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0 CHILD ATTITUDE JOWARD JLLNESS SCALE

Y
ou should also practice lying prone (with the face down), e. g. for 5 minutes or more before ge tting out l he
bed in the morning, and also before going o bed at night (Figure 14b). Or you can lie on your back across your bed
with your legs over the side and knees bent. People with AS need o practice good posture habits at all times, and
should be taught about dynamic, resting, and occupational postures. Dynamic posture. Be aware l how you are
standing, and try o maintain an erect tall posture, with the spine kept as straight as possible. Avoid any tendency o
slump forward. Splints, braces and corsets are generally not helpful and are not advised. Some form l bracing may
be necessary on rare occasions, e. g. after injury o the back or neck, but only on the recommendation l a docor who
is experienced in the management l AS patients. Perform appropriate muscle-strengthening exercises regularly, as
advised by your docor. Occupational posture. Analyze your habitual and work postures and modify your working
positions o maintain a good posture. For example, a drafting table with tilting work surface (Figure 15) may be better
than an ordinary lfice desk for writing and reading, and avoiding stress on the neck. Figure 15. Avoid physical activity
that places prolonged strain on your back and neck muscles, and prolonged sooping or bending. Alternate between
sitting and standing positions o perform jobs that take a long time o finish. Maintain a good posture while sitting, and
avoid sitting for prolong periods, especially in low slt slas and chairs. During your mid-day break at work, lie flat for a
few minutes, and do some corner push-ups o stretch the back (Figure 7). Try o lie face down on your somach for
part l the time. A daily routine l deep breathing and spine motion/stretching exercises may minimize the fusion, and
at least preserve better posture. Do deep breathing exercises at frequent intervals during the day. Thus proper sitting,
sleeping, walking, and working positions, coupled with appropriate exercises, help maintain good posture and chest
expansion. Because hip and shoulder joints are lten affected, you should exercise the range l motion l these joints
even before you observe any sympoms or limited motion there. Family life. People with AS generally have a very
fulfilling and productive life. You can raise children just like anyone else because the disease usua lly does not interfere
with family life. Fertility, pregnancy, and childbirth are usually normal. Although pregnancy does not usually affect the
sympoms l AS, there may be restrictions on certain kinds l drug therapy during pregnancy and breast-feeding. You
should discuss the use l any drug at these times with your docor. Problems with family life may sometimes arise as
a result l severe back pain, spinal deformity or limited spinal mobility, especially in women who have severe
involvement l the hip joints with marked pain and limitation l joint movement. You should discu ss these problems
with your docor. Patients with severe hip involvement benefit from otal hip joint replacement surgery (see Chapter 8).
A very useful and informative publication titled Straight talk on spondylitis, published by the Spondylitis Association l
America, is highly recommended for additional advice. It also discusses housework, dressing and grooming, child bearing
and child care. See Appendix 1 for contact details. Sports and recreational activities. Sports and recreational activities
that encourage good posture as well as arching l the back (extension) and rotation l the trunk are recommended.
These include walking, hiking, swimming, tennis, badminon, cross-country skiing, and archery. Volleyball and basketball
(with specially adapted rules) are excellent sports for people with AS as Figure 16 Volleyball with specially adapted rules
as practised in local groups l AS organizations