Relationship between spinal mobility measures and quality of life in patients with ankylosing spondylitis

Abstract

The aim of this study was to assess spinal mobility status and Quality of life (QoL) of patients with ankylosing spondylitis (AS) and determine the relationship between spinal mobility and measures of clinical condition including QoL. A total of 74 patients with AS were included in this study. Disease specific instruments Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were applied, and mobility testing: occiput-wall distance and chest expansion. QoL was assessed by the Short Form-36 (SF-36). The mean age was 48.5 years; there were significant correlations between BASMI score and age (P < 0.001), disease duration (P < 0.001), symptoms duration (P < 0.001) and BASFI (P < 0.001). BASMI was negatively correlated with SF-36 physical function subscale (P < 0.001) and general health subscale (P = 0.029). In multivariate regression analysis, BASFI score (P < 0.001) was independently associated factor with physical function domain of SF-36. This study showed that in AS spinal mobility measures are associated with physical function, general health, emotional role and mental health domains of QoL.

Which clinical variables have the most significant correlation with quality of life evaluated by SF-36 survey in Croatian cohort of patient with ankylosing spondylitis and psoriatic arthritis?

“…It had the strongest impact on physical functioning concept of SF-36 in both diseases in our study. Our results confirmed previously observed association between spinal mobility measurements in AS and SF-36 concepts concerning physical health [5,10,11,27,28]. As we stressed before, most of our PsA patients had spinal affection, which explains the results similar to AS.…”

“…Moreover, psoriatic skin manifestations in PsA have the impact on emotional and social functioning [7,8]. SF-36 survey has been widely used by numerous studies to assess QOL in chronic rheumatic diseases [4,5,8,10,[26][27][28][29][30]. We used Croatian version of SF-36 QOL questionnaire and, even though we had rather limited number of patients within groups, obtained strong correlations between different clinical variables and several SF-36 health concepts for those diseases.…”

“…Previous studies already showed the relationship between SF-36 concepts and disease activity or functional indices in patients with AS [27,28]. However there are only few studies focused on the relationship between spinal mobility and health-related QOL assessment by SF-36 in AS [5,11,26]. One of them found that Bath ankylosing spondylitis metrology index correlated with physical functioning and general health concepts [5], whereas another showed the correlation of modified Schober index, measuring spinal mobility, with the role limitations due to physical health problems and pain [26].…”

“…However there are only few studies focused on the relationship between spinal mobility and health-related QOL assessment by SF-36 in AS [5,11,26]. One of them found that Bath ankylosing spondylitis metrology index correlated with physical functioning and general health concepts [5], whereas another showed the correlation of modified Schober index, measuring spinal mobility, with the role limitations due to physical health problems and pain [26]. In our study, patient assessment of enthesial pain but not the number of affected entheses correlated with the pain subscale of SF-36.…”

“…AS predominantly affects axial skeleton with the involvement of sacroiliac joints, and often also entheses and extra-articular structures. It leads to irreversible structural changes causing decreased spinal mobility [4,5]. PsA may involve both the peripheral joints and spine, with variable incidence.…”