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van Bentum RE, Ibáñez Vodnizza SE, Poblete de la Fuente MP, Valenzuela Aldridge F, Navarro-Compán V, Rusman TR, Ter Wee MM, Valenzuela Letelier O, van Weely SFE, van der Horst-Bruinsma IE. The Ankylosing Spondylitis Performance Index: Reliability and Feasibility of an Objective Test for Physical Functioning. J Rheumatol 2020; 47:1475-1482. [PMID: 32007935 DOI: 10.3899/jrheum.191063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Physical function in patients with axial spondyloarthritis (axSpA) is currently evaluated through questionnaires. The Ankylosing Spondylitis Performance Index (ASPI) is a performance-based measure for physical functioning, which has been validated in Dutch patients with radiographic (r-) axSpA. The interrater reliability has not yet been determined. To our knowledge, this study is the first to evaluate the validity, reliability, and feasibility of the ASPI in another patient population, including both r- and nonradiographic (nr-) axSpA patients. METHODS Patients with axSpA were recruited from rheumatology clinics in Santiago, Chile. Dutch instructions were translated to Spanish by a forward-backward procedure. Study visits were performed at baseline and 1-4 weeks later. Four ASPI observers were involved, measuring the performance times of the 3 ASPI tests. Validity was assessed through a patient questionnaire (numeric rating scale 0-10: ≥ 6 sufficient). For reliability, intraclass correlation coefficients (ICC) were calculated (with 95% CI). Correlations between the ASPI and disease variables were tested with regression analyses. RESULTS Sixty-eight patients were included (57% male, 52% r-axSpA). All patients understood the Spanish instructions and considered the ASPI to reach its aim (84%) and representativeness (85%) for physical functioning. The overall interrater (n = 62) and test-retest (n = 39) reliability (ICC) of the 3 tests combined were 0.93 (0.88-0.96) and 0.94 (0.87-0.97), respectively. Eighty-two percent of the patients completed all tests and 94% finished in < 15 min (feasibility). CONCLUSION This study demonstrated a high validity and feasibility in an entirely different population, with both r-axSpA and nr-axSpA. The interrater and test-retest reliability was excellent. The ASPI instructions are now available for Spanish-speaking patients.
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Affiliation(s)
- Rianne E van Bentum
- R.E. van Bentum, MD, T.R. Rusman, MSc, I.E. van der Horst-Bruinsma, MD, PhD, Professor, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam, the Netherlands
| | - Sebastian E Ibáñez Vodnizza
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Maria P Poblete de la Fuente
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Francisca Valenzuela Aldridge
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Victoria Navarro-Compán
- V. Navarro-Compán, MD, PhD, Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain
| | - Tamara R Rusman
- R.E. van Bentum, MD, T.R. Rusman, MSc, I.E. van der Horst-Bruinsma, MD, PhD, Professor, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marieke M Ter Wee
- M.M. ter Wee, PhD, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, and Department of Epidemiology & Biostatistics, Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam
| | - Omar Valenzuela Letelier
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Salima F E van Weely
- S.F. van Weely, PhD, Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Centre, Leiden, the Netherlands
| | - Irene E van der Horst-Bruinsma
- R.E. van Bentum, MD, T.R. Rusman, MSc, I.E. van der Horst-Bruinsma, MD, PhD, Professor, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam, the Netherlands;
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Mogard E, Lindqvist E, Bergman S, Bremander A. Spinal Mobility in Axial Spondyloarthritis: A Cross-Sectional Clinical Study. Musculoskeletal Care 2016; 15:36-48. [PMID: 26916253 DOI: 10.1002/msc.1138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Elisabeth Mogard
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Department of Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Elisabet Lindqvist
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Department of Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Stefan Bergman
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Spenshult Research and Development Center, Halmstad, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Bremander
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,School of Business Engineering and Science, Halmstad University, Halmstad, Sweden.,Spenshult Research and Development Center, Halmstad, Sweden
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Farzad M, Layeghi F, Asgari A, Hosseini SA, Rassafiani M. Evaluation of Non Diseased Specified Outcome Measures in Hand Injuries to Assess Activity and Participation Based on ICF Content. J Hand Microsurg 2013; 6:27-34. [PMID: 24876687 DOI: 10.1007/s12593-013-0109-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 11/11/2013] [Indexed: 01/09/2023] Open
Abstract
The objective of the study is to provide information about non disease specified outcome measures which evaluate disability in patients who have impairments in hand and upper extremity and to find the extent to which they are evaluating "disability" based on ICF hand Core Set (activity limitation and participation restriction). MEDLINE, CINAHL, GOOGLE SCHOLAR , OVID and SCIENCE DIRECT databases were systematically searched for studies on non disease specified outcome measures used to evaluate upper extremity function; only studies written in English were considered. We reviewed titles and abstracts of the identified studies to determine whether the studies met predefined eligibility criteria (eg, non disease specified out come measures used in hand injured patients). All the outcome measures which had eligibility included. After full text review ,7 non disease specified outcome measures in hand were identified. Studies were extracted, and the information retrieved from them. All the outcome measures which had incuded, were linked with ICF hand core set disability part (activity and participation). All of them only linked to 16 (42 %) components of ICF hand Core Set, which were most activity and less participation from ICF. None of the non disease specified out come measures in hand injuries cover all domains of disability from the ICF Hand Core Set.
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Affiliation(s)
- Maryam Farzad
- Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran, Iran 1985713831
| | - Fereydoun Layeghi
- Department of Clinical Sciences, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran, Iran 1985713831
| | - Ali Asgari
- Department of Educational Pshychology, The University of Kharazmi, Khaghani St, Tehran, Iran
| | - Seyed Ali Hosseini
- Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran, Iran 1985713831
| | - Mehdi Rassafiani
- Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran, Iran 1985713831
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Ward MM, Learch TJ, Gensler LS, Davis JC, Reveille JD, Weisman MH. Regional radiographic damage and functional limitations in patients with ankylosing spondylitis: differences in early and late disease. Arthritis Care Res (Hoboken) 2013; 65:257-65. [PMID: 23042639 PMCID: PMC3541454 DOI: 10.1002/acr.21821] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/31/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Both radiographic damage and functional limitations increase with the duration of ankylosing spondylitis (AS). We examined whether radiographic damage contributed more to functional limitations in late AS than in early AS, and if the strength of association varied with the anatomic region of damage. METHODS In this cross-sectional study of 801 patients with AS, we examined associations of the lumbar modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), the cervical mSASSS, lumbar posterior fusion, cervical posterior fusion, and hip arthritis with the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Health Assessment Questionnaire modified for the spondyloarthritides (HAQ-S). RESULTS Higher lumbar and cervical mSASSS scores were associated with more functional limitations, but there was an interaction between mSASSS scores and the duration of AS, such that the strength of their association with functional limitations decreased with increasing duration of AS. Cervical posterior fusion was associated with worse functioning independent of mSASSS scores. Hip arthritis was significantly associated with functional limitations independent of spinal damage measures. Among patients with AS duration ≥40 years, the number of comorbid conditions accounted for most of the variation in functioning. Results were similar for both the BASFI and the HAQ-S. CONCLUSION Although both radiographic damage and functional limitations increase over time in AS, the relative contribution of radiographic damage to functional limitations is lower among patients with longstanding AS than with early AS, suggesting patients may accommodate to limited flexibility. Damage in different skeletal regions impacts functioning over the duration of AS. Functional limitations due to comorbidity supervene in late AS.
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Affiliation(s)
- Michael M Ward
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD 20892-1468, USA.
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Lundälv J, Larsson PO, Törnbom M, Sunnerhagen KS. The ICF: International Classification of Functioning, Disability and Health (ICF)--a Swiss army knife? Accessibility and disability in a Scandinavian disability magazine (SDM)--a quantitative content analysis. Health Policy 2012; 108:67-75. [PMID: 22975119 DOI: 10.1016/j.healthpol.2012.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 07/19/2012] [Accepted: 07/27/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The study describes the extent to which the concept of accessibility and accessibility issues has been reported in a national Scandinavian disability magazine. In this study particular attention is paid to how the compatibility between the various domains of the international classification - International Classification of Functioning, Disability and Health (ICF) - has been covered in the magazine over a decade. Furthermore, other types of descriptions that the magazine has made of accessibility for people with physical disabilities are considered. METHODS The study is based on a quantitative content analysis of a total of 326 articles from the Swedish disability magazine (SDM); 450 text pages published during the years 2000-2009. The magazine's coverage has been comprehensive. RESULTS AND CONCLUSIONS More than half of the studied texts were news items about various accessibility issues. Every third article can be characterised as a news article or feature article. The most frequently reported of the ICF domains consist of two perspectives: environmental accessibility and civil rights. Public opinion articles in the form of letters to editors and editorials focused on accessibility have a low frequency. Likewise, research reports are few. The study has included a review of illustrations and photographs. The illustrations are generally of high quality, reinforcing the disability message of the article.
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Affiliation(s)
- Jörgen Lundälv
- Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
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