DEFINING SPINAL MOBILITY IN ANKYLOSING-SPONDYLITIS (AS) - THE BATH ASMETROLOGY INDEX

Citation
Tr. Jenkinson et al., DEFINING SPINAL MOBILITY IN ANKYLOSING-SPONDYLITIS (AS) - THE BATH ASMETROLOGY INDEX, Journal of rheumatology, 21(9), 1994, pp. 1694-1698
Citations number
22
Categorie Soggetti
Rheumatology
Journal title
ISSN journal
0315162X
Volume
21
Issue
9
Year of publication
1994
Pages
1694 - 1698
Database
ISI
SICI code
0315-162X(1994)21:9<1694:DSMIA(>2.0.ZU;2-7
Abstract
Objective. To determine the most appropriate clinical measurements for the assessment of ankylosing spondylitis (AS) and to develop the new metrology index.Methods. One hundred and ninety-three individuals with AS were studied. The patients reflected the entire spectrum of cases of AS. Metrology was performed on 327 occasions. First the metrology ( 20 measurements) of 43 patients was analyzed. From this, 5 simple clin ical measurements were defined which most accurately reflect axial sta tus: cervical rotation, tragus to wall distance, lateral flexion, modi fied Schober's, and intermalleolar distance. These measurements were a ssessed for reliability, speed and both inter and intraobserver variab ility in another 40 patients. Results. Analysis of the first group of 43 patients and a subsequent group of 54 patients, using the 5 measure ments that constitute this new Bath AS Metrology Index (BASMI), demons trated that they accurately and reliably mirror the 20 clinical measur ements assessed previously (r = 0.92, p <0.001). In a new group of 40 patients the measurements were demonstrated to be accurate and reprodu cible for both intraobserver variability (r = 0.99, p <0.001) and inte robserver variability (r = 0.97, p <0.001). In a further 56 patients, admitted for inpatient therapy, an improvement in the BASMI from 3.34 (SD 2.71) to 2.16 (SD 2.42) was noted over a period of 3 weeks (regard less of disease severity) which indicates a sensitivity to change (X(2 ) = 6.55, P <0.01). The mean improvement over baseline was about 30%. Conclusion. Five clinical measurements provide a composite index (BASM I) and define disease status in AS. The BASMI is quick (7 min), reprod ucible and sensitive to change across the disease spectrum.