HLA B27

1. Ankylosing Spondylitis
Ashish J. P
Asst. Professor
Department of Musculoskeletal Sciences
DVVPF’s College of Physiotherapy,
Ahmednagar

2. Introduction
• Arthritis is inflammation within a joint,
regardless of the causative process which
results in pain, stiffness and swelling
which leads to joint damage
Joan M. Walker, physical rehab in
arthritis.
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3. Classification
Arthritis
• There are over 100 different forms of arthritis. The
commonly encountered are
Degenerative Inflammatory Psychogenic
Eg Eg- RA Eg- Fibromyalgia
Osteoarthritis Gout
Connective Tissue disease
Spondyloarthropathies
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4. • Connective tissue disorders
• Spondyloarthropathies
Ankylosing spondylitis
Reiters syndrome
Psoriatic arthritis
Enteropathic arthritis
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SLE / Lupus
Systemic sclerosis
Polymyositis and dermatomyositis

5. Clinical Manifestations
 The modified New York criteria for AS
 Low back pain of at least 3 months
duration that improves with exercise and
is not relieved by rest
 Limited lumbar spinal motion in sagittal
and frontal planes
 Chest expansion decreased relative to
normal values for sex and age
 Bilateral or unilateral sacroiliitis seen on
X-ray

6. AS
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7. PT management
• Educate
• Manage pain
• Maintain spinal mobility
• Maintain chest expansion
• General health
• ADL modification

8. • Ankylosing Spondylitis-
o Hydrotherapy- in a study by P S Helliwell et al
compared 3 different PT regimens in AS I;e
intensive in- patient physiotherapy, out patient
hydrotherapy and home exercises, and home
exercises. They found in patients and
hydrotherapy patients reported more
improvement as compared to exercises only.
o TENS-
o Manual therapy- has no role to play in the
management of peripheral or spinal joints in
RA, AS.
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9. • Exercises- as given by Australian
medicare, NASS.
• Stretching exercises & ROM five times a
week
• Aerobic exercises at least 20 min duration
at least 3 time a week.
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Trunk rotation
flexion

10. 4/12/2018 Arthritis 10
Back stretch
Back arch

11. Lifestyle modification
• Assistive modification
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12. Thank you