Useful References:

AS and Balance:

Zimi Sawacha et al. (2012) Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis. Journal of Neuro Engineering and Rehabilitation Link

Cardiovascular risk in AxSpA:

Patients with spondyloarthritis (SpA) were at elevated risk for acute coronary syndrome (ACS) and venous thromboembolism vs the general population.
Stroke was also a higher risk in those with ankylosing spondylitis (AS) and psoriatic arthritis (PsA).  "Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events".  Link

Patients with ankylosing spondylitis (AS) are at a 30%-50% increased risk of incident cardiovascular (CV) events compared with the general population.?Compared with patients with rheumatoid arthritis (RA), those with AS have about the same stroke risk, but only half the risk for thrombotic events or acute coronary syndromes Link

Diagnostic Dilema:

Axial spondyloarthritis, as common as rheumatoid arthritis, goes undiagnosed for years:


Disease Activity:

Is Spinal Mobility in Patients With Spondylitis Determined By Age, Structural Damage, and Inflammation Link

Exercise Interventions:

O'Dwyer et al. (2017) Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial.

Talexeira et al (2012) Exercise, physical activity, and self-determination theory: A systematic review

O'Dwyer et al (2014) Exercise therapy for spondyloarthritis: a systematic review

de Souza et al (2017) Swiss ball exercises improve muscle strength and walking performance in ankylosing spondylitis: a randomized controlled trial.

Fracture Risk:

Nugent et al. (2017) Clinical outcomes following spinal fracture in patients with ankylosing spondylitis Link

Inflammatory associated diseases:

Patients with IBD often suffer from extraintestinal rheumatic manifestations, prevalently including inflammatory back disorders like ankylosing spondylitis (AS), axial spondylarthropathy (axial SpA) and inflammatory back pain (IBP):

Evans et al. (2021) Prevalence of axial spondyloarthritis in patients with inflammatory bowel disease using cross-sectional imaging: a systematic literature review

Presented at the annual 2017 meeting of the European Crohn's and Colitis Organisation: Spondyloarthritis (SpA)-associated musculoskeletal manifestations were frequently reported by inflammatory bowel disease (IBD) patients on TNF inhibitors; increased recognition of SpA accompanied use of a SpA self-reported questionnaire, which could alter management and improve patient outcomes.

Enthesitis is thought to be the key to the inflammatory arthritis, this site provides information on the latest research and expert knowledge on the way forward.

Rosenbaum (2015) Uveitis in spondyloarthritis including psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease

Medical Guidelines:

Efficacy and safety of non-pharmacological and non-biological pharmacological treatment: a systematic literature review informing the 2016 update of the ASAS/EULAR recommendations for

Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs. National Institute for Health and Care Excellence. 2017 May 24. Link

In patients with active psoriatic arthritis, secukinumab inhibited radiographic disease progression.

Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force Link

Pregnancy and Risk Factors:

Patients with RA or AS often experience disease flares during pregnancy, but it is unknown whether changes in treatment around the time of conception influence flare risk

This study suggests; to prevent flares, consider continuing medication for axial spondyloarthritis (AS) and rheumatoid arthritis (RA) after conception in pregnant patients.Link

Pregnancy outcome in patients with ankylosing spondylitis. Link

Published peer reviewed abstracts:

Martindale, J, Dickinson, S, Bampouras, T.  Is falling really a problem for people living with Ankylosing Spondylitis? A survey of National Ankylosing Spondylitis Society members.  Rheumatology 2017: 6: Supplement 2; E71

Gregory, W, McCall, G, Shaw, K, Martindale, J.  Audit and clinical evaluation of the North West spondyloarthritis physiotherapy services.  Rheumatology 2017: 6: Supplement 2; E03

Shukla, R, Martindale, J, Gladston- Chelliah, E, Goodacre, J.  Lets talk inflammatory back pain:  A qualitative study regarding experiences of disclosure in people with Ankylosing Spondylitis/Axial Spondylitis. Rheumatology 2017:56 Supplement 2: 019

Respiratory function and AS:

Rehabilitation of pulmonary dysfunction in patients with ankylosing spondylitis, ERJ.

OLS É N M F et al. Measuring chest expansion; A study comparing two different instructions, Advances in Physiotherapy.

The Effect(s) of a Six-Week Home-Based Exercise Program on the Respiratory Muscle and Functional Status in Ankylosing Spondylitis, JCR:

Chest wall kinematics and respiratory muscle action in ankylosing spondylitis patients,

Work and Lyfestyle Issues:

The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity.Link

The relationship between body weight and inflammation:

Cigarette smoking has a dose depend impact on structural damage in the spine in patients with Spondyloarthritis:



About us

AStretch is a not for profit organisation; our main aim is to provide a co-ordinated approach to the planning and delivery of education and best practice. Also to support physiotherapists working with people who have Axial Spondyloarthritis (AxSpA) and Ankylosing Spondylitis (AS).


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