Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography

Nuray Gülgönül; Ebru Karaca Umay; Bilge Kesikburun; Fatma Hülya Şahin; Rabia Sökmen

doi:10.4274/atfm.galenos.2022.27880

Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography

Abstract

Objectives: The aim of this study is to investigate the effect of work conditions that require physical performance on axial spondyloarthritis with clinical, laboratory and radiological measurements. In addition, the performance of ultrasonographic examination in showing the effect of work characteristics on enthesopathy was evaluated. Materials and Methods: The present study is a single-center cross-sectional analysis conducted on 51 axial spondyloarthritis (axSpA) patients who were diagnosed according to the Assessment of Spondyloarthritis International Society criteria between October 2020 and December 2020 (24 females, 27 males, mean age: 46.98±9.30 years, 15 ankylosing spondylitis patients, 36 nr-axSpA). Demographic and clinical characteristics, along with disease related laboratory data of the patients, were recorded. Results: Work duration was found to be positively correlated with Maastricht ankylosing spondylitis enthesitis score (MASES), foot deformity, and erythrocyte sedimentation rate (ESR), while negatively correlated with thoracal Schober. Physical activity level at work was positively correlated with the Bath ankylosing spondylitis metrology index, Bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-ESR, MASES, foot deformity and ESR, while it was negatively correlated with thoracal Schober. Leisure activity level was only positively correlated with foot deformity. In the findings in radiological parameters, it was measured that the work duration was positively correlated with the thickness of the distal patellar and Achilles tendon. The level of physical activity at work positively correlates with distal patellar tendon thickness, Achilles tendon thickness, and plantar fascia thickness. It was seen that the activity level in leisure time was only positively correlated with distal patellar tendon thickness. Conclusion: Physical activity level at work in axSpA patients is related to the severity of disease activity and decreased spinal mobility. In particular, increase of mechanical workload causes acute inflammation at the lower extremity and all enthesopathy points, independently from radiological progression and disease activity. The addition of ultrasonographical examination may supply a better evaluation of the effects of physical activity level at work on patients.

Keywords

Axial Spondyloarthritis, Physical Activity, Enthesopathy, Ultrasonography

Ethical Statement

Approval of the study was obtained from University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Clinical Research Ethic Committee (approval no: 98/03, date: 19.10.2020).

References

1. Stolwijk C, Boonen A, van Tubergen A, et al. Epidemiology of Spondyloarthritis. Rheum Dis Clin North Am. 2012;38:441-476.
2. Stolwijk C, van Onna M, Boonen A, et al. Global Prevalence of Spondyloarthritis: A Systematic Review and Meta-Regression Analysis. Arthritis Care Res. 2016;68:1320-331.
3. Singh JA, Strand V. Spondyloarthritis is associated with poor function and physical health-related quality of life. J Rheumatol. 2009;36:1012-1020.
4. Ramonda R, Marchesoni A, Carletto A, et al. Patient-reported impact of spondyloarthritis on work disability and working life: the ATLANTIS survey. Arthritis Res Ther. 2016;18:78.
5. Nikiphorou E, Ramiro S. Work Disability in Axial Spondyloarthritis. Curr Rheumatol Rep. 2020;22:55.
6. Goh Y, Kwan YH, Leung YY, et al. A cross-sectional study on factors associated with poor work outcomes in patients with axial spondyloarthritis in Singapore. Int J Rheum Dis. 2019;22:2001-2008.
7. Haglund E, Bremander A, Bergman S, et al. Work productivity in a population-based cohort of patients with spondyloarthritis. Rheumatology. 2013;52:1708-1714.
8. Bakland G, Gran JT, Becker-Merok A, et al.Work disability in patients with ankylosing spondylitis in Norway. J Rheumatol. 2011;38:479-484.
9. Macfarlane GJ, Shim J, Jones GT, et al. Identifying Persons with Axial Spondyloarthritis At Risk of Poor Work Outcome: Results from the British Society for Rheumatology Biologics Register. J Rheumatol. 2019;46:145-152.
10. Ariza-Ariza R, Hernández-Cruz B, Collantes E, et al. Work Disability in Patients with Ankylosing Spondylitis. J Rheumatol. 2009;36:2512-2516.

11. Frauendorf R, Pinheiro M de M, Ciconelli RM. Variables related to work productivity loss in patients with ankylosing spondylitis. Rev Bras Reumatol. 2013;53:303-309.
12. Boonen A, Brinkhuizen T, Landewé R, et al. Impact of ankylosing spondylitis on sick leave, presenteeism and unpaid productivity, and estimation of the societal cost. Ann Rheum Dis. 2010;69:1123-1128.
13. Rudwaleit M, van der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68:777-783.
14. Kurtze N, Rangul V, Hustvedt BE, et al. Reliability and validity of selfreported physical activity in the Nord-Trøndelag Health Study (HUNT 2). Eur J Epidemiol. 2007;22:379-387.
15. Garrett S, Jenkinson T, Kennedy LG, et al. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21:2286-2891.
16. Akkoc Y, Karatepe AG, Akar S, et al. A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int. 2005;25:280-284.
17. Calin A, Garrett S, Whitelock H, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol. 1994;21:2281-2285.
18. Yanik B, Gürsel YK, Kutlay S, et al. Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol. 2005;24:41-47.
19. Jenkinson TR, Mallorie PA, Whitelock HC, et al. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol. 1994;21:1694-1698.
20. Heuft-Dorenbosch L, Spoorenberg A, van Tubergen A, et al. Assessment of enthesitis in ankylosing spondylitis. Ann Rheum Dis. 2003;62:127-132.
21. Howley ET, Franks BD. Health fitness instructor’s handbook. 2nd ed. Champaign, Ill: Human Kinetics Books; 1992. 402 p.
22. Berg K, Wood-Dauphine S, Williams J i., Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiother Can. 1989;41:304-311.
23. Doward LC, Spoorenberg A, Cook SA, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis. 2003;62:20-26.
24. Duruöz MT, Doward L, Turan Y, et al. Translation and validation of the Turkish version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Rheumatol Int. 2013;33:2717-2722.
25. van der Heijde D, Braun J, Deodhar A, et al. Modified stoke ankylosing spondylitis spinal score as an outcome measure to assess the impact of treatment on structural progression in ankylosing spondylitis. Rheumatol Oxf Engl. 2019;58:388-400.
26. Yates B, Merriman LM. Merriman’s assessment of the lower limb. 3rd ed./ edited by Ben Yates. Edinburgh; New York: Churchill Livingstone/Elsevier; 2009.
27. Flores DV, Mejía Gómez C, Fernández Hernando M, et al. Adult Acquired Flatfoot Deformity: Anatomy, Biomechanics, Staging, and Imaging Findings. Radiogr Rev Publ Radiol Soc N Am Inc. 2019;39:1437-1460.
28. Alcalde M, Acebes JC, Cruz M, et al. A Sonographic Enthesitic Index of lower limbs is a valuable tool in the assessment of ankylosing spondylitis. Ann Rheum Dis. 2007;66:1015-1019.
29. Balint PV, Kane D, Wilson H, McInnes IB, Sturrock RD. Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy. Ann Rheum Dis. 2002;61:905-910.
30. Molto A, Tezenas du Montcel S, Wendling D, et al. Disease activity trajectories in early axial spondyloarthritis: results from the DESIR cohort. Ann Rheum Dis. 2017;76:1036-1041.
31. Strand V, Singh JA. Patient Burden of Axial Spondyloarthritis. J Clin Rheumatol. 2017;23:383-391.
32. Ramiro S, Landewé R, van Tubergen A, et al. Lifestyle factors may modify the effect of disease activity on radiographic progression in patients with ankylosing spondylitis: a longitudinal analysis. RMD Open. 2015;1:e000153.
33. Harper BE, Reveille JD. Spondyloarthritis: clinical suspicion, diagnosis, and sports. Curr Sports Med Rep. 2009;8:29-34.
34. Aydog E, Depedibi R, Bal A, et al. Dynamic postural balance in ankylosing spondylitis patients. Rheumatol Oxf Engl. 2006;45:445-448.
35. Debarge R, Demey G, Roussouly P. Radiological analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle subtraction osteotomy. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2010;19:65-70.
36. D’Agostino MA, Olivieri I. Enthesitis. Best Pract Res Clin Rheumatol. 2006;20:473-486.
37. Jacques P, Lambrecht S, Verheugen E, et al. Proof of concept: enthesitis and new bone formation in spondyloarthritis are driven by mechanical strain and stromal cells. Ann Rheum Dis. 2014;73:437–445.
38. Tolu S, Rezvani A, Hindioglu N, et al. Postural stability and the relationship with enthesitis in ankylosing spondylitis: A cross-sectional study. Med Sci Int Med J. 2019;1.
39. Scholes M, Stadler S, Connell D, et al. Men with unilateral Achilles tendinopathy have impaired balance on the symptomatic side. J Sci Med Sport. 2018;21:479-482.
40. Jacques P, McGonagle D. The role of mechanical stress in the pathogenesis of spondyloarthritis and how to combat it. Best Pract Res Clin Rheumatol. 2014;28:703-710.
41. Kehl AS, Corr M, Weisman MH. Review: Enthesitis: New Insights Into Pathogenesis, Diagnostic Modalities, and Treatment. Arthritis Rheumatol Hoboken NJ. 2016;68:312-322.
42. Vahidfar S, Sunar İ, Ataman Ş, et al. Ultrasonographic evaluation of Achilles tendon: Is there any difference between ankylosing spondylitis, nonradiographic axial spondyloarthropathy and controls? Int J Rheum Dis. 2020;23:511-519.
43. Attili R, Hussein A, Odeh H, Hejaz H. Prevalence and Comparison of HLA-B27 among Ankylosing Spondylitis Patients in Palestine and Arab Population. J Clin Med Sci. 2018;2:1.

Details

Primary Language

English

Subjects

Physical Medicine and Rehabilitation

Journal Section

Research Article

Authors

Nuray Gülgönül ^* This is me
0000-0001-6089-8439
Türkiye

Ebru Karaca Umay
0000-0002-4137-7731
Türkiye

Bilge Kesikburun
0000-0001-6110-2252
Türkiye

Fatma Hülya Şahin This is me
0000-0002-0158-5050
Türkiye

Rabia Sökmen This is me
0000-0003-4936-123X
Türkiye

Publication Date

October 18, 2022

Submission Date

May 2, 2021

Acceptance Date

May 6, 2022

Published in Issue

Year 2022 Volume: 75 Number: 3

DOI

https://doi.org/10.4274/atfm.galenos.2022.27880

IZ

https://izlik.org/JA38XY25RH

APA

Gülgönül, N., Umay, E. K., Kesikburun, B., Şahin, F. H., & Sökmen, R. (2022). Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 75(3), 454-461. https://doi.org/10.4274/atfm.galenos.2022.27880

AMA

1.Gülgönül N, Umay EK, Kesikburun B, Şahin FH, Sökmen R. Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75(3):454-461. doi:10.4274/atfm.galenos.2022.27880

Chicago

Gülgönül, Nuray, Ebru Karaca Umay, Bilge Kesikburun, Fatma Hülya Şahin, and Rabia Sökmen. 2022. “Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective With Clinical, Laboratory, Radiography and Ultrasonography”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 (3): 454-61. https://doi.org/10.4274/atfm.galenos.2022.27880.

EndNote

Gülgönül N, Umay EK, Kesikburun B, Şahin FH, Sökmen R (October 1, 2022) Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 3 454–461.

IEEE

[1]N. Gülgönül, E. K. Umay, B. Kesikburun, F. H. Şahin, and R. Sökmen, “Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 3, pp. 454–461, Oct. 2022, doi: 10.4274/atfm.galenos.2022.27880.

ISNAD

Gülgönül, Nuray - Umay, Ebru Karaca - Kesikburun, Bilge - Şahin, Fatma Hülya - Sökmen, Rabia. “Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective With Clinical, Laboratory, Radiography and Ultrasonography”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75/3 (October 1, 2022): 454-461. https://doi.org/10.4274/atfm.galenos.2022.27880.

JAMA

1.Gülgönül N, Umay EK, Kesikburun B, Şahin FH, Sökmen R. Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75:454–461.

MLA

Gülgönül, Nuray, et al. “Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective With Clinical, Laboratory, Radiography and Ultrasonography”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 3, Oct. 2022, pp. 454-61, doi:10.4274/atfm.galenos.2022.27880.

Vancouver

1.Nuray Gülgönül, Ebru Karaca Umay, Bilge Kesikburun, Fatma Hülya Şahin, Rabia Sökmen. Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022 Oct. 1;75(3):454-61. doi:10.4274/atfm.galenos.2022.27880

Work Characteristics and Axial Spondyloarthritis: Evaluation from a Broad Perspective with Clinical, Laboratory, Radiography and Ultrasonography

Abstract

Keywords

Ethical Statement

References

Details

Primary Language

Subjects

Journal Section

Authors

Publication Date

Submission Date

Acceptance Date

Published in Issue

DOI

IZ

Cite