Changes in Serum Calprotectin and Their Clinical Correlates in Axial Spondyloarthritis Patients Undergoing Pulmonary Rehabilitation

Changes in C-reactive protein [CRP] before and after pulmonary rehabilitation.

Measured via standard blood serum analysis in milligrams per liter (mg/L) from baseline to 4 weeks post-pulmonary rehabilitation.

Time frame: Baseline and 4 weeks

Change in Erythrocyte Sedimentation Rate (ESR)

Measured in millimeters per hour (mm/hr) from baseline to 4 weeks post-pulmonary rehabilitation.

Time frame: Baseline and 4 weeks

Change in Systemic Inflammation Response Index (SIRI)

Calculated from peripheral blood counts using the formula: SIRI = (Neutrophil count × Monocyte count) / Lymphocyte count. Assessed as a unitless ratio to evaluate systemic inflammatory status from baseline to 4 weeks post-pulmonary rehabilitation.

Time frame: Baseline and 4 weeks

Change in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Score

Assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Total score ranges from 0 to 10, where 0 indicates no disease activity and 10 indicates severe disease activity. Higher scores represent worse outcomes.

Time frame: Baseline and 4 weeks

Change in Bath Ankylosing Spondylitis Functional Index (BASFI) Score

Assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI) to evaluate functional limitations. The BASFI consists of 10 items assessing daily physical activities. Total score ranges from 0 to 10, where 0 represents easy/no functional impairment and 10 represents impossible/severe functional impairment. Higher scores indicate worse functional limitations.

Time frame: Baseline and 4 weeks

Change in Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP)

Assessed using the Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP), a composite index combining patient-reported assessments and serum C-reactive protein (CRP) levels. Scores are categorized as: \< 1.3 indicates inactive disease, 1.3 to 2.0 indicates moderate disease activity, 2.1 to 3.5 indicates high disease activity, and \> 3.5 indicates very high disease activity. Higher scores represent worse disease activity.

Time frame: Baseline and 4 weeks

Change in St. George's Respiratory Questionnaire (SGRQ) Total Score

Assessed using the St. George's Respiratory Questionnaire (SGRQ) to measure health-related quality of life. The questionnaire consists of 50 items across three domains: symptoms, activity, and impacts. Total scores range from 0 to 100, where 0 indicates no impairment and 100 indicates maximum impairment. Higher scores indicate worse health status and greater limitation.

Time frame: Baseline and 4 weeks

Change in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES)

Assessed using the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) to evaluate enthesitis across 13 anatomical locations bilaterally and at the 5th lumbar spinous process. Tenderness is scored dichotomously (0 = absent, 1 = present). Total score ranges from 0 to 13. Higher scores indicate worse outcomes (more tender enthesis sites and greater disease activity).

Time frame: Baseline and 4 weeks

Change in Nottingham Health Profile (NHP) Total Score

Assessed using the Nottingham Health Profile (NHP) to evaluate perceived emotional, social, and physical health problems across 38 items. Each subscale score and the combined total score range from 0 to 100. Higher scores indicate worse outcomes (greater perceived health problems and poorer quality of life).

Time frame: Baseline and 4 weeks

Change in Systemic Immune-Inflammation Index (SII)

Calculated from peripheral blood counts using the formula: SII = (Platelet count × Neutrophil count) / Lymphocyte count. Assessed as a unitless ratio from baseline to 4 weeks post-pulmonary rehabilitation.

Time frame: Baseline and 4 weeks

Change in Neutrophil-to-Lymphocyte Ratio (NLR)

Calculated as the ratio of absolute neutrophil count to absolute lymphocyte count from baseline to 4 weeks post-pulmonary rehabilitation.

Time frame: Baseline and 4 weeks