Gait characteristics in patients with ankylosing spondylitis: a systematic review

Objective. Ankylosing spondylitis (AS) is a chronic rheumatic disease which affects the axial skeleton and sacroiliac joints. By impacting spinal mobility and physical functions, AS could also potentially impair gait. However, while published data are rather sparse, it appears that discrepancies exist regarding AS consequences on gait characteristics, tasks and analysis techniques used to assess gait ability of patients with AS. The review questions are twofold: ( I) How is gait assessed in patients with AS? and (2) What are the consequences of AS on gait? Methods. Databases were systematically searched to identify studies satisfying the search criteria, using the synonyms of ankylosing spondylitis and gait. Two reviewers extracted from the articles study characteristics, methods and main results in relation to gait. Results. 192 titles were extracted from databases and 21 studies were included in the review. 16 studies (76%) used clinical gait measurements and 5 (23%) used laboratory gait measurements. Only 7 involved a healthy control group. Studies used various protocols, instructions and parameters when assessing gait. Gait of patients with AS was associated with decreased stride length, pelvic movements and lower limbs angles in the sagittal plane, and increased hip abduction and external rotation compared to healthy controls. Conclusion. Only few studies have assessed gait characteristics in patients with AS and published data evidence that kinematic parameters of gait is altered, but no consensus exists regarding gait analysis methods for patients with AS. Guidelines are provided to improve the design and methodology for future studies on gait and AS.