Ankylosing spondylitis in a patient referred to physical therapy with low back pain

Living with ankylosing spondylitis: an open response survey exploring physical activity experiences

Objective

The aim was to gather in-depth, rich accounts of physical activity experiences of people living with AS, to include symptom management, consequences for symptoms, factors that encourage and disrupt physical activity, and motivations that underpin participation in physical activity.

Methods

Participants (n = 149; 60% female) completed a Bristol Online Survey that consisted of open questions to capture rich qualitative data. In total, 96% of participants self-reported having AS (1% other arthritis; 3% missing), and 51% had this diagnosis for >20 years. A content analysis was conducted to identify the key themes/factors from within the open question responses. A frequency analysis was used to ascertain the most commonly identified themes and factors.

Results

Fifty different physical activities were participated in over the previous month. Physical activity can improve and worsen arthritis symptoms, and fluctuations in participation exist even in the most active. Pain and fatigue were the two most frequently identified factors that stopped people with AS from being physically active. Participants reported more autonomously driven motivations than controlled motivations for participating in physical activity.

Conclusion

People with AS can and do participate in a diverse range of physical activities, but fluctuations in activity levels occur owing to disease- and non-disease-specific factors. Individually tailored plans and self-monitoring are important to optimize levels of physical activity and maximize benefits for people living with AS. Multiple reasons why AS patients participate in physical activity were revealed that included both adaptive (i.e. autonomous) and maladaptive (i.e. controlled) forms of motivation.

Men's experiences of living with ankylosing spondylitis: a qualitative study

BACKGROUND

The majority of patients with ankylosing spondylitis (AS) are male, although potential gender differences have not been investigated in relation to disease management. Moreover, men's perceptions of experiencing AS have not been reported in the literature.

AIMS

This study sought to develop an understanding of how men experience AS and the challenges related to living with AS as a chronic disease.

METHODS

A purposive sample of 13 men diagnosed with AS, with a median age of 44 years (range 32-58) was recruited from a rheumatology outpatient clinic. The median duration of disease was 12 years (range 0.3-28 years), and the median time from the first symptom to final diagnosis was seven years (range 2-20 years). Semi-structured interviews were conducted using an interview guide, and the interviews were analysed using content analysis inspired by Graneheim qualitative methodology.

RESULTS

The analysis revealed four categories: (1) 'Approaching a diagnosis'; (2) 'Ill in a social context'; (3) 'Challenged as a man'; and (4) 'The importance of remaining physically well'. Based on these categories, the overall category of 'An invisible companion for life' emerged, which captures the experience of living with an invisible, life-long disease.

CONCLUSIONS

These findings demonstrate that AS impacts men's perceptions of themselves as men, relationships as a partner and father, social lives, and masculine identity. Physical activity was highlighted as an important part of being a man, and not being able to exercise challenged the men's masculine identity.