Viitanen J V, Kokko M L, Lehtinen K, Suni J, Kautiainen H
Department of Clinical Medicine, University of Tampere, Finland.
Spine (Phila Pa 1976). 1995 Feb 15;20(4):492-6. doi: 10.1097/00007632-199502001-00015.
In 151 adult patients with ankylosing spondylitis who participated in an inpatient rehabilitation program of 3-4 weeks, 10 different range of motion (ROM) values were measured, and their lumbar spine and sacroiliac joints were radiographed.
To determine whether a correlation obtained between restriction of ROM and progression of radiologic findings in ankylosing spondylitis, together with a high enough reliability level in measurements.
A significant correlation was observed between the restriction of eight ROMs: the Schober test, thoracolumbar rotation, thoracolumbar flexion, cervical rotation, occiput-wall distance, chin-chest distance, chest expansion, finger-floor distance, and overall radiologic changes in both lumbar spine and sacroiliac joints; straight leg raise did not correlate, and vital capacity only with sacroiliac joint changes. Spearman's correlation coefficients for ROMs were slightly higher to lumbar spine changes than to sacroiliac joint changes. A corresponding correlation was also observed between spinal mobility restrictions and six detailed changes in lumbar roentgenogram: syndesmophytes, apophyseal arthritis, sclerotic anterior borders of vertebrae, straightened anterior surface of vertebrae, and ossification of interspinous and anterior longitudinal ligaments. Other detailed lumbar spine findings did not correlate. As assessed by erythrocyte sedimentation rate values the disease activity increased in the course of radiologic progression, decreasing again, however, to the end stage.
Conventional methods with a tape and (Myrin) inclinometer were used to measure thoracolumbar flexion, cervical rotation, occiput-wall distance, chin-chest distance, finger-floor distance, chest expansion, vital capacity, and straight leg raise. In addition, a new method of thoracolumbar rotation and a new modification of the Schober test were introduced. Thirty-nine patients were randomized for a reliability assessment using repeated measurements of ROMs. Radiologic changes were evaluated (in a masked fashion) using the method of Dale and Vinje.
The reliability of all ROMs was good (except for interrater intraclass correlation coefficients of chest expansion: 0.53).
The clear correlation between radiologic sacroiliac joint and lumbar spine progression and eight ROMs showed that these are useful noninvasive measurements of disease progression and severity in ankylosing spondylitis that can be used in daily practice.
在151名参与为期3 - 4周住院康复项目的成年强直性脊柱炎患者中，测量了10种不同的活动范围（ROM）值，并对他们的腰椎和骶髂关节进行了X光检查。
确定强直性脊柱炎中ROM受限与放射学检查结果进展之间是否存在相关性，以及测量结果是否具有足够高的可靠性。
观察到8种ROM受限情况与腰椎和骶髂关节的总体放射学变化之间存在显著相关性，这8种ROM分别是：Schober试验、胸腰段旋转、胸腰段前屈、颈椎旋转、枕墙距、颏胸距、胸廓扩张度、指尖触地距离；直腿抬高与放射学变化无相关性，肺活量仅与骶髂关节变化相关。ROM的Spearman相关系数与腰椎变化的相关性略高于与骶髂关节变化的相关性。在脊柱活动受限与腰椎X线片的6项详细变化之间也观察到了相应的相关性，这些变化包括：韧带骨赘、关节突关节炎、椎体前缘硬化、椎体前表面变直以及棘间韧带和前纵韧带骨化。腰椎的其他详细检查结果无相关性。通过红细胞沉降率值评估，疾病活动度在放射学进展过程中增加，但在末期又再次下降。
使用卷尺和（Myrin）倾角仪等传统方法测量胸腰段前屈、颈椎旋转、枕墙距、颏胸距、指尖触地距离、胸廓扩张度、肺活量和直腿抬高。此外，引入了一种新的胸腰段旋转测量方法和Schober试验的一种新改良方法。39名患者被随机分组，通过重复测量ROM进行可靠性评估。使用Dale和Vinje的方法（以盲法）评估放射学变化。
所有ROM的可靠性良好（胸廓扩张度的组间类内相关系数除外：0.53）。
放射学骶髂关节和腰椎进展与8种ROM之间的明确相关性表明，这些是强直性脊柱炎疾病进展和严重程度的有用无创测量方法，可用于日常实践。
