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Functional Limitations Due to Axial and Peripheral Joint Impairments in Patients With Ankylosing Spondylitis: Are Focused Measures More Informative?
Author(s) -
Bethi Siddharth,
Dasgupta Abhijit,
Weisman Michael H.,
Learch Thomas J.,
Gensler Lianne S.,
Davis John C.,
Reveille John D.,
Ward Michael M.
Publication year - 2013
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.21878
Subject(s) - basfi , medicine , ankylosing spondylitis , enthesis , physical therapy , basdai , range of motion , peripheral , spondylitis , arthritis , surgery , psoriatic arthritis , tendon
Objective Functional limitations in ankylosing spondylitis (AS) may be due to peripheral joint or axial involvement. To determine if the Bath Ankylosing Spondylitis Functional Index (BASFI), an axial‐focused measure, can detect limitations related to peripheral joint involvement equally as well as the Health Assessment Questionnaire modified for the spondyloarthropathies (HAQ‐S), a peripheral arthritis–focused measure, and vice versa, we compared associations of each questionnaire with spinal and hip range of motion, peripheral arthritis, and enthesitis in patients with AS. Methods We examined patients every 4–6 months in this prospective longitudinal study. We used mixed linear models to analyze the associations between 10 physical examination measures and the BASFI and HAQ‐S. Results We studied 411 patients for a median of 1.5 years (median 3 visits). In multivariate analyses, cervical rotation, chest expansion, lateral thoracolumbar flexion, hip motion, tender joint count, and tender enthesis count were equally strongly associated with the BASFI and HAQ‐S. Peripheral joint swelling was more strongly associated with the HAQ‐S. Individual items of the BASFI were more likely than items of the HAQ‐S to be associated with unrelated physical examination measures (e.g., the association between difficulty rising from a chair and cervical rotation), which may have diminished the axial/peripheral distinction for the BASFI. Conclusion The BASFI and HAQ‐S had similar associations with impairments in axial measures, while the HAQ‐S had stronger associations with the number of swollen peripheral joints. The HAQ‐S should be considered for use in studies focused on spondyloarthritis with peripheral joint involvement.