Measurement of spinal mobility in ankylosing spondylitis: comparison of occiput-to-wall and tragus-to-wall distance.
Measurement of spinal mobility in ankylosing spondylitis: comparison of occiput-to-wall and tragus-to-wall distance.
复制标题
强直性脊柱炎脊柱活动度的测量：枕骨到墙和耳屏到墙距离的比较。
DOI：
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发表时间：
2004
影响因子：
3.9
通讯作者：
D. M. van der Heijde
中科院分区：
文献类型：
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作者：
L. Heuft;D. Vosse;R. Landewé;A. Spoorenberg;M. Dougados;H. Mielants;H. van der Tempel;S. van der Linden;D. M. van der Heijde
目的
研究在强直性脊柱炎（AS）患者中，作为胸椎伸展的测量指标，耳屏-胸壁距离（TWD）是否比枕骨-胸壁距离（OWD）更可靠。
方法
使用了来自OASIS队列的数据，这是一项关于AS结局的国际纵向观察性研究。在基线和6、12、18和24个月时测量OWD和TWD。Tx和Tx+6个月的配对数据用于进行重测测量（组内相关性、一致性限度和周期间相关性矩阵）。构建Bland和Altman图，以研究两个观察结果之间的一致性，假设0和6个月之间没有真实变化。为了研究疾病活动性的变化是否会影响结果，计算了T0和T6之间Bath强直性脊柱炎疾病活动指数（BASDAI;定义为最大BASDAI变化+/- 1）稳定的患者亚组的一致性限度，并与整个组的结果进行比较。还仅计算了脊柱后凸患者的一致性限度。
结果
重测组内相关系数OWD在0.94 ~ 0.96之间，TWD在0.93 ~ 0.95之间。通过期间相关回归线外推计算的直接测量-再测量相关系数为0.92，OWD为0.90。OWD和TWD在整个评分值上表现出相当的可靠性。OWD的95%一致性下限为-3.4 cm至-2.5 cm，TWD的95%一致性下限为-3.4 cm至-3.1 cm。OWD的一致性上限为3.1 cm至4.2 cm，TWD的一致性上限为2.9 cm至3.9 cm。在所有患者以及仅在脊柱后凸患者中，OWD和TWD之间的一致性限度相当。根据Bland和Altman的散点图，OWD和TWD的模式相似。与正常胸椎伸展的患者相比，后凸患者的测量误差更明显。然而，在整个脊柱后凸范围内，测量误差相似。
结论
OWD和TWD在评估胸椎伸展方面同样可靠。尽管与OWD相比，TWD通常更容易在AS患者中进行，但我们建议OWD测量优于TWD：在OWD测量中，零值很容易区分胸椎正常伸展的患者与脊柱后凸患者。
OBJECTIVE
To investigate if the tragus-to-wall distance (TWD) is more reliable compared to the occiput-to-wall distance (OWD) as a measurement for thoracic spine extension in patients with ankylosing spondylitis (AS).
METHODS
Data from the OASIS cohort, an international longitudinal observational study on outcome in AS, were used. Measurements of OWD and TWD were performed at baseline and at 6, 12, 18, and 24 months. Paired data of Tx and Tx+6 months were used to perform test-retest measurements (intraclass correlations, limits of agreement, and interperiod correlation matrix). Bland and Altman plots were constructed to investigate the agreement between both observations, assuming that there was no true change between 0 and 6 months. To investigate whether a change in disease activity would have influenced the results, limits of agreement were calculated in a subgroup of patients with a stable Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; defined as a maximum BASDAI change of +/- 1) between T0 and T6 and compared with the results of the whole group. Limits of agreement were also calculated for kyphosed patients only.
RESULTS
The test-retest intraclass correlations were between 0.94 and 0.96 for OWD and between 0.93 and 0.95 for TWD. The direct measurement-remeasurement correlation calculated by extrapolation of the interperiod correlation regression line was 0.92 for OWD and 0.90 for TWD. OWD and TWD showed comparable reliability on the entire value of scores. The lower 95% limit of agreement was between -3.4 cm and -2.5 cm for OWD and between -3.4 cm and -3.1 cm for TWD. The upper limit of agreement was between 3.1 cm and 4.2 cm for OWD and between 2.9 cm and 3.9 cm for TWD. In all patients as well as in kyphosed patients only, limits of agreement were comparable between OWD and TWD. The patterns of the scatterplots according to Bland and Altman were similar for OWD and TWD. Measurement error was more pronounced in kyphosed patients compared to patients with a normal thoracic extension. However, over the entire range of kyphosis, measurement error was similar.
CONCLUSION
OWD and TWD are equally reliable in assessing thoracic spine extension. Although the TWD is in general easier to perform in AS patients compared to OWD, we recommend the OWD measurement over TWD: in OWD measurement a value of zero easily distinguishes patients with normal thoracic spine extension from kyphosed patients.