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首页> 外文期刊>The Journal of rheumatology >Measurement of spinal mobility in ankylosing spondylitis: comparison of occiput-to-wall and tragus-to-wall distance.
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Measurement of spinal mobility in ankylosing spondylitis: comparison of occiput-to-wall and tragus-to-wall distance.

机译：强直性脊柱炎中脊柱活动度的测量：枕骨至壁和耳屏至壁距离的比较。

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OBJECTIVE: To investigate if the tragus-to-wall distance (TWD) is more reliable compared to the occiput-to-wall distance (OWD) as a measurement for thoracic spine extension in patients with ankylosing spondylitis (AS). METHODS: Data from the OASIS cohort, an international longitudinal observational study on outcome in AS, were used. Measurements of OWD and TWD were performed at baseline and at 6, 12, 18, and 24 months. Paired data of Tx and Tx+6 months were used to perform test-retest measurements (intraclass correlations, limits of agreement, and interperiod correlation matrix). Bland and Altman plots were constructed to investigate the agreement between both observations, assuming that there was no true change between 0 and 6 months. To investigate whether a change in disease activity would have influenced the results, limits of agreement were calculated in a subgroup of patients with a stable Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; defined as a maximum BASDAI change of +/- 1) between T0 and T6 and compared with the results of the whole group. Limits of agreement were also calculated for kyphosed patients only. RESULTS: The test-retest intraclass correlations were between 0.94 and 0.96 for OWD and between 0.93 and 0.95 for TWD. The direct measurement-remeasurement correlation calculated by extrapolation of the interperiod correlation regression line was 0.92 for OWD and 0.90 for TWD. OWD and TWD showed comparable reliability on the entire value of scores. The lower 95% limit of agreement was between -3.4 cm and -2.5 cm for OWD and between -3.4 cm and -3.1 cm for TWD. The upper limit of agreement was between 3.1 cm and 4.2 cm for OWD and between 2.9 cm and 3.9 cm for TWD. In all patients as well as in kyphosed patients only, limits of agreement were comparable between OWD and TWD. The patterns of the scatterplots according to Bland and Altman were similar for OWD and TWD. Measurement error was more pronounced in kyphosed patients compared to patients with a normal thoracic extension. However, over the entire range of kyphosis, measurement error was similar. CONCLUSION: OWD and TWD are equally reliable in assessing thoracic spine extension. Although the TWD is in general easier to perform in AS patients compared to OWD, we recommend the OWD measurement over TWD: in OWD measurement a value of zero easily distinguishes patients with normal thoracic spine extension from kyphosed patients.
机译：目的：探讨对于强直性脊柱炎（AS）患者的胸椎伸展度，耳屏到墙距离（TWD）是否比枕骨到墙距离（OWD）更可靠。方法：使用来自OASIS队列的数据，该队列是关于AS结局的国际纵向观察研究。在基线以及第6、12、18和24个月进行OWD和TWD的测量。 Tx和Tx + 6个月的配对数据用于执行重测测试（类内相关性，一致性限制和期间相关性矩阵）。假设在0到6个月之间没有真实变化，构建了Bland和Altman图以调查两个观察值之间的一致性。为了研究疾病活动的变化是否会对结果产生影响，计算了T0至T0之间稳定的巴斯强直性脊柱炎疾病活动指数（BASDAI;定义为最大BASDAI变化+/- 1）的亚组患者的同意限。和T6并与整个小组的结果进行比较。还仅针对驼背型患者计算了一致极限。结果：测验组内相关性对于OWD为0.94至0.96，而TWD为0.93至0.95。通过期间相关回归线的外推计算得出的直接测量-重新测量相关性对于OWD为0.92，对于TWD为0.90。 OWD和TWD在整个分数上显示出可比的可靠性。 OWD的一致性下限95％在-3.4 cm至-2.5 cm之间，而TWD在-3.4 cm至-3.1 cm之间。 OWD的一致性上限为3.1厘米至4.2厘米，TWD的一致性上限为2.9厘米至3.9厘米。在所有患者以及仅在脊椎后凸患者中，OWD和TWD之间的一致限均相当。对于OWD和TWD，根据Bland和Altman的散点图模式相似。与正常胸廓扩张的患者相比，后凸畸形患者的测量误差更为明显。但是，在驼背的整个范围内，测量误差相似。结论：OWD和TWD在评估胸椎伸展度方面同样可靠。尽管与OWD相比，TWD在AS患者中通常更容易执行，但我们建议使用OWD测量而不是TWD：在OWD测量中，零值可以轻松地区分正常脊柱伸展患者和后凸患者。

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