Mogard Elisabeth, Lindqvist Elisabet, Bergman Stefan, Bremander Ann
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
Department of Rheumatology, Skåne University Hospital, Lund, Sweden.
Musculoskeletal Care. 2017 Mar;15(1):36-48. doi: 10.1002/msc.1138. Epub 2016 Feb 24.
Research concerning spinal mobility in axial spondyloarthritis (axSpA) has focused on ankylosing spondylitis (AS), and data on the clinical diagnosis of undifferentiated spondyloarthritis (USpA) are limited. The objective was to study differences in spinal mobility between axSpA subgroups AS and USpA, including gender differences.
A total of 183 patients with axSpA from a rheumatology clinic were included in the study. The earliest recorded spinal mobility measures (cervical rotation/flexion/extension/lateral flexion, tragus-to-wall distance, vital capacity, chest expansion, thoracic flexion, thoracolumbar flexion, lateral spinal flexion, lumbar flexion and intermalleolar distance) were obtained by specialized physiotherapists. Differences between subgroups were analysed using analysis of covariance, controlled for gender and disease duration.
In the USpA group (n = 57), the mean [standard deviation (SD)] age was 41.6 (11.4) years, and disease duration was 13 (10.6) years, with 54% men. In the AS group (n = 126), the mean (SD) age was 48.4 (13.5) years, and disease duration 24.6 (13.3) years, with 77% men. Spinal mobility was less restricted in USpA versus AS patients (p ≤ 0.05), with a median (interquartile range) tragus-to-wall distance of 11 (10-12) cm versus 13 (11.3-18.5) cm; thoracolumbar flexion 9 (7-10) cm versus 6.5 (4-9) cm; lateral spinal flexion 29 (25-36) cm versus 21.3 (12-31) cm; lumbar flexion 4.5 (3.5-5.0) cm versus 3.5 (2.0-4.5) cm and intermalleolar distance 113 (102-121) cm versus 101 (86-114) cm. There were no differences between the subgroups in cervical mobility, vital capacity, chest expansion or thoracic flexion, and there were few gender differences, besides anthropometric measures.
Patients with USpA and AS had similar cervical and chest mobility, while thoracic and lumbar mobility were more severely restricted in AS. There were few gender differences in either subgroup. Further studies, to understand the full impact of USpA on spinal mobility, are needed. Copyright © 2016 John Wiley & Sons, Ltd.
关于中轴型脊柱关节炎（axSpA）脊柱活动度的研究主要集中在强直性脊柱炎（AS），而关于未分化脊柱关节炎（USpA）临床诊断的数据有限。本研究旨在探讨axSpA亚组AS和USpA之间脊柱活动度的差异，包括性别差异。
本研究纳入了一家风湿病诊所的183例axSpA患者。最早记录的脊柱活动度指标（颈椎旋转/前屈/后伸/侧屈、耳屏至墙距离、肺活量、胸廓扩张度、胸椎前屈、胸腰段前屈、脊柱侧屈、腰椎前屈和内踝间距）由专业物理治疗师获取。采用协方差分析对亚组间差异进行分析，并对性别和病程进行校正。
USpA组（n = 57）平均[标准差（SD）]年龄为41.6（11.4）岁，病程为13（10.6）年，男性占54%。AS组（n = 126）平均（SD）年龄为48.4（13.5）岁，病程为24.6（13.3）年，男性占77%。与AS患者相比，USpA患者的脊柱活动度受限程度较轻（p≤0.05），耳屏至墙距离中位数（四分位间距）为11（10 - 12）cm，而AS组为13（11.3 - 18.5）cm；胸腰段前屈分别为9（7 - 10）cm和6.5（4 - 9）cm；脊柱侧屈分别为29（25 - 36）cm和21.3（12 - 31）cm；腰椎前屈分别为4.5（3.5 - 5.0）cm和3.5（2.0 - 4.5）cm；内踝间距分别为113（102 - 121）cm和101（86 - 114）cm。亚组间在颈椎活动度、肺活量、胸廓扩张度或胸椎前屈方面无差异，除人体测量指标外，性别差异也很少。
USpA和AS患者的颈椎和胸廓活动度相似，而AS患者的胸段和腰段活动度受限更为严重。两个亚组中性别差异均较少。需要进一步研究以全面了解USpA对脊柱活动度的影响。版权所有© 2016约翰威立父子有限公司。
