生物与非生物治疗对中轴型脊柱关节炎功能及生理结局影响的比较研究：核心耐力、运动能力与生活质量的深度剖析

本研究针对中轴型脊柱关节炎（axSpA）患者功能恢复难题，由研究人员开展治疗方式对比研究。通过比较生物制剂与非生物药物治疗组及健康对照组的核心耐力、运动能力（六分钟踏步测试）、疾病活动指数（BASDAI、BASMI、BASFI、ASDAS-CRP）及生活质量（ASQoL），发现患者组运动能力与核心耐力显著降低，且非生物治疗组BASMI指数更优。结果揭示了治疗史对功能结局的影响，为个性化康复方案制定提供关键依据。

　　

pharmacological treatments have been shown to improve physical and physiological functions in patients with axial spondyloarthritis (axSpA). This study aimed to compare core endurance, exercise capacity, cardiopulmonary responses during exercise testing, quality of life (QoL), and disease activity among patients with axSpA using biological and non-biological treatments, and healthy controls. This cross-sectional study involved 52 patients on biological therapy, 57 on non-biological drugs, and 46 healthy controls. Core endurance (McGill tests), exercise capacity (six-minute stepper test), and disease activity indexes (The Bath Ankylosing Spondylitis Disease Indices; BASDAI, BASMI, BASFI, ASDAS-CRP, Leeds Enthesitis Index; LEI), spinal and hip radiographic scores (modified Stoke Ankylosing Spondylitis Spinal Score; mSASSS), Bath Ankylosing Spondylitis Radiology Hip Index; BASRI-hip), pain (Numeric Rating Scale), patient and physician global assessments, cardiopulmonary responses, quadriceps muscle fatigue and dyspnea (Modified Borg scale), laboratory markers (CRP, ESR), and QoL (Ankylosing Spondylitis QoL Scale; ASQoL) were measured. Step counts in the six-minute stepper test, trunk flexor, and lateral flexor muscle endurance values were significantly lower, while fatigue and quadriceps muscle fatigue during the six-minute stepper test were significantly higher in patients compared to healthy controls (p<0.05). BASMI values were significantly lower in the non-biological treatment group compared to the biological group (p<0.05). Step counts showed weak correlation with BASMI (r=?0.142; p=0.167), moderate-strong correlation with BASDAI (r=?0.458; p<0.001), ASQoL (r=?0.450; p<0.001), ASDAS-CRP (r=?0.361; p<0.001), trunk extensor and flexor muscle endurance (r=0.489; p<0.001, r=0.485; p<0.001), right and left trunk lateral flexor muscle endurance (r=0.584; p<0.001, r=0.572; p<0.001), and BASFI (r=?0.582; p<0.001). Step count variance was explained by BASMI, BASDAI, BASFI, ASQoL, and trunk endurance, accounting for 34.1% of the total variance. These findings may assist clinicians in planning personalized rehabilitation programs by considering not only functional limitations but also treatment history of the patients with axSpA. Understanding the effects of pharmacological treatment history on exercise capacity and core muscle endurance may guide the development of more effective physiotherapy approaches.