{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T18:59:57Z","timestamp":1788029997108,"version":"build-2784847793"},"reference-count":39,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Ankylosing spondylitis (AS) is characterised as a chronic inflammatory disease of the axial skeleton. The force platform is an option for performing the postural assessment of these individuals.\n\nObjectives:\u00a0To review and evaluate the behaviour of the centre of pressure (CoP) variables during the postural control examination in patients with AS compared to a control group.\n\nMethod:\u00a0A systematic review, registered in PROSPERO, that followed the PRISMA Statement. A search was carried out in the following databases: Medline, Web of Science, Embase, Scopus, and Scielo, from 1945 to 2023. Studies were selected that aimed to understand the use of the force platform for the assessment of postural control. The risk of bias assessment was performed using the AXIS tool.\n\nResults:\u00a0Five studies were included, with a total of 247 participants. The assessment of risk of bias presented high scores in the AXIS tool. Patients with a diagnosis of AS presented increased thoracic kyphosis in most of the studies, as well as large displacements in the anteroposterior (AP) and mediolateral (ML) directions, and altered total mean velocity (TMV) and frequency, indicating worse postural stability. Regarding the functional status, the most used questionnaires were the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Disease Activity Index (BASDAI).\n\nConclusion:\u00a0Patients with ankylosing spondylitis present postural instability, verified by means of higher values of centre of posture variables.\n\nClinical implications:\u00a0Individuals with ankylosing spondylitis presented postural instability and balance deficit. Therefore, exercises for balance training and postural control are essential in the clinical management of these patients.<\/jats:p>","DOI":"10.4102\/sajp.v80i1.1953","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T09:46:33Z","timestamp":1710150393000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Use of posturography in patients with ankylosing spondylitis: A systematic review"],"prefix":"10.4102","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1009-3090","authenticated-orcid":false,"given":"Caroline F.O.","family":"Silva","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01585b035","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Estadual de Londrina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9928-3685","authenticated-orcid":false,"given":"Karen","family":"Obara","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01585b035","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Estadual de Londrina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9766-0037","authenticated-orcid":false,"given":"Luana","family":"Paix\u00e3o","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01585b035","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Estadual de Londrina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4340-0798","authenticated-orcid":false,"given":"Eduarda H.","family":"Santos","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01585b035","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Estadual de Londrina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2204-2984","authenticated-orcid":false,"given":"Amanda I.Z.","family":"Santos","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01585b035","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Estadual de Londrina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0111-9156","authenticated-orcid":false,"given":"Jefferson R.","family":"Cardoso","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01585b035","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidade Estadual de Londrina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Acar, Y., Il\u00e7in, N., G\u00fcrpinar, B. & Can, G., 2019, \u2018Core stability and balance in patients with ankylosing spondylitis\u2019, Rheumatology International 39(8), 1389\u20131396. https:\/\/doi.org\/10.1007\/s00296-019-04341-5","DOI":"10.1007\/s00296-019-04341-5"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Atar, E. & Askin, A., 2020, \u2018Somatosensory dysfunction related neuropathic pain component affects disease activity, functional status and quality of life in ankylosing spondylitis\u2019, International Journal of Rheumatic Diseases 23(12), 1656\u20131663. https:\/\/doi.org\/10.1111\/1756-185X.13993","DOI":"10.1111\/1756-185X.13993"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Batur, E.B. & Karatas, G.K., 2017, \u2018Do postural changes affect balance in patients with ankylosing spondylitis?\u2019, Journal of Rehabilitation Medicine 49(5), 437\u2013440. https:\/\/doi.org\/10.2340\/16501977-2230","DOI":"10.2340\/16501977-2230"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Bot, S.D.M., Caspers, M., Van Royen, B.J., Toussaint, H.M. & Kingma, I., 1999, \u2018Biomechanical analysis of posture in patients with spinal kyphosis due to ankylosing spondylitis: A pilot study\u2019, Rheumatology 38(5), 441\u2013443. https:\/\/doi.org\/10.1093\/rheumatology\/38.5.441","DOI":"10.1093\/rheumatology\/38.5.441"},{"key":"ref4","unstructured":"Calin, A., Garrett, S., Whitelock, H., Kennedy, L.G., O\u2019Hea, J., Mallorie, J. et al., 1994, \u2018A new approach to defining functional ability in ankylosing spondylitis: The development of the bath ankylosing spondylitis functional index\u2019, The Journal of Rheumatology 21(12), 2281\u20132285."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Chen, B., Liu, P., Xiao, F., Liu, Z. & Wang, Y., 2021, \u2018Review of the upright balance assessment based on the force plate\u2019, International Journal of Environmental Research and Public Health 18(5), 2696. https:\/\/doi.org\/10.3390\/ijerph18052696","DOI":"10.3390\/ijerph18052696"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"\u00c7\u0131nar, E., Akko\u00e7, Y., Karapolat, H., Durusoy, R. & Keser, G., 2016, \u2018Postural deformities: Potential morbidities to cause balance problems in patients with ankylosing spondylitis?\u2019, European Journal of Rheumatololy 3(1), 5\u20139. https:\/\/doi.org\/10.5152\/eurjrheum.2015.15104","DOI":"10.5152\/eurjrheum.2015.15104"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Corriveau, H., Hebert, R. & Prince, F., 2004, \u2018Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people\u2019, Archives of Physical and Medicine Rehabilitation 85(6), 896\u2013901. https:\/\/doi.org\/10.1016\/j.apmr.2003.08.089","DOI":"10.1016\/j.apmr.2003.08.089"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"De Nunzio, A.M., Iervolino, S., Zincarelli, C., Di Gioia, L., Rengo, G., Multari, V. et al., 2015, \u2018Ankylosing spondylitis and posture control: The role of visual input\u2019, Biomed Research International 2015, 948674. https:\/\/doi.org\/10.1155\/2015\/948674","DOI":"10.1155\/2015\/948674"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Doward, L.C., Spoorenberg, A., Cook, S.A., Whalley, D., Helliwell, P.S., Kay, L.J. et al., 2003, \u2018Development of the ASQoL: A quality of life instrument specific to ankylosing spondylitis\u2019, Annals of the Rheumatic Diseases 62(1), 20\u201326. https:\/\/doi.org\/10.1136\/ard.62.1.20","DOI":"10.1136\/ard.62.1.20"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Downes, M.J., Brennan, M.L., Williams, H.C. & Dean, R.S., 2016, \u2018Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS)\u2019, BMJ Open 6(12), e011458. https:\/\/doi.org\/10.1136\/bmjopen-2016-011458","DOI":"10.1136\/bmjopen-2016-011458"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Duarte, M. & Freitas, S.M., 2010, \u2018Review of force platform-based posturography for balance assessment\u2019, Revista Brasileira de Fisioterapia 14(3), 183\u2013192. https:\/\/doi.org\/10.1590\/S1413-35552010000300003","DOI":"10.1590\/S1413-35552010000300003"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"El Miedany, Y., El Gaafary, M., Youssef, S. & Palmer, D, 2010, \u2018Towards a multidimensional patient reported outcome measures assessment: Development and validation of a questionnaire for patients with ankylosing spondylitits\/spondyloarthritis\u2019, Joint Bone Spine 77(6), 575\u2013581. https:\/\/doi.org\/10.1016\/j.jbspin.2010.02.017","DOI":"10.1016\/j.jbspin.2010.02.017"},{"key":"ref13","unstructured":"Garrett, S., Jenkinson, T., Kennedy, L.G., Whitelock, H., Gaisford, P. & Calin, A., 1994, \u2018A new approach to defining disease status in ankylosing spondylitis: The bath ankylosing spondylitis disease activity index\u2019, The Journal of Rheumatology 21(12), 2286\u20132291."},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Gokcen, N., Sariyildiz, A. & Benlidayi, I.C., 2021, \u2018Static foot posture and its relation to clinical variables in ankylosing spondylitis\u2019, International Journal of Rheumatic Diseases 24(9), 1148\u20131152. https:\/\/doi.org\/10.1111\/1756-185X.14180","DOI":"10.1111\/1756-185X.14180"},{"key":"ref15","unstructured":"Grubisi\u0107, F., Jaji\u0107, Z., Alegi\u0107-Karin, A., Bori\u0107, I. & Jaji\u0107, I., 2015, \u2018Advanced clinical and radiological features of ankylosing spondylitis: Relation to gender, onset of first symptoms and disease duration\u2019, Collegium Antropologicum 39(4), 927\u2013934."},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"G\u00fcnduz, O.H., \u00d6zcan-Eksi, E.E., Giray, E. & Yagci, I., 2017, \u2018What impairs balance in ankylosing spondylitis? Posture or disease activity?\u2019, Archives of Rheumatology 32(3), 221\u2013226. https:\/\/doi.org\/10.5606\/ArchRheumatol.2017.6222","DOI":"10.5606\/ArchRheumatol.2017.6222"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Halpern, S.D., Karlawish, J.H.T. & Berlin, J.A., 2002, \u2018The continuing unethical conduct of underpowered clinical trials\u2019, Journal of the American Medical Association 288(3), 358\u2013362. https:\/\/doi.org\/10.1001\/jama.288.3.358","DOI":"10.1001\/jama.288.3.358"},{"key":"ref18","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J. et al., 2023, Cochrane handbook for systematic reviews of interventions version 6.4, viewed 23 February 2023, from http:\/\/www.training.cochrane.org\/handbook"},{"key":"ref19","unstructured":"Jenkinson, T., Mallorie, P., Whitelock, H., Kennedy, L., Garrett, S. & Calin, A., 1994, \u2018Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index\u2019, The Journal of Rheumatology 21(9), 1694\u20131698."},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Kim, S.C., Lee, Y.G., Park, S., Kim, T.H. & Lee, K.H., 2017, \u2018Muscle mass, strength, mobility, quality of life, and disease severity in ankylosing spondylitis patients: A preliminary study\u2019, Annals of Rehabilitation Medicine 41(6), 990\u2013997. https:\/\/doi.org\/10.5535\/arm.2017.41.6.990","DOI":"10.5535\/arm.2017.41.6.990"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Machado, P., Landew\u00e9, R., Lie, E., Kvien, T.K., Braun, J., Baker, D. et al., 2011, \u2018Ankylosing spondylitis disease activity score (ASDAS): Defining cut-off values for disease activity states and improvement scores\u2019, Annals of the Rheumatic Diseases 70(1), 47\u201353. https:\/\/doi.org\/10.1136\/ard.2010.138594","DOI":"10.1136\/ard.2010.138594"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Machin, D., Campbell, M.J., Tan, S.B. & Tan, S.H., 2008, Sample size tables for clinical studies, 3rd edn., Wiley-Blackwell, Chichester.","DOI":"10.1002\/9781444300710"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Masi, A.T., Nair, K., Andonian, B.J., Prus, K.M., Kelly, J., Sanchez, J.R. et al., 2011, \u2018Integrative structural biomechanical concepts of ankylosing spondylitis\u2019, Arthritis 2011, 205904. https:\/\/doi.org\/10.1155\/2011\/205904","DOI":"10.1155\/2011\/205904"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Murray, H.C., Elliott, C., Barton, S.E. & Murray, A., 2000, \u2018Do patients with ankylosing spondylitis have poorer balance than normal subjects?\u2019, Rheumatology 39(5), 497\u2013500. https:\/\/doi.org\/10.1093\/rheumatology\/39.5.497","DOI":"10.1093\/rheumatology\/39.5.497"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Nam, B., Jo, S., Bang, S., Bang, S.Y., Park, Y., Shin, J.H. et al., 2022, \u2018Clinical and genetic factors associated with radiographic damage in patients with ankylosing spondylitis\u2019, Annals of the Rheumatic Diseases 82(4), 527\u2013532. https:\/\/doi.org\/10.1136\/ard-2022-222796","DOI":"10.1136\/ard-2022-222796"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Nogueira, J.F., Carrasco, A.C., Pelegrinelli, A.R.M., Guenka, L.C., Silva, M.F., Dela Bela, L.F. et al., 2020, \u2018Posturography comparison and discriminant analysis between individuals with and without chronic low back pain\u2019, Journal of Manipulative and Physiological Therapeutics 43(5), 469\u2013475. https:\/\/doi.org\/10.1016\/j.jmpt.2019.01.002","DOI":"10.1016\/j.jmpt.2019.01.002"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Page, M.J, McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D. et al., 2021, \u2018The PRISMA 2020 statement: An updated guideline for reporting systematic reviews\u2019, Systematic Reviews 10(1), 89. https:\/\/doi.org\/10.1186\/s13643-021-01626-4","DOI":"10.1186\/s13643-021-01626-4"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Pompeu, J.E., Romano, R.S., Pompeu, S.M. & Lima, S.M., 2012, \u2018Static and dynamic balance in the individual with ankylosing spondylitis: Literature review\u2019, Revista Brasileira de Reumatologia 52(3), 413\u2013416.","DOI":"10.1590\/S0482-50042012000300010"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Resorlu, H., Savas, Y., Aylanc, N. & Gokmen, F., 2017, \u2018Evaluation of paravertebral muscle atrophy and fatty degeneration in ankylosing spondylitis\u2019, Modern Rheumatology 27(4), 683\u2013687. https:\/\/doi.org\/10.1080\/14397595.2016.1245176","DOI":"10.1080\/14397595.2016.1245176"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Ritchlin, C. & Adamopoulos, I.E., 2021, \u2018Axial spondyloarthritis: New advances in diagnosis and management\u2019, British Medical Journal 372, m4447. https:\/\/doi.org\/10.1136\/bmj.m4447","DOI":"10.1136\/bmj.m4447"},{"key":"ref31","unstructured":"Rugelj, D. & Sevsek, F., 2007, \u2018Analysis of postural sway data of elderly subjects\u2019, in 6th WSEAR International conference on signal processing, robotics and automation, WSEAR World Scientific Engineering Academy and Society, Corfu Island. Greece, viewed n.d. from https:\/\/dl.acm.org\/doi\/abs\/10.5555\/1355681.1355699."},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Sawacha, Z., Carraro, E., Del Din, S., Guiotto, A., Bonaldo, L., Punzi, L. et al., 2012, \u2018Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis\u2019, Journal of Neuroengineering and Rehabilitation 29, 9\u201363. https:\/\/doi.org\/10.1186\/1743-0003-9-63","DOI":"10.1186\/1743-0003-9-63"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Seeger, J.B. & Clarius, M., 2009, \u2018Luxatio pedis subtalus medialis [Subtalar dislocation]\u2019, Unfallchirurgic 112, 1066\u20131069. https:\/\/doi.org\/10.1007\/s00113-009-1698-7","DOI":"10.1007\/s00113-009-1698-7"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Uckun, A. & Sezer, I., 2017, \u2018Ankylosing spondylitis and balance\u2019, The Eurasian Journal of Medicine 49(3), 207\u2013210. https:\/\/doi.org\/10.5152\/eurasianjmed.2017.17116","DOI":"10.5152\/eurasianjmed.2017.17116"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Vergara, M.E., O\u2019Shea, F.D., Inman, R.D. & Gage, W.H., 2012, \u2018Postural control is altered in patients with ankylosing spondylitis\u2019, Clinical Biomechanics 27(4), 334\u2013340. https:\/\/doi.org\/10.1016\/j.clinbiomech.2011.10.016","DOI":"10.1016\/j.clinbiomech.2011.10.016"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Ward, M.M., Deodhar, A., Akl, E.A., Lui, A., Ermann, J., Gensler, L.S. et al., 2016, \u2018American College of rheumatology\/spondylitis Association of America\/spondyloarthritis research and treatment network 2015. Recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis\u2019, Arthritis & Rheumatology 68(2), 282\u2013298. https:\/\/doi.org\/10.1002\/art.39298","DOI":"10.1002\/art.39298"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Wright, G.C., Kaine, J. & Deodhar, A., 2020, \u2018Understanding differences between men and women with axial spondyloarthritis\u2019, Seminars in Arthritis Rheumatism 50(4), 687\u2013694. https:\/\/doi.org\/10.1016\/j.semarthrit.2020.05.005","DOI":"10.1016\/j.semarthrit.2020.05.005"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Yildirim, T. & Yildirim, O., 2015, \u2018Postural control and balance in ankylosing spondylitis\u2019, Medicine Science 4(1), 2057\u20132064. https:\/\/doi.org\/10.5455\/medscience.2014.03.8202","DOI":"10.5455\/medscience.2014.03.8202"}],"container-title":["South African Journal of Physiotherapy"],"original-title":[],"link":[{"URL":"https:\/\/sajp.co.za\/index.php\/sajp\/article\/view\/1953\/3605","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:01:28Z","timestamp":1787922088000},"score":1,"resource":{"primary":{"URL":"https:\/\/sajp.co.za\/index.php\/sajp\/article\/view\/1953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,14]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/sajp.v80i1.1953","relation":{},"ISSN":["0379-6175","2410-8219"],"issn-type":[{"value":"0379-6175","type":"print"},{"value":"2410-8219","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,14]]},"article-number":"a1953"}}