Vlak Tonko
Odjel za fizikalnu medicinu, rehabilitaciju i reumatologiju Klinicka bolnica Split, Marmontova 4, 21000 Split.
Reumatizam. 2004;51(2):29-33.
Spondyloarthropathy is a group of chronic autoimmune disorders including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, acute anterior uveitis and undifferentiated spondyloarthropathies. The spondyloarthropathies share common clinical, radiological, and genetic features that are clearly distinct from other inflammatory rheumatic diseases. The major goal in the management of patients with rheumatic disorders is to control or cure the disease and to preserve and control function and health status. To measure treatments' efficacy standardized assessment of organ morphology, function, and of health status are required. The instruments for measuring health status or quality of life cover a variety of dimensions of health, including physical, social, and emotional functioning. Measurements used to evaluate the efficacy of treatments in ankylosing spondylitis include spinal and chest movement, duration and severity of morning stiffness, and quality of sleep. Health status indices such as the HAQ or AIMS are not readily applicable to spondyloarthropaties. It is reason to use some others: 1. Functional status measure S-HAQ for patients with spondylitis by adding five items to the HAQ, to cover the activities identified as most problematic; 2. Functional index for the assessment of ankylosing spondylitis (Dougados Functional Index - DFI) - it is valid and reliable and shows sufficient responsiveness; S-HAQ appears at least as sensitive to change as the Dougados Index; 3. The Leeds Disability Questionnaire assesses disability in ankylosing spondylitis, inquiring about four areas of function: mobility, bending down, reaching up and neck movements, and postures; 4. The Bath Ankylosing Spondylitis Functional Index (BASFI) 10 item self-administered questionnaire to assess function and activities of daily living in patients with ankylosing spondylitis. Physical therapy is one of the most important way to restore function and health status in patients with spondyloarthropathies, esspecially individual kinesitherapy. We use and many other procedures combine them with kinesitherapy (ultrasound, cryotherapy, electrotherapy, laser ...).
脊柱关节炎是一组慢性自身免疫性疾病，包括强直性脊柱炎、反应性关节炎、银屑病关节炎、与炎症性肠病相关的关节炎、急性前葡萄膜炎和未分化脊柱关节炎。脊柱关节炎具有共同的临床、放射学和遗传学特征，明显有别于其他炎性风湿性疾病。风湿性疾病患者管理的主要目标是控制或治愈疾病，以及维持和控制功能及健康状况。为衡量治疗效果，需要对器官形态、功能和健康状况进行标准化评估。用于测量健康状况或生活质量的工具涵盖健康的多个维度，包括身体、社会和情感功能。用于评估强直性脊柱炎治疗效果的测量指标包括脊柱和胸部活动度、晨僵持续时间和严重程度以及睡眠质量。健康状况指数如健康评估问卷（HAQ）或关节炎影响测量尺度（AIMS）并不容易适用于脊柱关节炎。有理由使用其他一些指标：1. 针对脊柱关节炎患者的功能状态测量指标简化健康评估问卷（S-HAQ），即在HAQ基础上增加五个项目，以涵盖被确定为最成问题的活动；2. 强直性脊柱炎评估功能指数（Dougados功能指数 - DFI）——它有效且可靠，并显示出足够的反应性；S-HAQ对变化的敏感性至少与Dougados指数相同；3. 利兹残疾问卷评估强直性脊柱炎患者的残疾情况，询问四个功能领域：活动能力、弯腰、伸手和颈部活动以及姿势；4. 巴斯强直性脊柱炎功能指数（BASFI）是一份10项自评问卷，用于评估强直性脊柱炎患者的功能和日常生活活动。物理治疗是恢复脊柱关节炎患者功能和健康状况的最重要方法之一，尤其是个体化运动疗法。我们使用多种其他程序，并将它们与运动疗法（超声、冷冻疗法、电疗法、激光……）相结合。
