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To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis

In the last years, new researches focused on the role of biomechanical stress and microdamage in the pathogenesis of inflammatory arthritis and, in particular, in axial spondyloarthritis (axSpA). Animal models showed how entheseal stress and physical exercise could contribute to the development of i...

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Autores principales: Perrotta, Fabio Massimo, Lories, Rik, Lubrano, Ennio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871344/
https://www.ncbi.nlm.nih.gov/pubmed/33547227
http://dx.doi.org/10.1136/rmdopen-2020-001480
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author Perrotta, Fabio Massimo
Lories, Rik
Lubrano, Ennio
author_facet Perrotta, Fabio Massimo
Lories, Rik
Lubrano, Ennio
author_sort Perrotta, Fabio Massimo
collection PubMed
description In the last years, new researches focused on the role of biomechanical stress and microdamage in the pathogenesis of inflammatory arthritis and, in particular, in axial spondyloarthritis (axSpA). Animal models showed how entheseal stress and physical exercise could contribute to the development of inflammation and new bone formation at entheseal and articular sites, by activating innate immune system and the release of cytokines. Furthermore, clues of the involvement of biomechanical stress in the development of axSpA are present in clinical experiences. However, rehabilitation and exercise programmes are the cornerstone of treatment for axSpA, reducing disease activity and improving spinal function and quality of life. The concept of mechanical stress as a contributor to disease development and progression represents, potentially, a conceptual challenge for this approach. The aim of this review is to discuss the current evidence on the intriguing contribution of the biomechanical stress to the pathogenesis of inflammation and new bone formation and to evaluate and reflect on the role of exercise in the treatment and in the management of the disease, considering both the beneficial effects and its possible paradoxical action.
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spelling pubmed-78713442021-02-18 To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis Perrotta, Fabio Massimo Lories, Rik Lubrano, Ennio RMD Open Spondyloarthritis In the last years, new researches focused on the role of biomechanical stress and microdamage in the pathogenesis of inflammatory arthritis and, in particular, in axial spondyloarthritis (axSpA). Animal models showed how entheseal stress and physical exercise could contribute to the development of inflammation and new bone formation at entheseal and articular sites, by activating innate immune system and the release of cytokines. Furthermore, clues of the involvement of biomechanical stress in the development of axSpA are present in clinical experiences. However, rehabilitation and exercise programmes are the cornerstone of treatment for axSpA, reducing disease activity and improving spinal function and quality of life. The concept of mechanical stress as a contributor to disease development and progression represents, potentially, a conceptual challenge for this approach. The aim of this review is to discuss the current evidence on the intriguing contribution of the biomechanical stress to the pathogenesis of inflammation and new bone formation and to evaluate and reflect on the role of exercise in the treatment and in the management of the disease, considering both the beneficial effects and its possible paradoxical action. BMJ Publishing Group 2021-02-05 /pmc/articles/PMC7871344/ /pubmed/33547227 http://dx.doi.org/10.1136/rmdopen-2020-001480 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Spondyloarthritis
Perrotta, Fabio Massimo
Lories, Rik
Lubrano, Ennio
To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis
title To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis
title_full To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis
title_fullStr To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis
title_full_unstemmed To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis
title_short To move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis
title_sort to move or not to move: the paradoxical effect of physical exercise in axial spondyloarthritis
topic Spondyloarthritis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871344/
https://www.ncbi.nlm.nih.gov/pubmed/33547227
http://dx.doi.org/10.1136/rmdopen-2020-001480
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