{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T21:32:46Z","timestamp":1778362366849,"version":"3.51.4"},"reference-count":90,"publisher":"Wiley","license":[{"start":{"date-parts":[[2011,12,18]],"date-time":"2011-12-18T00:00:00Z","timestamp":1324166400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis"],"published-print":{"date-parts":[[2011,12,18]]},"abstract":"<jats:p>Ankylosing spondylitis (AS) is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS.<\/jats:p>","DOI":"10.1155\/2011\/205904","type":"journal-article","created":{"date-parts":[[2011,12,18]],"date-time":"2011-12-18T21:08:44Z","timestamp":1324242524000},"page":"1-10","source":"Crossref","is-referenced-by-count":11,"title":["Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis"],"prefix":"10.1155","volume":"2011","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-6634","authenticated-orcid":true,"given":"Alfonse T.","family":"Masi","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Illinois College of Medicine, Peoria, IL 61656, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalyani","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Bradley University, Peoria, IL 61625, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian J.","family":"Andonian","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois College of Medicine, Peoria, IL 61656, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina M.","family":"Prus","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois College of Medicine, Peoria, IL 61656, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy & Health Science, Bradley University, Peoria, IL 61625, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose R.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Bradley University, Peoria, IL 61625, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Henderson","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Bradley University, Peoria, IL 61625, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"issue":"4","key":"1","first-page":"391","volume":"2","year":"1950","journal-title":"American Journal of Human Genetics"},{"issue":"7809","key":"2","first-page":"904","volume":"1","year":"1973","journal-title":"The Lancet"},{"issue":"14","key":"3","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1056\/NEJM197304052881403","volume":"288","year":"1973","journal-title":"The New England Journal of Medicine"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e3283364483"},{"issue":"4","key":"5","first-page":"359","volume":"5","year":"1978","journal-title":"Journal of Rheumatology"},{"key":"6","doi-asserted-by":"crossref","first-page":"suppl 131","DOI":"10.1136\/ard.38.Suppl_1.131","volume":"38","year":"1979","journal-title":"Annals of the Rheumatic Diseases"},{"key":"7","first-page":"15","volume":"143","year":"1979","journal-title":"Clinical Orthopaedics and Related Research"},{"issue":"1","key":"8","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0889-857X(21)00715-8","volume":"18","year":"1992","journal-title":"Rheumatic Disease Clinics of North America"},{"issue":"2","key":"9","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1136\/ard.17.2.209","volume":"17","year":"1958","journal-title":"Annals of the Rheumatic Diseases"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110330"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100888"},{"key":"12","year":"1995"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2006.00540.x"},{"issue":"10","key":"14","first-page":"2155","volume":"28","year":"2001","journal-title":"Journal of Rheumatology"},{"key":"15","first-page":"16","volume":"3","year":"2010","journal-title":"International Journal of Therapeutic Massage & Bodywork"},{"key":"16","volume-title":"Anatomical, biomechanical, and clinical perspectives on sacroiliac joints: an integrative synthesis of biodynamic mechanisms related to ankylosing spondylitis","year":"2007"},{"issue":"1","key":"17","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/scientificamerican0198-48","volume":"278","year":"1998","journal-title":"Scientific American"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1080\/07853890310016333"},{"issue":"1","key":"19","first-page":"1","volume":"21","year":"2003","journal-title":"Clinical and Experimental Rheumatology"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2008.05.007"},{"key":"21","volume-title":"Increased muscle tone as a cause of muscle pain","year":"2010"},{"key":"22","year":"1951"},{"issue":"6","key":"23","first-page":"760","volume":"23","year":"2005","journal-title":"Clinical and Experimental Rheumatology"},{"issue":"5","key":"24","first-page":"573","volume":"21","year":"2003","journal-title":"Clinical and Experimental Rheumatology"},{"key":"25","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1001\/jama.1959.73000200002011a","volume":"169","year":"1959","journal-title":"JAMA"},{"key":"26","first-page":"5","volume":"1","year":"1966","journal-title":"Acta Rheumatol Balneol Pistiniana"},{"issue":"5","key":"27","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1046\/j.1469-7580.2001.19950503.x","volume":"199","year":"2001","journal-title":"Journal of Anatomy"},{"issue":"3","key":"28","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1136\/ard.13.3.219","volume":"13","year":"1954","journal-title":"Annals of the Rheumatic Diseases"},{"key":"29","year":"1967"},{"issue":"3","key":"30","first-page":"330","volume":"28","year":"1969","journal-title":"Annals of the Rheumatic Diseases"},{"issue":"3","key":"31","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1136\/ard.30.3.213","volume":"30","year":"1971","journal-title":"Annals of the Rheumatic Diseases"},{"key":"32","first-page":"30","volume":"143","year":"1979","journal-title":"Clinical Orthopaedics and Related Research"},{"key":"33","volume-title":"Pathology and pathogenesis","year":"1980"},{"issue":"4, supplement 2","key":"34","first-page":"25","volume":"22","year":"1983","journal-title":"British Journal of Rheumatology"},{"key":"35","doi-asserted-by":"publisher","DOI":"10.1016\/j.matbio.2009.06.004"},{"issue":"7338","key":"36","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1136\/bmj.324.7338.626","volume":"324","year":"2002","journal-title":"British Medical Journal"},{"key":"37","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2007.00689.x"},{"issue":"3","key":"38","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1186\/ar2723","volume":"11","year":"2009","journal-title":"Arthritis Research &amp; Therapy"},{"key":"39","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2555-2-30"},{"key":"40","year":"2010"},{"key":"41","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.091074"},{"key":"42","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.97.10.472"},{"key":"43","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508324283"},{"key":"44","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-0298-6_4"},{"key":"45","doi-asserted-by":"publisher","DOI":"10.1002\/art.23755"},{"issue":"4","key":"46","first-page":"S10","volume":"27","year":"2009","journal-title":"Clinical and Experimental Rheumatology"},{"key":"47","doi-asserted-by":"publisher","DOI":"10.1016\/S1937-6448(08)01207-0"},{"issue":"2","key":"48","first-page":"322","volume":"29","year":"2011","journal-title":"Clinical and Experimental Rheumatology"},{"key":"49","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20984"},{"issue":"3","key":"50","first-page":"373","volume":"28","year":"2010","journal-title":"Clinical and Experimental Rheumatology"},{"key":"51","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2008.0498"},{"key":"52","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511413370"},{"key":"53","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2008.10.001"},{"key":"54","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(03)00071-8"},{"key":"55","doi-asserted-by":"publisher","DOI":"10.1002\/art.21619"},{"issue":"9","key":"56","first-page":"1694","volume":"21","year":"1994","journal-title":"Journal of Rheumatology"},{"issue":"2","key":"57","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1177\/03635465010290021201","volume":"29","year":"2001","journal-title":"American Journal of Sports Medicine"},{"key":"58","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.151027"},{"key":"59","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100987"},{"key":"60","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002822.pub3"},{"key":"61","doi-asserted-by":"publisher","DOI":"10.1097\/01.phm.0000163862.89217.fe"},{"key":"62","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-0298-6_5"},{"key":"63","first-page":"64","volume":"11","year":"2005","journal-title":"Exercise Immunology Review"},{"issue":"2","key":"64","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/ar2642","volume":"11","year":"2009","journal-title":"Arthritis Research &amp; Therapy"},{"key":"65","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100925"},{"key":"66","doi-asserted-by":"publisher","DOI":"10.1007\/s10237-005-0012-z"},{"key":"67","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0278-4"},{"key":"68","doi-asserted-by":"publisher","DOI":"10.1172\/JCI23738"},{"key":"69","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-007-0084-1"},{"key":"70","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.102046"},{"key":"71","doi-asserted-by":"publisher","DOI":"10.1038\/nm1538"},{"key":"72","doi-asserted-by":"publisher","DOI":"10.1002\/art.27231"},{"key":"73","doi-asserted-by":"publisher","DOI":"10.1186\/ar2565"},{"key":"74","doi-asserted-by":"publisher","DOI":"10.1002\/art.11389"},{"key":"75","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2006.11.005"},{"key":"76","doi-asserted-by":"publisher","DOI":"10.1080\/03009740701774941"},{"key":"77","doi-asserted-by":"publisher","DOI":"10.1016\/0303-7207(96)03887-7"},{"key":"78","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1136\/ard.2003.016386","volume":"63","year":"2004","journal-title":"Annals of the Rheumatic Diseases"},{"key":"79","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-02-139147"},{"key":"80","volume":"70","year":"2011","journal-title":"Annals of the Rheumatic Diseases"},{"key":"81","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00406.2006"},{"key":"82","year":"2010"},{"issue":"230","key":"83","first-page":"5","volume":"60","year":"1989","journal-title":"Acta Orthopaedica Scandinavica, Supplement"},{"key":"84","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000229232.66090.58"},{"key":"85","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(00)00061-9"},{"key":"86","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(03)00042-1"},{"key":"87","doi-asserted-by":"publisher","DOI":"10.1088\/0967-3334\/26\/6\/006"},{"key":"88","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2008.02.002"},{"key":"89","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10090385"},{"key":"90","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21723"}],"container-title":["Arthritis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/archive\/2011\/205904.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/archive\/2011\/205904.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/archive\/2011\/205904.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T23:57:19Z","timestamp":1640044639000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/arthritis\/2011\/205904\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12,18]]},"references-count":90,"alternative-id":["205904","205904"],"URL":"https:\/\/doi.org\/10.1155\/2011\/205904","relation":{},"ISSN":["2090-1984","2090-1992"],"issn-type":[{"value":"2090-1984","type":"print"},{"value":"2090-1992","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12,18]]}}}