723-2] [PMID: 23543327]
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