The Effect of Laughter Yoga on Patients With Ankylosing Spondylitis

Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)

BASDAI, which assesses disease activity in ankylosing spondylitis, was developed by Garret and colleagues in 1994 . The scale includes six questions to assess disease activity over the past week, consisting of fatigue, spinal pain, joint swelling, tenderness, and morning stiffness. The patient's symptoms are scored on a scale of 0 to 10 (0 = none, 10 = very severe). When calculating the total score, the average of questions 5 and 6 is added to the scores of questions 1, 2, 3, and 4, and the total is divided by 5 to determine the total score. The total score of the scale ranges from 0 to 10. Higher scores indicate greater disease activity.

Pain Scale (Visual Analog Scale)

The VAS is a straight line used to measure the variability of pain and indicates the continuity of pain. At one end of this line is painlessness (0), and at the other end is the most severe pain (10) that can occur.

Bath Ankylosing Spondylitis Functional Index (BASFI)

The BASFI, which assesses functional status in ankylosing spondylitis, was developed in 1994 by Calin et al. The scale assesses patients' ability to put on socks/tights, bend forward from the waist, reach high, get up from a chair or the floor without support, stand without support, look sideways over their shoulders without turning their body, climbing stairs without assistance, performing activities requiring physical strength, and performing activities at home/work. Eight of the questions in the scale relate to daily living activities, and two relate to coping with life. Patients are asked to rate how much difficulty they experience while performing each activity on a visual analog scale from 0 to 10 (0 = easy, 10 = impossible). The scale is scored by summing the points given for each question and dividing by 10 to obtain the average. The total score ranges from 0 to 10. An increase in the BASFI score is interpreted as a decrease in functional capacity.

DASS-42 Scale (Depression-Anxiety-Stress Scale)

The scale is a 4-point Likert scale consisting of 3 subscales (depression,anxiety, stress).Each subscale has 14 items,for a total of 42 items on the scale.The depression items assess feelings of helplessness,worthlessness, dissatisfaction,loss of interest,and low energy levels.Anxiety items measure muscle response levels,the individual's autonomic arousal,and subjective and situational anxiety.Stress items assess discomfort,difficulty relaxing, overreaction,nervous arousal,intolerance,easy sadness,and boredom levels. Depression is categorized as remission(0-9),mild(10-13),moderate(14-20),severe (21-27),and very severe (28-42);anxiety is categorized as remission (0-7),mild (8-9),moderate (10-14),severe (15-19),and very severe(20-42);and stress remission (0-14),mild(15-18),moderate(19-25),severe(26-33),and very severe (34-42)into five categories.Each of the depression,anxiety,and stress scores ranges from 0 to 42,and as the score increases,depression,anxiety,and stres also increases.

Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL)

The Ankylosing Spondylitis Quality of Life Questionnaire was developed in 2007 by Doward and colleagues to assess the quality of life of patients with this specific disease. The questionnaire consists of 18 items related to the symptoms, functioning, and concerns associated with the disease. Each statement is followed by "no" and "yes" options. Each 'yes' answer is scored as one point, while each "no" answer is scored as zero points. The total score of the scale ranges from 0 to 18. An increase in the total score indicates a lower quality of life for the individual.