Rahali-Khachlouf H, Poiraudeau S, Fermanian J, Ben Salah F Z, Dziri C, Revel M
Service de médecine physique et réadaptation fonctionnelle, Institut national dorthopédie Kassab Mannouba, Tunis, Tunisie
Ann Readapt Med Phys. 2001 May;44(4):205-12. doi: 10.1016/s0168-6054(01)00091-5.
To evaluate the validity and the reliability of the main clinical measures of mobility and sagittal spinal curves in ankylosing spondylitis (AS).
Criterion validity of the measure of the distance between C7 spinous process to plumbline (dorsal kyphosis), L3-plumb line (lumbar lordosis), lumbar, dorsolumbar and dorsal mobility. The gold standard was the value obtained from lateral radiological views of the dorsal and lumbar spine in standing position and maximum flexion. The correlation between radiological and clinical measures was assessed by a Spearman correlation coefficient (SCC). The reliability was assessed for all the clinical parameters and for chin-sternum distance (flexion, extension), chin-acromion distance (rotations) and chest expansion using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Were included patients with AS and needing dorsal and lumbar Xrays.
Twenty-two patients (21 men), 32 +/- 11 year old, 51 +/- 10 kg weight, with a mean duration of the disease of 120 +/- 60 months. The ICC values were good or excellent for all parameters except for the measures of dorsal mobility. The validity was evaluated in 18 patients. The value of the SCC between clinical and radiological measures was good except the measures of dorsal kyphosis and dorsal mobility.
The clinical measures of mobility and sagittal curves have metrological properties good enough to be used in the monitoring of AS mainly for the follow-up and the evaluation of the rehabilitation. The measurement of dorsal mobility should be restricted to the lower part only. Although apparently not valid the distance C7-plumbline can be used in management of AS because of its excellent reliability.
评估强直性脊柱炎（AS）中主要的活动度和矢状位脊柱曲度临床测量方法的有效性和可靠性。
评估C7棘突至铅垂线距离（背侧后凸）、L3铅垂线（腰椎前凸）、腰椎、胸腰段和背部活动度测量方法的标准效度。金标准是站立位和最大屈曲位时胸腰椎侧位X线片获得的值。通过Spearman相关系数（SCC）评估影像学测量与临床测量之间的相关性。使用组内相关系数（ICC）以及Bland和Altman方法评估所有临床参数、颏-胸骨距离（屈曲、伸展）、颏-肩峰距离（旋转）和胸廓扩张度的可靠性。纳入需要进行胸腰椎X线检查的AS患者。
22例患者（21例男性），年龄32±11岁，体重51±10 kg，疾病平均病程120±60个月。除背部活动度测量外，所有参数的ICC值均为良好或优秀。对18例患者进行了效度评估。临床测量与影像学测量之间的SCC值良好，除了背侧后凸和背部活动度测量。
活动度和矢状位曲线的临床测量方法具有足够好的计量学特性，可用于AS的监测，主要用于随访和康复评估。背部活动度测量应仅限制在下部。尽管C7至铅垂线距离显然无效，但因其可靠性极佳，可用于AS的管理。
