Clinical presentation and rehabilitation approaches in patients with ankylosing spondylitis and comorbidities: a...

Ankylosing spondylitis (AS) is a chronic immune-mediated disease characterized by damage to the axial skeleton and a high prevalence of comorbidities that influence disease severity and rehabilitation strategy. Rehabilitation strategies in AS patients with comorbidities are scarcely examined. The aim of this study was to examine the influence of comorbidities on clinical presentation, disease activity, and rehabilitation strategies in AS. A retrospective multicenter study was conducted in three rheumatology centers from January 1st to December 31st, 2023. The study included patients aged above 18 with existing X-ray lesions of the axial skeleton and comorbidities. Demographic, clinical, and radiological data were recorded. The statistical analysis included descriptive data. The normality of distribution for continuous variables was assessed using the Shapiro-Wilk test. Comparisons between groups were assessed using the Mann-Whitney U test. The Chi-square test was used for categorical data. A significance threshold was set at P < 0.05. Of 148 examined patients with AS, 59 (39.8%) had comorbidities. Arterial hypertension (n = 33, 55.9%), osteoporosis/osteopenia (n = 12, 20.3%), and diabetes mellitus (n = 10, 16.9%), were among the most frequent comorbidities. Disease activity indices were moderate (Mean BASDAI = 4.7; Mean ASDAS = 2.5); there were no significant differences between patients with and without comorbidities. Patients with comorbidities presented with extensive axial damage involving all parts of the spine (p = 0.021). Swimming (n = 26, 44.1%), low-intensity physical activity therapy (n = 18, 30.5%), massage (n = 14, 23.7%), and lumbar orthosis (n = 8, 13.6%) were recommended for patients with comorbidities. Rehabilitation approaches, including swimming are frequently recommended to stabilize symptoms in patient with AS.