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Search Menu Abstract Objective. A cross-sectional study of volunteers stratified by gender and age was completed. Exclusion criteria comprised factors potentially influencing spinal mobility.
Each component of the BASMI was assessed, with the total score computed using the point scoring system. Measurements were taken by physiotherapists following an agreed protocol. Data were summarized and analysed with age-specific centiles and CIs calculated. The estimated median score for an individual age 25 years was 0.
There was a corresponding increase in component BASMI scores, which was more pronounced for some components than others. Our data indicate that it is unusual for healthy individuals to score zero on the BASMI, which has implications for the interpretation of scores, especially at baseline.
The generation of normative values has the potential to inform clinical assessment of spinal mobility and assist patients in understanding how their spinal mobility compares with that of a healthy age-matched population. The loss of spinal mobility is widely recognized as an important clinical sign, and this is reflected by its inclusion in the Modified New York Criteria for diagnosis [ 2 ], and more recently as a core domain in the evaluation of patients in clinical practice and trials by the Assessment of SpondyloArthritis international Society ASAS [ 3 ].
The BASMI [ 4 ], a composite index of spinal mobility, is used internationally in research and clinical practice and is the measure of spinal mobility recommended by the ASAS [ 3 ]. The BASMI is used clinically to obtain a baseline measurement and monitor change over time [ 4 ] and to assess the impact of clinical interventions [ 3 ].
The scale of the BASMI ranges from 0 to 10, where 0 is no mobility limitation and 10 is very severe limitation [ 5 ]. With this scale in mind, clinicians and patients may have expectations that a score of zero is representative of normal spinal movement in a healthy population. However, as a number of studies have demonstrated age-dependent changes in isolated spinal mobility measurements [ 6—11 ], it would seem reasonable to assume that there are similar changes in the total BASMI score with age, suggesting that it may be more appropriate to interpret BASMI values and changes in values over time in relation to age-specific centiles.
This therefore highlighted the need for further work to explore if this was a coincidental finding or if in fact this should be expected.
When receiving a diagnosis and being informed about the meaning of clinical measures, patients are keen to understand the implications and relevance of their measurements.
As well as helping patients to interpret their BASMI scores, clinicians may find age- and gender-related reference values helpful to inform their understanding and interpretation of spinal mobility in the patients they treat. Materials and methods Ethical approval was obtained from the Faculty of Health and Medicine Ethics Committee at Lancaster University and written informed consent was obtained from all participants according to the Declaration of Helsinki. This was based on simulations from a uniform distribution consistent with pilot data [ 12 ].
In total, participants were recruited from a UK population, stratified by gender and age, between September and December Procedure To address possible inconsistencies in measurement, the ASSIGNw consensus of measurement for each domain was followed [ 12 ]. For cervical rotation, tragus-to-wall and lumbar side flexion, the average of the right and left measurements was taken [ 4 ].
Additional data collected included gender, ethnicity, date of birth and history of back problems. Current evidence suggests that the diagnosis of AS most commonly occurs between the ages of 25 and 34 years [ 15 , 16 ]. Results A total of participants with a mean age of The majority of participants were white Caucasian
BASMI (Bath Ankylosing Spondylitis Metrology Index)
Normative values for the Bath Ankylosing Spondylitis Metrology Index in a UK population
Bath Ankylosing Spondylitis Metrology Index (BASMI)