Physiotherapeutic rehabilitation strategies for juvenile ankylosing spondylitis with HLA-B27 association: A case report

Ankylosing spondylitis (AS) is a chronic, progressive inflammatory arthritis primarily affecting the axial skeleton, often leading to pain, stiffness, and potential spinal fusion. Although more prevalent in young adults, juvenile onset AS is rare and presents unique challenges in diagnosis and management. This case report details the physical therapy (PT) management of a 7-year-old female diagnosed with HLA-B27–positive ankylosing spondylitis presenting with low back pain, reduced spinal mobility, and functional limitations. The comprehensive rehabilitation program was tailored to her developmental stage, focusing on pain control, posture correction, flexibility maintenance, and functional activity enhancement. Interventions included gentle spinal mobilization, core stabilization, stretching of shortened muscle groups, respiratory exercises to preserve chest expansion, and age-appropriate therapeutic play to maintain engagement. Education was provided to the family regarding activity modification, ergonomic support, and home exercise compliance. Outcomes were assessed through improvements in pain scores, range of motion, functional independence, and quality of life measures. This case emphasizes the critical role of individualized PT programs in managing juvenile AS, aiming to delay structural progression, preserve function, and promote long-term independence. The report also underscores the importance of multidisciplinary care and early intervention to address both the physical and psychosocial impact of the condition.

Dr. Karthikeyan Thangavelu is a distinguished academician, researcher, and physiotherapy educator with over two decades of multifaceted experience in functional rehabilitation care, sports medicine, and clinical physiotherapy education. As a prominent figure in the field, he currently serves as an Associate Professor in the Department of Physiotherapy and holds key administrative roles as Deputy Director (Sports) and Secretary of the Sports Council at Gurugram University, Haryana.

His academic and clinical interests span across neurology, post-neurosurgical rehabilitation, psychosomatic disorders, and sports injury management, with specialized expertise in fitness assessment, physical testing, and exercise prescription.