Clinical Relevance of Axial Radiographic Damage in Axial Spondyloarthritis: Evaluation of Functional Consequences by an Objective Electronic Device

Abstract

ObjectiveAxial spondyloarthritis (axSpA) is associated with decreased function and mobility of patients due to inflammation and radiographic damage. The Epionics SPINE device (ES), an electronic device that objectively measures spinal mobility, including range of motion (RoM) and speed (RoK) of movement, has been clinically validated in axSpA. We investigated the performance of the ES relative to radiographic damage in the axial skeleton of patients with axSpA.MethodsA total of 103 patients with axSpA (31 non- [nr-] and 72 radiographic [r]- axSpA) were consecutively examined. Conventional radiographs of the spine (including presence, number and location of syndesmophytes) and the sacroiliac joints (SIJs, rated by mNY criteria) were analyzed with the ES and assessments of function and mobility using analyses of covariance and Spearman correlation.ResultsThe number of syndesmophytes correlated positively with BASMI scores (r=0.38;P=0.016) and negatively with chest expansion (r=-0.39;P=0.015) and ES measurements (-0.53 ≤r≤ -0.34,P<0.03) except for RoM and RoK regarding rotation and RoK for extension of the lumbar and thoracic spine. In the radiographic evaluation of SIJs, the extent of damage correlated negatively with ES scores and metric measurements (-0.49 ≤r≤ -0.33;P<0.001). Patients with r-axSpA showed significantly worse ES scores for RoM, RoK and chest expansion than those with nr-axSpA.ConclusionThe ES scores, in accordance with mobility measurements, correlated well with the presence and extent of radiographic damage in the spine and SIJs. As expected, patients with r-axSpA had more severe impairments than those with nr-axSpA.

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

“…10 11 Epionics SPINE (ES) is an electronic device capable of objectively assessing spinal mobility that was currently validated in axSpA. [10][11][12][13][14][15] Cross-sectional use of the common instruments like the BASMI is informative in patients with axSpA, and it has recently been shown also for patients with early axSpA. 16 However, the high variation of the measurements over time impairs their use at the individual patient level.…”

A Move Toward Precision: Innovations in Measuring Spinal Mobility in Axial Spondyloarthritis

“…8 In 2 recent studies, Kiefer et al leveraged an electronic tool, the Epionics SPINE device (ES), for more accurate spinal mobility measurements. 9,10 The ES comprises 2 strips of motion sensors linked to a computer. The sensor strips are attached to the back of the proband, parallel to the spine, 5 cm left and right of the midline, reaching from the level of the C7 spinous process to the posterior superior iliac spine.…”

“…9 In this issue of The Journal of Rheumatology, the effect of syndesmophytes on spinal mobility was assessed using the ES. 10 The study involved 103 patients with axSpA, 72 with radiographic and 31 with nonradiographic disease; 43 patients had evidence for syndesmophytes on spinal radiographs. The patients with axSpA who had syndesmophytes were older than those without syndesmophytes, with a nonsignificant trend for longer disease duration.…”

Impact of daily physical therapy over 2 weeks on spinal mobility including objective electronic measurements and function in patients with axial spondyloarthritis

“… 34 RoM and RoK are directly related to radiographic changes in the axial skeleton of patients with axSpA. 39 …”