{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T01:45:11Z","timestamp":1774921511960,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,10,27]],"date-time":"2015-10-27T00:00:00Z","timestamp":1445904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["SFRH\/BD\/68684\/20"],"award-info":[{"award-number":["SFRH\/BD\/68684\/20"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate which spinal mobility measures (SMMs) are most frequently impaired in patients with ankylosing spondylitis (AS), whether a hierarchy of impairment can be established, and whether assessing fewer measures sufficiently captures impairment in spinal mobility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients from the Outcome in Ankylosing Spondylitis International Study were followed up for 12 years. SMMs were considered impaired when falling below predefined cutoffs, derived from normal individuals. The proportion of patients in whom each SMM was impaired was calculated using baseline observation. In patients with \u22651 impaired SMM, we investigated how often impairment in spinal mobility would be missed if only a fixed number of SMMs was assessed. Analyses were repeated using all 12\u2010year observations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 216 patients were included (70% males). Lateral spinal flexion (LSF) was the most frequently impaired measure, followed by the modified Schober (mSchober) test, tragus\u2010to\u2010wall, cervical rotation, intermalleolar distance, and chest expansion measures, respectively. This hierarchy was strikingly consistent over time, and independent of sex, symptom duration, and presence of syndesmophytes. In patients with \u22651 impaired SMM, LSF was impaired most frequently (86%), followed by the mSchober test (58%). If only LSF was measured, 14% of patients with impairment in any SMM would be missed; if additionally the mSchober test was measured, 9% would be missed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LSF followed by the mSchober test are the most frequently impaired mobility measures in AS, reflecting an earlier involvement of the lumbar spine, followed by involvement of the thoracic and cervical spine. In clinical practice LSF and the mSchober test suffice to screen impairment in spinal mobility.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22614","type":"journal-article","created":{"date-parts":[[2015,5,18]],"date-time":"2015-05-18T14:39:10Z","timestamp":1431959950000},"page":"1571-1577","source":"Crossref","is-referenced-by-count":21,"title":["Hierarchy of Impairment of Spinal Mobility Measures in Ankylosing Spondylitis: Twelve\u2010Year Data"],"prefix":"10.1002","volume":"67","author":[{"given":"Sofia","family":"Ramiro","sequence":"first","affiliation":[{"name":"University of Amsterdam, Amsterdam, The Netherlands, and Hospital Garcia de Orta, Almada  Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert B. M.","family":"Landew\u00e9","sequence":"additional","affiliation":[{"name":"Amsterdam Rheumatology Center, University of Amsterdam, Amsterdam, and Atrium Medical Center Heerlen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D\u00e9sir\u00e9e","family":"van der Heijde","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Stolwijk","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center and University of Maastricht Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxime","family":"Dougados","sequence":"additional","affiliation":[{"name":"Paris Descartes University, Cochin Hospital, AP\u2010HP, INSERM (U1153), PRES Sorbonne Paris\u2010Cit\u00e9 France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"van den Bosch","sequence":"additional","affiliation":[{"name":"Ghent University Hospital and Ghent University Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"van Tubergen","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center and University of Maastricht Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,27]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"951","article-title":"Selection of instruments in the core set for DC\u2010ART, SMARD, physical therapy, and clinical record keeping in ankylosing spondylitis: progress report of the ASAS Working Group. Assessments in Ankylosing Spondylitis","volume":"26","author":"Heijde D","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780260210"},{"key":"e_1_2_6_4_1","first-page":"1883","article-title":"Predictive factors for the long term outcome of spondyloarthropathies","volume":"21","author":"Amor B","year":"1994","journal-title":"J Rheumatol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/30.5.326"},{"key":"e_1_2_6_6_1","first-page":"1694","article-title":"Defining spinal mobility in ankylosing spondylitis (AS): the Bath AS Metrology Index","volume":"21","author":"Jenkinson TR","year":"1994","journal-title":"J Rheumatol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.104018"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.029728"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20852"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21913"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204953"},{"key":"e_1_2_6_12_1","first-page":"980","article-title":"Relative value of erythrocyte sedimentation rate and C\u2010reactive protein in assessment of disease activity in ankylosing spondylitis","volume":"26","author":"Spoorenberg A","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.074724"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205716"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204055"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.31.1.1"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/11.5.225"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.016717"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.22614","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.22614","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:53:37Z","timestamp":1759424017000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.22614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,27]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1002\/acr.22614"],"URL":"https:\/\/doi.org\/10.1002\/acr.22614","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,27]]}}}