Comparison of balance and gait parameters in patients with non-radrographic axial spondyloarthritis and ankylosing spondylitis

The aim of this study is to compare the gait and balance parameters, lumbopelvic stability, trunk position sense and spine posture of patients with non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). The study included 24 AS patients (41.33±9.67 years, 17 females), 23 nr-axSpA patients (36.22±8.32 years, 17 females), and 24 healthy individuals (37.83±3.13 years, 17 females) with similar age and gender characteristics, randomized based on age and gender. The gait parameters of all individuals were evaluated with a pedobarographic walking analysis system, their static balance with a stabilometric system, body position sense and spinal postures with a digital inclinometer, and lumbopelvic stability with a stabilizer pressure biofeedback unit. The disease-related characteristics of axial spondyloarthritis (axSpA) patients, spinal mobility, disease activity, physical function, general health status, and quality of life outcomes were recorded. As a result of the evaluation, it was found that the clinical features, gait and balance parameters, lumbopelvic stability and trunk position senses of individuals with AS and nr-axSpA were similar regardless of radiographic involvement (p>0.05). The static rearfoot pressures of nr-axSpA patients were lower than those of healthy individuals (p=0.049). The dynamic forefoot pressures of AS and nr-axSpA patients were higher than those of healthy individuals (p=0.047), while rearfoot pressures were lower (p=0.044). AS patients had a lower cadence and increased stride width than healthy individuals (p=0.027, p=0.045; respectively), while AS and nr-axSpA patients had lower accelerations and longer stance times than healthy individuals regardless of radiographic involvement (p<0.001, p=0.006; respectively). The lateral displacement amount of the static balance parameter was higher in axSpA patients than in healthy individuals regardless of radiographic involvement (p<0.001). Lumbopelvic stabilization, body position sense, and lumbar lordosis degree were lower in axSpA patients than in healthy individuals (p<0.001). The most important result of the study was that spinal mobility and thoracic kyphosis degree were affected by radiographic involvement. It was found that the spinal mobility of AS patients was lower and the thoracic kyphosis degrees were higher than those of nr-axSpA patients. In conclusion, we believe that personalized strategies should be developed for individuals with AS and nr-axSpA, taking into account similarities in disease burden and differences, especially in spinal parameters and static plantar pressure, while creating a rehabilitation program.