Thoracoabdominal motion in ankylosing spondylitis: association with standardised clinical measures and response to therapy

Tzelepis, George E.; Kalliakosta, Georgia; Tzioufas, Athanasios G.; Sfikakis, Petros P.; Mandros, Charalampos; Boki, Kyriaki; Roussos, Charalambos; Moutsopoulos, Haralampos Μ.

doi:10.1136/ard.2008.092650

Cited by 11 publications

(5 citation statements)

References 29 publications

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“…This measurement may be useful, because the reduction of pulmonary capacity in AS is well known, but the actual measure system is not appropriate. Tzelepis et al [17] used the thoracoabdominal movement in breathing as outcome parameter of the disease.…”

Section: Discussionmentioning

confidence: 99%

Inter-rater reliability of clinical mobility measures in ankylosing spondylitis

Calvo‐Gutiérrez

Garrido-Castro

Gonzalez-Navas

et al. 2016

BMC Musculoskelet Disord

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BackgroundSeveral measurements are often used in daily clinical practice in the assessment of Ankylosing Spondylitis (AS) patients. The Assessment in SpondyloArthiritis International Society (ASAS) recommend in its core set: chest expansion modified Schöber test, Occiput to wall distance, lateral lumbar flexion, cervical rotation and The Bath Ankylosing Spondylitis Metrology Index (BASMI). BASMI also includes five measurements, some of them recommended by ASAS. Three versions of BASMI have been published with different scales and intervals for each component of the index. Though studies about reliability of these measurements are needed. The aim of this study was to analyze inter-rater reliability of recommended spinal mobility measures in AS.MethodsWe examined reproducibility of spinal mobility measurements on 33 AS patients performed by two experienced rheumatologists in the same day. Descriptive statistics, Intraclass Correlation Coefficients (ICC), and Smallest Detectable Difference (SDD) using the Bland-Altman criteria were obtained for all the measurements.ResultsChest expansion showed the lowest value of ICC (0.66) and occiput-wall the highest (0.97). SDD was 2.43 units for BASMI2 and 1.27 units for BASMI10.ConclusionsReliability according to ICC was moderate to high in all measurements. BASMI10, instead BASMI2, must be used: measurements used to calculate are the same but there is better reliability. Inter-rater variation, expressed as SDD, must be taken in account: smaller improvements do not demonstrate the efficacy of treatment because they can be due to experimental error and not to the treatment itself.

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Section: Discussionmentioning

confidence: 99%

Inter-rater reliability of clinical mobility measures in ankylosing spondylitis

Calvo‐Gutiérrez

Garrido-Castro

Gonzalez-Navas

et al. 2016

BMC Musculoskelet Disord

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“…Content validity is fair, with the initial instrument development based on an extensive literature review and a panel of clinicians and research associates with a special interest in AS. Thoracic spinal mobility is under‐represented in this instrument as indicated by the lack of association between the BASMI and thoraco‐abdominal motion in AS patients (68), and the ASAS group recommends the addition of chest expansion to the core set for clinical evaluation in AS patients to address this limitation. Regarding construct validity, the BASMI has been shown to discriminate between patients with and without radiographic change due to AS (69).…”

Section: Bath Ankylosing Spondylitis Metrology Index (Basmi)mentioning

confidence: 99%

Measures of symptoms and disease status in ankylosing spondylitis: Ankylosing Spondylitis Disease Activity Score (ASDAS), Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score (BAS‐G), Bath Ankylosing Spondylitis Metrology Index (BASMI), Dougados Functional Index (DFI), and Health Assessment Questionnaire for the Spondylarthropathies (HAQ‐S)

Zochling

2011

Arthritis Care & Research

276

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“…There is some disagreement over whether chest expansion improves after TNF-α-blocker therapy in AS [ 4 , 5 , 6 ] because chest expansion has disadvantages such as significant inter-tester variability, poor reproducibility, high dependence on patient effort, and a broad range of normal values with an age-related decrease. [ 22 , 36 ] Therefore, it is necessary to clarify whether chest expansion can efficiently assess spinal mobility change with TNF-α-blocker therapy in AS patients.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal mobility is usually measured with the Bath AS Metrology Index (BASMI), which was developed to measure the status of the axial skeleton accurately and to objectively assess clinically significant changes in spinal function in AS patients and is the most reliable and clinically useful metrological measurement. [ 20 , 21 ] However, because thoraco-abdominal movement shows a poor relationship with BASMI, [ 22 ] the use of chest expansion in conjunction with BASMI is recommended for a more accurate assessment of thoracic spinal mobility. [ 21 , 23 ] Spinal mobility is determined by radiographic spinal progression and spinal inflammation, [ 24 ] both of which are closely related to disease activity outcomes, such as Bath AS Disease Activity Index (BASDAI) and the AS Disease Activity Score (ASDAS), and acute phase reactants (ESR and CRP).…”

Section: Introductionmentioning

confidence: 99%

Early achievement of ASDAS clinical response is associated with long-term improvements in metrological outcomes in patients with ankylosing spondylitis treated with TNF-α blockers

Nam¹,

Lee

2020

Medicine

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The aim of this study was to investigate the relationship between long-term spinal mobility improvements and early disease activity changes or achievement of clinical response criteria in patients with ankylosing spondylitis (AS) treated with tumor necrosis factor (TNF-α) blockers. This retrospective study included 112 patients with AS treated with TNF-α blockers for up to 33 months. The paired t -test was used to compare outcome measures between visits. The correlation between disease activity changes and metrological improvements was analyzed using cumulative probability plots, Spearman correlation coefficient, and canonical correlation. The difference in metrological outcomes between responders and non-responders to clinical response criteria was also examined. Metrological and disease activity outcomes improved most markedly in month 3. All disease activity outcomes and ESR from baseline to month 3 (3-month) were significantly correlated with the Bath Ankylosing Spondylitis Metrology Index (BASMI 10 ) improvements from baseline to month 33 (33-month). The 3-month changes in ankylosing spondylitis disease activity score (ASDAS-CRP) and patient's global assessment showed a significant correlation with the 33-month changes in chest expansion. Only responders according to ASDAS major improvement at month 3 demonstrated significant 33-month improvements in both BASMI 10 and chest expansion, compared to non-responders. Responders according to Assessment of Spondylo Arthritis international Society 40 at month 3 showed significant 33-month improvements in BASMI 10 , but not chest expansion, compared to non-responders. The degree of early changes in disease activity outcomes influenced the extent of long-term metrological improvements in AS treated with TNF-α blockers. Additionally, the achievement of ASDAS- major improvement at month 3 predicted significant metrological improvements throughout long-term TNF-α-blocker therapy.

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Thoracoabdominal motion in ankylosing spondylitis: association with standardised clinical measures and response to therapy

Cited by 11 publications

References 29 publications

Inter-rater reliability of clinical mobility measures in ankylosing spondylitis

Inter-rater reliability of clinical mobility measures in ankylosing spondylitis

Early achievement of ASDAS clinical response is associated with long-term improvements in metrological outcomes in patients with ankylosing spondylitis treated with TNF-α blockers

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