Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis

Objective Patients with axial spondyloarthritis (axSpA) suffer from clinical symptoms like morning stiffness and back pain. Mobility of patients with axSpA is often impaired. The aim of this study is to compare the performance of patients with axSpA regarding mobility measures including performance-...

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Main Authors: Jürgen Braun, Xenofon Baraliakos, Uta Kiltz, Philipp Sewerin, David Kiefer, Ioana Andreica, Bjoern Buehring, Styliani Tsiami, Lucia Schneider, Niklas Kolle, Susanne Herbold
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/1/e003733.full
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author Jürgen Braun
Xenofon Baraliakos
Uta Kiltz
Philipp Sewerin
David Kiefer
Ioana Andreica
Bjoern Buehring
Styliani Tsiami
Lucia Schneider
Niklas Kolle
Susanne Herbold
author_facet Jürgen Braun
Xenofon Baraliakos
Uta Kiltz
Philipp Sewerin
David Kiefer
Ioana Andreica
Bjoern Buehring
Styliani Tsiami
Lucia Schneider
Niklas Kolle
Susanne Herbold
author_sort Jürgen Braun
collection DOAJ
description Objective Patients with axial spondyloarthritis (axSpA) suffer from clinical symptoms like morning stiffness and back pain. Mobility of patients with axSpA is often impaired. The aim of this study is to compare the performance of patients with axSpA regarding mobility measures including performance-based tests and objective electronic assessments with the Epionics SPINE device (ES) at different times of the day compared with healthy controls (HC).Methods Observational trial, consecutive inpatients with axSpA (n=100) and 20 HCs were examined in the morning (V1: before 10:00 am) and in the afternoon (V2: after 02:00 pm) by the Bath Ankylosing Spondylitis Metrology Index (BASMI), the AS physical performance index (ASPI), the Short Physical Performance Battery (SPPB) and ES measurements, including range of motion (RoM) and range of kinematics (RoK).Results The assessments of patients with axSpA performed in the morning clearly differed from those in the afternoon, especially regarding performance-based tests. Significant improvements were seen for BASMI (4.0±3.8 to 3.8±1.9; p<0.001), ASPI (36.2±18.3 to 28.8±11.9 s; p<0.001), SPPB (10.1±1.5 to 10.7±1.4 points; p<0.001) and for ES measures of speed (RoK; p<0.018) but not for RoM, except for lateral flexion (13.3±7.4 to 14.7±8.2°; p=0.002). This time of assessment-related variability was not observed in HC.Conclusion The spinal mobility of patients with axSpA was worse in the morning but significantly improved in the afternoon. This was captured best by performance-based measures and was not seen in HC. The diurnal variation of mobility has implications for clinical studies, suggesting that the time of assessments needs to be standardised.
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spelling doaj-art-629841712dbb41f18b736dfc00a688752025-08-20T01:48:47ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003733Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritisJürgen Braun0Xenofon Baraliakos1Uta Kiltz2Philipp Sewerin3David Kiefer4Ioana Andreica5Bjoern Buehring6Styliani Tsiami7Lucia Schneider8Niklas Kolle9Susanne Herbold102 Rheumatologisches Versorgungszentrum Steglitz (RVZ), Charité, Berlin, Germany3 Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Herne, GermanyRheumazentrum Ruhrgebiet, Herne, GermanyRheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, GermanyRheumatologie, Ruhr-Universitat Bochum, Bochum, GermanyRheumazentrum Ruhrgebiet, Herne, Nordrhein-Westfalen, GermanyKrankenhaus St. Josef, Wuppertal, GermanyRheumatology, Ruhr-Universität Bochum and Rheumazentrum Ruhrgebiet, Bochum, GermanyRuhr University Bochum, Bochum, Nordrhein-Westfalen, GermanyRuhr University Bochum, Bochum, Nordrhein-Westfalen, GermanyRuhr University Bochum, Bochum, Nordrhein-Westfalen, GermanyObjective Patients with axial spondyloarthritis (axSpA) suffer from clinical symptoms like morning stiffness and back pain. Mobility of patients with axSpA is often impaired. The aim of this study is to compare the performance of patients with axSpA regarding mobility measures including performance-based tests and objective electronic assessments with the Epionics SPINE device (ES) at different times of the day compared with healthy controls (HC).Methods Observational trial, consecutive inpatients with axSpA (n=100) and 20 HCs were examined in the morning (V1: before 10:00 am) and in the afternoon (V2: after 02:00 pm) by the Bath Ankylosing Spondylitis Metrology Index (BASMI), the AS physical performance index (ASPI), the Short Physical Performance Battery (SPPB) and ES measurements, including range of motion (RoM) and range of kinematics (RoK).Results The assessments of patients with axSpA performed in the morning clearly differed from those in the afternoon, especially regarding performance-based tests. Significant improvements were seen for BASMI (4.0±3.8 to 3.8±1.9; p<0.001), ASPI (36.2±18.3 to 28.8±11.9 s; p<0.001), SPPB (10.1±1.5 to 10.7±1.4 points; p<0.001) and for ES measures of speed (RoK; p<0.018) but not for RoM, except for lateral flexion (13.3±7.4 to 14.7±8.2°; p=0.002). This time of assessment-related variability was not observed in HC.Conclusion The spinal mobility of patients with axSpA was worse in the morning but significantly improved in the afternoon. This was captured best by performance-based measures and was not seen in HC. The diurnal variation of mobility has implications for clinical studies, suggesting that the time of assessments needs to be standardised.https://rmdopen.bmj.com/content/10/1/e003733.full
spellingShingle Jürgen Braun
Xenofon Baraliakos
Uta Kiltz
Philipp Sewerin
David Kiefer
Ioana Andreica
Bjoern Buehring
Styliani Tsiami
Lucia Schneider
Niklas Kolle
Susanne Herbold
Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
RMD Open
title Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
title_full Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
title_fullStr Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
title_full_unstemmed Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
title_short Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
title_sort clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis
url https://rmdopen.bmj.com/content/10/1/e003733.full
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