{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:11:12Z","timestamp":1792023072698,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T00:00:00Z","timestamp":1591833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the course of impaired spinal mobility in patients with long\u2010standing well\u2010defined ankylosing spondylitis (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 232 patients with <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> (186 men, 46 women) and 3,849 clinical measurements performed between February 1980 and June 2016 were analyzed. Lateral spinal flexion (<jats:styled-content style=\"fixed-case\">LSF<\/jats:styled-content>), the 10\u2010cm Schober test, chest expansion (<jats:styled-content style=\"fixed-case\">CE<\/jats:styled-content>), and cervical rotation measurements were stratified by disease duration at 10\u2010year intervals and compared with published age\u2010 and height\u2010adjusted spinal mobility reference intervals as well as with fixed reference values commonly used in clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 10 years of <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>, most patients exhibited at least 1 measurement, most commonly <jats:styled-content style=\"fixed-case\">LSF<\/jats:styled-content>, that was under the 2.5th percentile of the adjusted reference interval (53% of men, 65% of women). In all measurements except <jats:styled-content style=\"fixed-case\">CE<\/jats:styled-content>, there were significant linear increases in the proportion of patients during 40 years of disease duration who exhibited impaired mobility. Measured <jats:styled-content style=\"fixed-case\">LSF<\/jats:styled-content> values &lt;2.5th percentile (mean 14.8 cm) after 10 years were associated with further spinal mobility impairments later in the disease course. Fixed reference values yielded higher proportions of patients with impaired mobility compared with adjusted reference intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Impaired spinal mobility in <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> is common after a 10\u2010year disease duration. <jats:styled-content style=\"fixed-case\">LSF<\/jats:styled-content> below the 2.5th percentile at 10 years appeared to be associated with a worse prognosis. Fixed reference values overestimated spinal mobility impairments in <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> and should be avoided.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23929","type":"journal-article","created":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T09:08:26Z","timestamp":1558084106000},"page":"1022-1028","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Long\u2010Term Spinal Mobility in Ankylosing Spondylitis: A Repeated Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7226-0969","authenticated-orcid":false,"given":"Bj\u00f6rn","family":"Sundstr\u00f6m","sequence":"first","affiliation":[{"name":"Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotta","family":"Ljung","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University, Ume\u00e5, and Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4750-6055","authenticated-orcid":false,"given":"Kristina","family":"H\u00f6rnberg","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solveig","family":"W\u00e5llberg\u2010Jonsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270401"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.124206"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200859"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22614"},{"key":"e_1_2_6_6_1","first-page":"1883","article-title":"Predictive factors for the longterm outcome of spondyloarthropathies","volume":"21","author":"Amor B","year":"1994","journal-title":"J Rheumatol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/30.5.326"},{"key":"e_1_2_6_8_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":"Van der Heijde D","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780260210"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-195602000-00001"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009749509095170"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.30.4.381"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204953"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22103"},{"key":"e_1_2_6_15_1","volume-title":"Rheumatology","author":"Klippel JH","year":"1994"},{"key":"e_1_2_6_16_1","first-page":"316","article-title":"Predictors of longterm outcome in ankylosing spondylitis","volume":"30","author":"Doran MF","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-203201"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170786"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.045872"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh169"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31825ef954"}],"container-title":["Arthritis Care &amp; 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