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Fongen C, Dagfinrud H, Berg IJ, Ramiro S, van Gaalen F, Landewé R, Ramonda R, van der Heijde D, Fagerli KM. Frequency of Impaired Spinal Mobility in Patients with Chronic Back Pain Compared to Patients with Early Axial Spondyloarthritis. J Rheumatol 2018; 45:1643-1650. [PMID: 29961689 DOI: 10.3899/jrheum.170786] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Camilla Fongen
- 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.
| | - Hanne Dagfinrud
- 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
| | - Inger Jorid Berg
- 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
| | - Sofia Ramiro
- 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
| | - Floris van Gaalen
- 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
| | - Robert Landewé
- 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
| | - Roberta Ramonda
- 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
| | - Désirée van der Heijde
- 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
| | - Karen Minde Fagerli
- 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
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