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

Abstract

Objective: To assess the sensitivity to change of 13 spinal, shoulder, and hip measurements and determine correlation between age, disease duration, and radiologic findings in ankylosing spondylitis (AS) and other spondyloarthropathies (SpA).

Methods: We assessed 112 patients with various types of SpA as changes before and after an intensive inpatient course.

Results: The most sensitive spinal measurements were finger to floor distance, 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 tests, thoracolumbar flexion, and occiput-wall distance were not sufficiently sensitive. Hip internal rotation (HRi), shoulder flexion, and abduction measurements were also sensitive, though possibly more suitable for patients with articular symptoms. TLR and HRi were the only measurements that correlated markedly with disease duration, but not with age. Changes in the measurements correlated significantly with radiological spinal changes.

Conclusion: Finger to floor distance, TLR, and thoracolumbar lateral flexion were the most sensitive to detect improvements in short term clinical trials, while the Schober test, thoracolumbar flexion, and occiput-wall distance were insensitive.