Publication:
Inter-rater reliability of clinical mobility measures in ankylosing spondylitis.

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Date

2016-09-02

Authors

Calvo-Gutierrez, J
Garrido-Castro, J L
Gonzalez-Navas, C
Castro-Villegas, M C
Ortega-Castro, R
Lopez-Medina, C
Font-Ugalde, P
Escudero-Contreras, A
Collantes-Estevez, E

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BioMed Central
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Abstract

Several 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. We 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. Chest 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. Reliability 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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MeSH Terms

Female
Humans
Male
Middle Aged
Observer Variation
Physical Examination
Spondylitis, Ankylosing

DeCS Terms

Espondilitis anquilosante
Examen físico
Variaciones dependientes del observador

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Keywords

Ankylosing spondylitis, BASMI, Reliability, Reproducibility, Smallest detectable difference

Citation

Calvo-Gutiérrez J, Garrido-Castro JL, González-Navas C, Castro-Villegas MC, Ortega-Castro R, López-Medina C, et al. Inter-rater reliability of clinical mobility measures in ankylosing spondylitis. BMC Musculoskelet Disord. 2016 Sep 5;17(1):38