When treating a patient with ankylosing spondylitis, the muscle requiring the MOST emphasis for strengthening exercises are the:

When treating a patient with ankylosing spondylitis, the muscle requiring the MOST emphasis for strengthening exercises are the:

• A. pectorals
• B. hip flexors
• C. back extensors
• D. abdominals

Answer: (C)

Ankylosing spondylitis tends to produce a forward-stooped posture with loss of spinal extension due to inflammatory changes and eventual fusion of the spine. Strengthening the back extensor muscles—such as the erector spinae group—directly supports the ability to extend the trunk and maintain an upright position. This helps preserve sagittal balance, improves daily function, and can lessen the progression of kyphotic deformity by counteracting flexion forces. Other muscle groups, like the abdominals, hip flexors, and pectorals, influence posture as well, but they don’t counteract the primary problem of reduced spinal extension as effectively. Overemphasizing them without building back extensor strength could perpetuate or worsen the forward-flexed posture, whereas prioritizing back extensors targets the most impactful functional improvement for someone with AS.

Ankylosing spondylitis tends to produce a forward-stooped posture with loss of spinal extension due to inflammatory changes and eventual fusion of the spine. Strengthening the back extensor muscles—such as the erector spinae group—directly supports the ability to extend the trunk and maintain an upright position. This helps preserve sagittal balance, improves daily function, and can lessen the progression of kyphotic deformity by counteracting flexion forces.

Other muscle groups, like the abdominals, hip flexors, and pectorals, influence posture as well, but they don’t counteract the primary problem of reduced spinal extension as effectively. Overemphasizing them without building back extensor strength could perpetuate or worsen the forward-flexed posture, whereas prioritizing back extensors targets the most impactful functional improvement for someone with AS.