From the Norwegian National Advisory Unit on Rehabilitation in Rheumatology, and the Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Rheumatology, Leiden University Medical Center, Leiden; Department of Rheumatology, Amsterdam Medical Center, Amsterdam, the Netherlands; Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
C. Fongen, PT, MSc, Norwegian National Advisory Unit on Rehabilitation in Rheumatology and Department of Rheumatology, Diakonhjemmet Hospital; H. Dagfinrud, PT, PhD, Norwegian National Advisory Unit on Rehabilitation in Rheumatology and Department of Rheumatology, Diakonhjemmet Hospital; I.J. Berg, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; S. Ramiro, MD, PhD, Department of Rheumatology, Leiden University Medical Center; F. van Gaalen, MD, PhD, Department of Rheumatology, Leiden University Medical Center; R. Landewé, MD, PhD, Department of Rheumatology, Amsterdam Medical Center; R. Ramonda, MD, PhD, Rheumatology Unit, Department of Medicine, University of Padua; D. van der Heijde, MD, PhD; Department of Rheumatology, Leiden University Medical Center; K.M. Fagerli, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital.
J Rheumatol. 2018 Dec;45(12):1643-1650. doi: 10.3899/jrheum.170786. Epub 2018 Jul 1.
To examine the frequency of impaired spinal mobility in patients with chronic back pain of short duration and to compare it with the frequency of impaired spinal mobility in patients with axial spondyloarthritis (axSpA), possible SpA, and no SpA.
The SpondyloArthritis Caught Early (SPACE) cohort includes patients with chronic back pain (≥ 3 mos, ≤ 2 yrs, onset < 45 yrs). Spinal mobility was assessed with lateral spinal flexion, chest expansion, cervical rotation, occiput-to-wall distance, and lumbar flexion. Hip mobility was assessed with intermalleolar distance. Mobility measures were defined as impaired if below the 5th percentile reference curve from general population, adjusted for age and height when appropriate. Proportions of patients categorized with impaired mobility were examined with chi square.
In total, 393 patients with chronic back pain were included: 142 axSpA, 140 possible SpA, and 111 no SpA. Impairment in ≥ 1 mobility measure was present in 66% of all patients. The most frequently impaired mobility measure was lateral spinal flexion (40%), followed by chest expansion (22%), cervical rotation (18%), intermalleolar distance (17%), lumbar flexion (15%), and occiput-to-wall distance (11%). No statistically significant differences in proportion of patients with impaired spinal mobility were found between patients with axSpA and the other subgroups in any of the tests.
Two out of 3 patients with chronic back pain of short duration had impaired spinal mobility compared to the general population. Impaired spinal mobility occurs as often in patients with early axSpA as in other forms of chronic back pain.
研究短期慢性腰痛患者脊柱活动受限的频率，并将其与中轴型脊柱关节炎（axSpA）、可能的脊柱关节炎（possible SpA）和非脊柱关节炎（no SpA）患者的脊柱活动受限频率进行比较。
SpondyloArthritis Caught Early（SPACE）队列包括慢性腰痛患者（≥3 个月，≤2 年，发病年龄＜45 岁）。通过侧向脊柱前屈、胸廓扩张、颈椎旋转、枕骨到墙的距离和腰椎前屈评估脊柱活动度。通过踝间距离评估髋关节活动度。如果测量值低于一般人群的第 5 百分位参考曲线，并适当调整年龄和身高，则将其定义为活动受限。通过卡方检验检查归类为活动受限的患者比例。
共纳入 393 例慢性腰痛患者：142 例 axSpA、140 例可能的 SpA 和 111 例非 SpA。所有患者中，有 66%存在≥1 项活动受限测量。最常受影响的活动测量是侧向脊柱前屈（40%），其次是胸廓扩张（22%）、颈椎旋转（18%）、踝间距离（17%）、腰椎前屈（15%）和枕骨到墙的距离（11%）。在任何一项测试中，axSpA 患者与其他亚组患者的脊柱活动受限患者比例均无统计学差异。
与一般人群相比，短期慢性腰痛患者中有 2/3 存在脊柱活动受限。早期 axSpA 患者的脊柱活动受限与其他类型的慢性腰痛一样常见。
