ANALYSIS OF GAIT IN LONGSTANDING AXIAL-SPONDYLOARTHRITIS: A MONOCENTRIC PILOT STUDY

M. Congia, F. Arippa, G. Solinas, M. M. Angioni, E. Chessa, A. Floris, M. Naitza, M. Piga, M. Monticone, M. Pau, A. CauliRheumatology Unit, AOU and University of Cagliari, Monserrato, CAGLIARI, Italy, Department of Medical Sciences and Public Health, Cagliari, Italy University of Cagliari, Department of Mechanical, Chemical and Materials Engineering, Cagliari, Italy University of Cagliari, Department of Medical Sciences and Public Health, Cagliari, Italy  Background Progression of radiographic damage in axial-spondyloarthropaties is related to higher functionality impairment in longstanding patients, resulting in poorer quality of life and autonomy. Its impact on gait has not been extensively studied yet. Time-up and go (TUG) test and GAIT analysis (GA) are currently used in neurological and musculoskeletal diseases to evaluate changes in patients gait and stance. Objectives The aim of this study is to evaluate with standardized procedures modifications of gait in patients with inactive longstanding axSpa with radiographic damage, comparing them with a cohort of sex, age and BMI matched healthy controls. Methods Patients followed at Rheumatology Unit of the University Hospital of Cagliari were enrolled. Inclusion criteria were: 1) having a diagnosis of axSpa, 2) having an inactive disease (BASDAI<4, PtGA<20, PhGA<20), 3) evidence of radiographic damage in the most recent spine x-ray available (mSASSS >20), 4) ability to walk autonomously. Exclusion criteria were: 1) deafness, 2) any medical condition that, according to investigators, could expose patients at any excess risk or interfere with the procedures of the study. Patients underwent a TUG test and a gait analysis at the Department of Mechanical, Chemical and Materials Engineering, University of Cagliari. For TUG Test the following parameters were recorded: TUG time, sit-to-stand time, first and second rotation time, stand-to-sit time, walking time. Walking speed and mean step length were recorded using GAIT analysis. Statistical analysis was performed with MANOVA (Pillai’s Trace, Wilk’s Lambda, Hotelling’s Trace, Roy’s Largest Roots). Level of statistical significance was set at<0,05. Results Fifteen patients and fifteen HC were enrolled in this study. Mean age was 60,1±7,8 years for patients and 61,3±7,8 for HC. Weight and height were similar in both groups (axSpa 76,7 ± 16,8kg vs HC 72 ±7,2kg; axSpa 169,33 ± 8,8cm vs HC 170,4 ± 5,2cm). Disease duration was 27.61±9,67 years, mean mSASSS was 46,33±16,84. All patients were inactive, but showed clinical signs of disease progression (BASMI 5,9±1,19). Thirteen patients were on treatment with bDMARDs (TNF inhibitors), while 2 were off treatment. MANOVA revealed differences between axSPa patients and HC for TUG test (p<0,05). TUG time and walking time were significant longer in axSpa (TUG time 12,88±1,92s vs 10,44±2,18s, p=0,003; walking time 5,69±1,17s vs 3,68±0,8, p<0,001), while other parameters were not different between groups. Finally, axSpa patients were slower (0,95±0,16 m/s vs 1,18±0,17 m/s; p<0,05), and had a shorter step (0,52±0,65 m vs 0,65±0,69 m; p<0,05). Conclusion Patients with longstanding axSpa showed a different gait when compared with matched HC: we found that axSpa patients walk slower than HC, and with shorter steps. This could be interpreted as a compensatory behaviour as walking speed slower than 1 m/s has been reported as a risk factor for falling in elderly. In conclusion, we found that disease progression in axSpa patients could interfere with walking speed. Clinical relevance of these findings should be confirmed in future studies, as well as if some medical intervention (e.g. physical therapy) could minimize the impact of disease progression on posture control and walking. Reference [1]Verghese et al. Quantitative Gait Markers and Incident Fall Risk in Older Adults. Gerontol, 2009. Vol. 64A, No. 8, 896–901 doi:10.1093/gerona/glp033 Table 1. Demographic and clinical features of patients and HC. Results of TUG and GA. axSpa HC p Age (years) 60,1 ± 7,8 61,3 ± 7,8 ns Sex 15 M 15 M Height (cm) 169,33 ± 8,8 170,4 ± 5,2 ns Weight (kg) 76,7 ± 16,8 72 ±7,2 ns Disease duration 27,6±9,67 BASMI 5,9±1,19 mSASSS 46,33±16,84 TUG Test – Total time (s) 12,88±1,92 10,44±2,18 0,003 Sit-stand time (s) 1,53±0,42 1,38±0,34 ns Stand-sit time (s) 1,26±0,37 1,36±0,62 ns first turn time (s) 2,49±0,53 2,22±0,65 ns second turn time (s) 1,9±0,47 1,79±0,75 ns walking time (s) 5,69±1,17 3,68±0,8 <0,001 GA - walking speed (m/s) 0,95±0,16 1,18±0,17 <0,05 Step length/m 0,52±0,65 0,65±0,69 <0,05 Acknowledgements: NIL. Disclosure of Interests None Declared. Keywords: Descriptive Studies, Spondyloarthritis, Motor function DOI: 10.1136/annrheumdis-2023-eular.2434Citation: , volume 82, supplement 1, year 2023, page 629Session: Spondyloarthritis - clinical aspects (other than treatment) (Poster View)