Sensitivity to change of mobility tests; Effect of short term intensive physiotherapy and exercise on spinal, hip, and shoulder measurements in spondyloarthropathy

Objective. To assess the sensitivity to change of 13 spinal, shoulder, and hip measurements and determine correlation between age, disease duration, a nd radiologic findings in ankylosing spondylitis (AS) and other spondyloart hropathies (SpA). Methods. We assessed 112 patients with various types of SpA as changes befo re and after an intensive inpatient course. Results. The most sensitive spinal measurements were finger to floor distan ce, chest expansion, thoracolumbar rotation (TLR), and lateral flexion, in that order. Cervical rotation, lateral flexion, and intermalleolar distance might also be useful in short term clinical trials, while the Schober test s, thoracolumbar flexion, and occiput-wall distance were not sufficiently s ensitive. Hip internal rotation (HRi), shoulder flexion, and abduction meas urements were also sensitive, though possibly more suitable for patients wi th articular symptoms. TLR and HRi were the only measurements that correlat ed markedly with disease duration, but not with age. Changes in the measure ments correlated significantly with radiological spinal changes. Conclusion. Finger to floor distance, TLR, and thoracolumbar lateral flexio n were the most sensitive to detect improvements in short term clinical tri als, while the Schober test, thoracolumbar flexion, and occiput-wall distan ce were insensitive.