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Epionics SPINE – Anwendung einer objektiven Untersuchungsmethode der Wirbelsäulenbeweglichkeit bei Patienten mit axialer Spondyloarthritis

Epionics SPINE—use of an objective method to examine spinal mobility in patients with axial spondyloarthritis

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An Erratum to this article was published on 20 September 2019

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Zusammenfassung

Die axiale Spondyloarthritis (axSpA) ist eine chronisch entzündliche Erkrankung der Wirbelsäule, die langfristig mit einem Verlust körperlicher Funktionen, der Beweglichkeit und der aufrechten Haltung einhergehen kann. Bisher gängige Methoden zur Messung der Beweglichkeit basieren zum einen auf subjektiver Patientenwahrnehmung, wobei verschiedene Funktionen durch standardisierte Fragebögen (BASFI) semiquantitativ erfasst werden, und zum anderen werden im Rahmen einer körperlichen Untersuchung verschiedene Bewegungsbereiche v. a. des Achsenskeletts vermessen (BASMI). Vor Kurzem kam der erste Test hinzu, mit dem die Durchführung und Geschwindigkeit bestimmter Aufgaben erfasst werden kann (ASPI). Da diese Tests nur begrenzt verlässlich und reproduzierbar sind, wäre ein objektiverer Test wünschenswert. In der hier berichteten Studie wurde die Mobilität der Wirbelsäule (WS) von Patienten mit axSpA mit dem Epionics SPINE-Gerät (ES) quantitativ untersucht und anhand der OMERACT(outcome measures in rheumatology)-Kriterien evaluiert. Das Gerät misst verschiedene Bewegungsmuster der Wirbelsäule anhand elektronischer Sensoren automatisiert, das schließt die Geschwindigkeit der Bewegungsdurchführung ein. Als Kontrollen dienten Patienten mit Rückenschmerzen anderer Genese und Menschen ohne Rückenschmerzen. Die mit ES erhobenen Messungen unterschieden sich zwischen den Gruppen und korrelierten mit den BASMI-Werten (r =0,53–0,82, alle p = <0,03). Röntgenologische axSpA-Patienten hatten zudem eine eingeschränktere und langsamere Beweglichkeit als die mit nr-axSpA. Insgesamt sprechen die Ergebnisse dieser Arbeit dafür, dass Messungen mit dem ES ein valides und objektives Messverfahren der Wirbelsäulenbeweglichkeit für axSpA-Patienten darstellen.

Abstract

Axial spondylarthritis (axSpA) is a chronic inflammatory disease of the spine that can be associated with loss of physical function, mobility and upright postural impairment. Established tools for the assessment of function that are largely based on subjective perception are semiquantitatively recorded by standardized questionnaires (Bath ankylosing spondylitis functional index, BASFI), while measurement of spinal mobility of patients with axSpA is based on physical examination of various movement regions particularly the axial skeleton (Bath ankylosing spondylitis metrology index, BASMI). Recently, a performance test has been added to assess the range of motion and speed of certain tasks (AS performance-based improved test, ASPI); however, since these tests have limited reliability and reproducibility, more objective tests would be desirable. In this study the spinal mobility of patients with axSpA was quantified using the Epionics SPINE device (ES) and data were evaluated using the outcome measures in rheumatology (OMERACT) criteria. The ES automatically measures various patterns of spinal movements using electronic sensors, which also assess the range and speed of carrying out movements. Patients with back pain from other causes and persons without back pain served as controls. The measurement results obtained with ES differed between the groups and correlated with BASMI values (r = 0.53–0.82, all p = <0.03). Patients with radiographically detectable axSpA had more limited and slower mobility than those with non-radiographically detectable axSpA. Overall, the results presented here suggest that ES measurements represent a valid and objective measurement procedure of spinal mobility for axSpA patients.

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Change history

  • 20 September 2019

    <Emphasis Type="Bold">Erratum zu:</Emphasis>

    <Emphasis Type="Bold">Z Rheumatol 2019</Emphasis>

    <ExternalRef><RefSource>https://doi.org/10.1007/s00393-019-00692-3</RefSource><RefTarget Address="10.1007/s00393-019-00692-3" TargetType="DOI"/></ExternalRef>

    Im ursprünglichen Artikel wurde der Name der Autorin U. Kiltz falsch geschrieben. Der Artikel wurde korrigiert.

    Bitte beachten Sie die korrigierte …

Literatur

  1. Braun J, Sieper J (2007) Ankylosing spondylitis. Lancet 369:1379–1390

    Article  PubMed  Google Scholar 

  2. Sieper J, Poddubnyy D (2017) Axial spondyloarthritis. Lancet 390:73–84

    Article  PubMed  Google Scholar 

  3. Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, Dougados M, Huang F, Gu J, Kirazli Y, Van den Bosch F, Olivieri I et al (2011) The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis 70:25–31

    Article  CAS  PubMed  Google Scholar 

  4. Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, Braun J, Chou CT, Collantes-Estevez E, Dougados M, Huang F, Gu J et al (2009) The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68:777–783

    Article  CAS  PubMed  Google Scholar 

  5. Kiltz U, Baraliakos X, Karakostas P, Igelmann M, Kalthoff L, Klink C, Krause D, Schmitz-Bortz E, Florecke M, Bollow M, Braun J (2012) Do patients with non-radiographic axial spondylarthritis differ from patients with ankylosing spondylitis? Arthritis Care Res (Hoboken) 64:1415–1422

    Article  Google Scholar 

  6. Keat A, Bennett AN, Gaffney K, Marzo-Ortega H, Sengupta R, Everiss T (2017) Should axial spondyloarthritis without radiographic changes be treated with anti-TNF agents? Rheumatol Int 37:327–336

    Article  PubMed  Google Scholar 

  7. Braun J, Bollow M, Eggens U, Konig H, Distler A, Sieper J (1994) Use of dynamic magnetic resonance imaging with fast imaging in the detection of early and advanced sacroiliitis in spondylarthropathy patients. Arthritis Rheum 37:1039–1045

    Article  CAS  PubMed  Google Scholar 

  8. Braun J, Bollow M, Sieper J (1998) Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin North Am 24:697–735

    Article  CAS  PubMed  Google Scholar 

  9. Machado P, Landewe R, Braun J, Hermann KG, Baker D, van der Heijde D (2010) Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis. Ann Rheum Dis 69:1465–1470

    Article  PubMed  Google Scholar 

  10. Landewe R, Dougados M, Mielants H, van der Tempel H, van der Heijde D (2009) Physical function in ankylosing spondylitis is independently determined by both disease activity and radiographic damage of the spine. Ann Rheum Dis 68:863–867

    Article  CAS  PubMed  Google Scholar 

  11. Poddubnyy D, Haibel H, Listing J, Braun J, Rudwaleit M, Sieper J (2013) FRI0436 Radiographic spinal progression and clinical disease activity are both relevant for the functional outcome in patients with early axial spondyloarthritis. Ann Rheum Dis 72:A522–A522

    Article  Google Scholar 

  12. Protopopov M, Sieper J, Haibel H, Listing J, Rudwaleit M, Poddubnyy D (2017) Relevance of structural damage in the sacroiliac joints for the functional status and spinal mobility in patients with axial spondyloarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Res Ther 19:240

    Article  PubMed  PubMed Central  Google Scholar 

  13. Zink A, Braun J, Listing J, Wollenhaupt J (2000) Disability and handicap in rheumatoid arthritis and ankylosing spondylitis—results from the German rheumatological database. German Collaborative Arthritis Centers. J Rheumatol 27:613–622

    CAS  PubMed  Google Scholar 

  14. Wanders A, Landewe R, Dougados M, Mielants H, van der Linden S, van der Heijde D (2005) Association between radiographic damage of the spine and spinal mobility for individual patients with ankylosing spondylitis: can assessment of spinal mobility be a proxy for radiographic evaluation? Ann Rheum Dis 64:988–994

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Castro MP, Stebbings SM, Milosavljevic S, Bussey MD (2016) Construct validity of clinical spinal mobility tests in ankylosing spondylitis: a systematic review and meta-analysis. Clin Rheumatol 35:1777–1787

    Article  PubMed  Google Scholar 

  16. Castro MP, Stebbings SM, Milosavljevic S, Bussey MD (2015) Criterion-concurrent validity of spinal mobility tests in ankylosing spondylitis: a systematic review of the literature. J Rheumatol 42:243–251

    Article  PubMed  Google Scholar 

  17. Rezvani A, Ergin O, Karacan I, Oncu M (2012) Validity and reliability of the metric measurements in the assessment of lumbar spine motion in patients with ankylosing spondylitis. Spine (Phila Pa 1976) 37:E1189–E1196

    Article  Google Scholar 

  18. Calvo-Gutierrez J, Garrido-Castro JL, Gonzalez-Navas C, Castro-Villegas MC, Ortega-Castro R, Lopez-Medina C, Font-Ugalde P, Escudero-Contreras A, Collantes-Estevez E (2016) Inter-rater reliability of clinical mobility measures in ankylosing spondylitis. BMC Musculoskelet Disord 17:382

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Poddubnyy D, Fedorova A, Listing J, Haibel H, Baraliakos X, Braun J, Sieper J (2016) Physical function and spinal mobility remain stable despite radiographic spinal progression in patients with Ankylosing Spondylitis treated with TNF-alpha inhibitors for up to 10 years. J Rheumatol 43:2142–2148

    Article  CAS  PubMed  Google Scholar 

  20. van Weely SF, van Denderen JC, Steultjens MP, Nurmohamed MT, Dijkmans BA, Dekker J, van der Horst-Bruinsma IE (2013) What do we miss? ASAS non-responders on anti-TNF therapy show improvement in performance-based physical function. Rheumatology (Oxf) 52:1884–1889

    Article  CAS  Google Scholar 

  21. van Weely SF, van Denderen CJ, van der Horst-Bruinsma IE, Nurmohamed MT, Dijkmans BA, Dekker J, Steultjens MP (2009) Reproducibility of performance measures of physical function based on the BASFI, in ankylosing spondylitis. Rheumatology (Oxf) 48:1254–1260

    Article  Google Scholar 

  22. van Weely SF, van Denderen JC, Steultjens MP, van der Leeden M, Nurmohamed MT, Dekker J, Dijkmans BA, van der Horst-Bruinsma IE (2012) Moving instead of asking? Performance-based tests and BASFI-questionnaire measure different aspects of physical function in ankylosing spondylitis. Arthritis Res Ther 14:R52

    Article  PubMed  PubMed Central  Google Scholar 

  23. van Weely SF, Dekker J, Steultjens MP, van Denderen JC, Nurmohamed MT, Dijkmans BA, van der Horst-Bruinsma IE (2015) Objective evaluation of physical functioning after tumor necrosis factor inhibitory therapy in patients with ankylosing spondylitis: a selection of 3 feasible performance-based tests. J Rheumatol 42:623–629

    Article  PubMed  CAS  Google Scholar 

  24. Consmuller T, Rohlmann A, Weinland D, Druschel C, Duda GN, Taylor WR (2012) Comparative evaluation of a novel measurement tool to assess lumbar spine posture and range of motion. Eur Spine J 21:2170–2180

    Article  PubMed  PubMed Central  Google Scholar 

  25. Schmidt H, Bashkuev M, Weerts J, Altenscheidt J, Maier C, Reitmaier S (2018) What does the shape of our back tell us? Correlation between sacrum orientation and lumbar lordosis. Spine J 18:655–662

    Article  PubMed  Google Scholar 

  26. Schmidt H, Bashkuev M, Weerts J, Graichen F, Altenscheidt J, Maier C, Reitmaier S (2018) How do we stand? Variations during repeated standing phases of asymptomatic subjects and low back pain patients. J Biomech 70:67–76

    Article  PubMed  Google Scholar 

  27. Dideriksen JL, Gizzi L, Petzke F, Falla D (2014) Deterministic accessory spinal movement in functional tasks characterizes individuals with low back pain. Clin Neurophysiol 125:1663–1668

    Article  CAS  PubMed  Google Scholar 

  28. Consmuller T, Rohlmann A, Weinland D, Druschel C, Duda GN, Taylor WR (2012) Velocity of lordosis angle during spinal flexion and extension. PLoS ONE 7:e50135

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Dreischarf M, Pries E, Bashkuev M, Putzier M, Schmidt H (2016) Differences between clinical “snap-shot” and “real-life” assessments of lumbar spine alignment and motion—What is the “real” lumbar lordosis of a human being? J Biomech 49:638–644

    Article  PubMed  Google Scholar 

  30. Rohlmann A, Consmuller T, Dreischarf M, Bashkuev M, Disch A, Pries E, Duda GN, Schmidt H (2014) Measurement of the number of lumbar spinal movements in the sagittal plane in a 24-hour period. Eur Spine J 23:2375–2384

    Article  PubMed  Google Scholar 

  31. Pries E, Dreischarf M, Bashkuev M, Putzier M, Schmidt H (2015) The effects of age and gender on the lumbopelvic rhythm in the sagittal plane in 309 subjects. J Biomech 48:3080–3087

    Article  PubMed  Google Scholar 

  32. Dreischarf M, Albiol L, Rohlmann A, Pries E, Bashkuev M, Zander T, Duda G, Druschel C, Strube P, Putzier M, Schmidt H (2014) Age-related loss of lumbar spinal lordosis and mobility—a study of 323 asymptomatic volunteers. PLoS ONE 9:e116186

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  33. Vaisy M, Gizzi L, Petzke F, Consmuller T, Pfingsten M, Falla D (2015) Measurement of lumbar spine functional movement in low back pain. Clin J Pain 31:876–885

    Article  PubMed  Google Scholar 

  34. Tugwell P, Boers M, D’Agostino MA, Beaton D, Boonen A, Bingham CO 3rd, Choy E, Conaghan PG, Dougados M, Duarte C, Furst DE, Guillemin F et al (2014) Updating the OMERACT filter: implications of filter 2.0 to select outcome instruments through assessment of “truth”: content, face, and construct validity. J Rheumatol 41:1000–1004

    Article  PubMed  PubMed Central  Google Scholar 

  35. Boers M, Brooks P, Strand CV, Tugwell P (1998) The OMERACT filter for outcome measures in rheumatology. J Rheumatol 25:198–199

    CAS  PubMed  Google Scholar 

  36. Bakker C, Boers M, van der Linden S (1993) Measures to assess ankylosing spondylitis: taxonomy, review and recommendations. J Rheumatol 20:1724–1730

    CAS  PubMed  Google Scholar 

  37. Zochling J, Braun J, van der Heijde D (2006) Assessments in ankylosing spondylitis. Best Pract Res Clin Rheumatol 20:521–537

    Article  PubMed  Google Scholar 

  38. Zochling J (2011) Measures of symptoms and disease status in ankylosing spondylitis: Ankylosing Spondylitis Disease Activity Score (ASDAS), Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score (BAS-G), Bath Ankylosing Spondylitis Metrology Index (BASMI), Dougados Functional Index (DFI), and Health Assessment Questionnaire for the Spondylarthropathies (HAQ-S). Arthritis Care Res (Hoboken) 63(Suppl 11):S47–S58

    Article  Google Scholar 

  39. D’Agostino MA, Boers M, Kirwan J, van der Heijde D, Ostergaard M, Schett G, Landewe RB, Maksymowych WP, Naredo E, Dougados M, Iagnocco A, Bingham CO 3rd et al (2014) Updating the OMERACT filter: implications for imaging and soluble biomarkers. J Rheumatol 41:1016–1024

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kivinen P, Sulkava R, Halonen P, Nissinen A (1998) Self-reported and performance-based functional status and associated factors among elderly men: the Finnish cohorts of the Seven Countries Study. J Clin Epidemiol 51:1243–1252

    Article  CAS  PubMed  Google Scholar 

  41. Guralnik JM, Branch LG, Cummings SR, Curb JD (1989) Physical performance measures in aging research. J Gerontol 44:M141–M146

    Article  CAS  PubMed  Google Scholar 

  42. Hoeymans N, Feskens EJ, van den Bos GA, Kromhout D (1996) Measuring functional status: cross-sectional and longitudinal associations between performance and self-report (Zutphen Elderly Study 1990–1993). J Clin Epidemiol 49:1103–1110

    Article  CAS  PubMed  Google Scholar 

  43. Wand BM, Chiffelle LA, O’Connell NE, McAuley JH, Desouza LH (2010) Self-reported assessment of disability and performance-based assessment of disability are influenced by different patient characteristics in acute low back pain. Eur Spine J 19:633–640

    Article  PubMed  Google Scholar 

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Förderung

Diese Studie wurde von Epionics Medical GmbH mittels Zur-Verfügung-Stellen des Messgerätes unterstützt. Die Schulung zur Gerätebedienung wurde von AbbVie im Rahmen einer anderen Studie finanziell unterstützt. Die Autoren bestimmten das Studiendesign, die Durchführung der Studie sowie den Inhalt der Publikation. Für das Verfassen dieses Manuskripts wurden keine Zahlungen an die Autoren geleistet

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  1. Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland

    D. Kiefer, X. Baraliakos, B. Bühring, U. Kiltz &  J. Braun

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  1. D. Kiefer
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  2. X. Baraliakos
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  3. B. Bühring
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  4. U. Kiltz
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  5. J. Braun
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Correspondence to J. Braun.

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Interessenkonflikt

D. Kiefer, X. Baraliakos, B. Bühring, U. Kilz und J. Braun geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Arzneimittelstudien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

Der Originalbeitrag wurde korrigiert: der Nachname von Autorin U. Kiltz war falsch geschrieben.

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Kiefer, D., Baraliakos, X., Bühring, B. et al. Epionics SPINE – Anwendung einer objektiven Untersuchungsmethode der Wirbelsäulenbeweglichkeit bei Patienten mit axialer Spondyloarthritis. Z Rheumatol 79, 143–152 (2020). https://doi.org/10.1007/s00393-019-00692-3

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