Back Mobility Research Articles

Characteristics of nurses with musculoskeletal disorders from Dr Soedarso Regional Hospital, Pontianak, Indonesia

Musculoskeletal disorders (MSDs) can have a significant negative impact on quality of life, resulting in reduced ability to work, absenteeism, and possibly switching occupations. The purpose of this study was to investigate the relationship between the prevalence and severity of MSDs and the nurse characteristics (NCs) of nurses working in the Dr Soedarso Regional Hospital (DSRH) inpatient department. An analytical and descriptive cross-sectional methodology was used to examine 134 nurses from Inpatient Wards A and B. Total sampling was used to select the respondents. The level of exposure to the conditions investigated by the quick exposure check (QEC), namely, static and dynamic movements in the back, shoulders/arms, neck, and work-related stress, was significantly correlated with gender and neck (0.050), a history of education-related physical strain, such as back mobility (0.021), years of work-related strain on the neck (0.040), and work-related stress (0.033). There were no significant correlations found between age and static and dynamic movements of the back, shoulders/arms, and neck. Gender, education level, and employment duration all have a strong correlation with MSDs among DSRH inpatient nurses.

A Method for Quantifying Back Flexion/Extension from Three Inertial Measurement Units Mounted on a Horse's Withers, Thoracolumbar Region, and Pelvis.

Back mobility is a criterion of well-being in a horse. Veterinarians visually assess the mobility of a horse's back during a locomotor examination. Quantifying it with on-board technology could be a major breakthrough to help them. The aim of this study was to evaluate the accuracy of a method of quantifying the back mobility of horses from inertial measurement units (IMUs) compared to motion capture (MOCAP) as a gold standard. Reflective markers and IMUs were positioned on the withers, eighteenth thoracic vertebra, and pelvis of four sound horses. The horses performed a walk and trot in straight lines and performed a gallop in circles on a soft surface. The developed method, based on the three IMUs, consists of calculating the flexion/extension angle of the thoracolumbar region. The IMU method showed a mean bias of 0.8° (±1.5°) (mean (±SD)) and 0.8° (±1.4°), respectively, for the flexion and extension movements, all gaits combined, compared to the MOCAP method. The results of this study suggest that the developed method has a similar accuracy to that of MOCAP, opening up possibilities for easy measurements under field conditions. Future studies will need to examine the correlations between these biomechanical measures and clinicians' visual assessment of back mobility defects.

E06 Does GGT level correlate with activity parameters in enthesitis-related arthritis?

Abstract Introduction Enthesitis-related arthritis (ERA) is one of the main subgroups of juvenile idiopathic arthritis. As in the adult population, monitoring of patients with ERA is based on clinical and laboratory evaluation. Some studies showed a correlation between Gamma-glutamyl transferase (GGT) levels and rheumatoid arthritis disease activity markers. Thus, we aimed to evaluate the correlation between GGT levels and ERA activity parameters. Methods This is a cross-sectional monocentric study including patients meeting the International League of Associations for Rheumatology (ILAR) 2001 criteria for ERA. We collected the demographic and clinical data. We assessed the ERA activity using clinical parameters including Patient Global Assessment (PGA), Visual Analogue Scale (VAS), Morning stiffness (MS), tender joint count (TJC), swollen joint count (SJC), active enthesitis count (AEC), clinical sacroiliitis, back mobility, and ocular involvement. We collected biological parameters such as the C-reactive protein (CRP) and the Erythrocyte sedimentation rate (ESR). We calculated the Juvenile spondyloarthritis disease activity (JSpADA). GGT level was measured on the same day. The correlation was evaluated using Spearman’s rho coefficient (r). r-value <0.3 was considered poor; between 0.3 and 0.39, moderate; between 0.4 and 0.69, strong; and >0.7 very strong. Results Thirty patients with a mean age of 15.1 ± 4.1 years, and a ratio-sex of 2.75 were included. The mean disease duration was 4.3 ± 3.2 years. The mean PGA and the mean VAS were 6.2 ± 7.1 and 8.9 ± 2.9 respectively. Mean TJC, mean SJC, and mean AEC were 1.53 ± 2.8, 0.18 ± 0.47, and 1.2 ± 1.6 respectively. Clinical sacroiliitis was found in eight patients, limited back mobility in six, and uveitis in three patients. The mean CRP and ESR were 15.1 ± 22.7 mg/l and 23.8 ± 21.2 mm, respectively. The mean JSpADA was 2.6 ± 1.7. Mean GGT was 14.3 ± 6.6 mg/l. A strong correlation was noted between the GGT level and both CRP (r = 0.504, P = 0.05) and ESR (r = 0.601, P = 0.01). However, no correlation was noted between GGT level and PGA (r = 0.107, P = 0.6), VAS (r = 0.03, P = 0.9), SJC (r = -0.17, P = 0.368), nor JSpADA (r = 0.323, P = 0.87). Conclusion Our results suggest a strong correlation between GGT level and biological ERA activity parameters, unlike clinical parameters and disease activity scores. More studies are needed to confirm these findings. Ethics The authors have no conflicts of interest to declare.

Effects of the Addition of Hands-on Procedures to McKenzie Exercises on Pain, Functional Disability and Back Mobility in Patients with Low Back Pain: A Randomised Clinical Trial.

Low back pain (LBP) is a common musculoskeletal disorder that affects people of all ages. This study investigates the effects of the addition of hands-on procedures to McKenzie exercises on patients with LBP and derangement syndrome. Forty-eight female patients were randomly assigned to either the experimental group or control group. All the patients in both groups underwent McKenzie exercises, transcutaneous electrical nerve stimulation (TENS) and education for 35 min/session-45 min/ session, with three sessions/week for 2 weeks. Hands-on procedures were added to the McKenzie extension exercises only for the patients in the experimental group. A visual analogue scale (VAS), the Oswestry disability index (ODI), back range of motion (BROM) and body diagrams were used to measure pain, functional disability, BROM and the centralisation of symptoms, respectively. The mean values of VAS, ODI and BROM significantly improved after the interventions in both groups (P < 0.05), whereas the results of repeated measures ANOVA and Mann-Whitney U tests showed statistically non-significant differences between the two groups (P > 0.05). The addition of hands-on procedures to McKenzie exercises, TENS and education significantly alleviated back pain and functional disability and improved the back mobility and centralisation of symptoms in patients with LBP and derangement syndrome; however, these measures did not result in any significant additional benefits for such patients.

Relationship between low back mobility test and low back pain in amateur paddle tennis players

BACKGROUND: There is not enough scientific literature to determine whether the deficit in lumbar mobility may be associated with pain in the lumbar region in paddle tennis players.METHODS: Analytical, observational, and cross-sectional study design. The range of low back mobility was assessed among a sample of 34 paddle tennis players. Modified-Modified Schöber Test (MMST), Toe-touch Test (TTT), FMS® scores from the Deep Squat (DS) and lumbar flexion measurement in the final position of the deep squat (LBM in FMS® DS) were selected.RESULTS: Significant differences were obtained in LBM in FMS® DS (P=0.014) in relation to presence/absence of low back pain. A moderate positive correlation was obtained between TTT and LBM in FMS® DS (0.517) in the no low back pain group, whereas a considerable negative correlation between TTT and LBM in FMS® DS (-0.592) was stated in the group with low back pain. A “high” positive correlation (0.721) between the MMST and the LBM in FMS® DS. A “considerable” negative correlation (-0.672) be-tween TTT and LBM in FMS® DS was also found.CONCLUSIONS: Low back mobility test and low back pain are related in amateur paddle tennis players.

Effects of Hypopressive Exercise on Posterior Back Chain Kinematics and Pulmonary Function in Professional Female Basketball Players.

Hypopressive exercise (HE) has been used as an alternative lumbo-pelvic injury prevention program and claimed to be a means of respiratory and flexibility improvement. However, the possible effects of HE on athletic populations and physical performance remain unclear. Examine the effects of a HE program on posterior back chain kinematics, thoracic mobility, pulmonary function, and lower lumbar pain in female basketball players over an 8-week training period. Prospective (1)baseline, (2)midpoint (4 wk), and (3)after 8 weeks. Sports field. A total of 17 professional female basketball players (mean age 20.7y, SD: 3.50; body mass index, 21.71, SD: 1.69). Participants performed 8 HE weekly sessions of 30minutes. Back chain kinematics was assessed with the sit and reach and finger to floor test, and back pain was assessed through numerical rating scale. Respiratory parameters were assessed by spirometry and through thoracic mobility. The analysis of variance revealed significant differences between the 3 measurement periods for thoracic mobility (P > .01); forced expiratory volume in the first second (P < .05) while no statistical differences were found for the rest of spirometry outcomes. Significant differences were also revealed between baseline and after the intervention for the sit and reach test (P > .01), peak expiratory flow (P = .01), and forced expiratory volume in the first 25seconds (P = .04). Also, significant differences between weeks were found in levels of lumbar pain (P = .003) and the finger to floor test (P = .002). These preliminary findings suggest that a HE program can improve posterior back chain and chest wall kinematics as well as lower lumbar pain levels. However, no gains seem to be observed for the majority of pulmonary variables except for peak expiratory flow and forced expiratory volume in the first seconds.

Influence of unstable shoes on women with lumbopelvic postpartum pain: randomized clinical trial.

Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth. To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period. Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center. A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform. The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed. Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anterior stability speed and anterior COP at nine weeks.

A Comparative Study on the Efficacy of Low Level Laser Therapy (LLLT) of Wavelength 905 NM and 808 NM in Management of Chronic Low Back Pain

Background: low back pain (LBP) is one of the most common musculoskeletal disorders whichare highly prevalent among the general population. Management of this disorder includes numerousinterventions which depend on severity of pain. Laser therapy is a non-invasive method to help reducemusculoskeletal disorders like chronic low back pain. This study aims to evaluate the efficacy of lowlevel laser therapy with wavelength 905 nm &amp; 808 nm.Method: The participants received low level laser therapy with wavelength 905 nm &amp; 808 nm once aday for 15 days. Stretching, strengthening and core exercise are also encouraged on the same days toimprove the lower back mobility and stability.Conclusion: The comparison of pain shows an average improvement of 3.20 ± 0.99 and 2.26 ± 0.44and disability shows an average improvement of 10.67 ± 5.48 and 10.22 ± 4.72 in 905 nm &amp; 808 nmrespectively. The findings show that, after 15 treatment sessions, Laser therapy with 905 nm &amp; 808 nmare effective for chronic low back pain. But 905 nm LLLT had a better clinical implication than 808nm LLLT.

Mobility change in Delhi due to COVID and its’ immediate and long term impact on demand with intervened non motorized transport friendly infrastructural policies

The COVID pandemic severely impacted mobility during lockdown as well as the period after that observing different phases of unlocking process. Lockdown has resulted in drastic mobility reduction and subsequent unlocking process brought back mobility gradually to a certain level, substantially lower than the Pre-COVID periods. However, this is expected to be back gradually to same level of Pre-COVID after certain period of time. While this change is planned to be gradual, it creates an opportunity to improve mobility towards non-motorized transport (NMT) which can influence travel behavior for present as well for the future covering Pre and Post-COVID periods. Apart from studying the influencing travel behavior during Pre and Post-COVID conditions, change in quantum of commuting population is required to be studied for various estimations related to transport planning. This quantum of commuting population is largely affected by the adopted locking/unlocking strategies by Government of India. Commuting population and travel behavior got influenced by the large migration from metro cities to smaller towns, adopted work from home (WFH) styles, reduced commute of elderly and children and other restrictions on gatherings, etc. Considering the range of allowed activities, influenced by the phases of locking/unlocking strategies, twelve different scenarios have been developed for various estimations. The developed scenarios have been named with alpha numeric style ranging from A0 to E5. A0 presenting the Pre-COVID scenario. Alphabet “A” represent Pre-COVID scenario, “B”, “C”, “D” and “E” Scenarios represent the unlocking phases, while number 1, 2, 3, 4 and 5 represents the different policy aspects related to the change on capacity of transport services (i.e. public transport capacity and change due to infrastructural improvement for NMT). Scenario A0 represents the Pre-COVID situation, while other ranges (viz., B1, B2, B3, C2, C3, C4, D2, D3, D5) represents various locking/unlocking levels. The Scenario E5 represents the situation without any movement restrictions, where public transport systems are assumed to be functioning with full capacity and infrastructure has been improved for NMT trips. Estimations for all the 12 scenarios include commuting population, their modal split, vehicle kilometers travelled by these vehicles and corresponding vehicular emission. Estimated modal split also includes the influence of improved NMT friendly infrastructure and reduced capacity of public transport systems. The results of developed scenarios provide a handy information for the policy makers to choose right policy to promote sustainable transportation with adequate emphasis on NMT. It is evident that as compared to the Pre-COVID scenario (A0), Post-COVID scenario with improved NMT infrastructure (E5) has VKT reduction of 19% in MTWs, 5% in Cars and 49% in Buses. Increase in bicycle trips have been estimated to be 5.88 million for Post-COVID scenario as compared to 1.1 million trips estimated for the Pre-COVID Scenario. Similar trend has also been observed for fuel consumption (reduction of 4.7%–11.8%) and corresponding vehicular emission (reduction of 14%). This study estimated the potential benefits of providing NMT friendly infrastructure considering the gradual shift influenced by locking/unlocking phases of COVID pandemic.

Neck and back muscle chains hypomobility in women with migraine

ObjectiveTo compare the mobility of neck and back flexor and extensor muscle chains in women with migraine, chronic migraine and headache-free. MethodsThis is a cross-sectional study. The muscle chain test was performed based on the theoretical assumptions of the Busquet method, in women with migraine (MG, n = 24), chronic migraine (CMG, n = 36) and headache-free (CG, n = 27). The evaluation of neck and back mobility was performed by an examiner expert in the Busquet method with the aid of cervical range of motion (CROM®) device (neck muscles) and the Tiltmeter® application (back muscles). ResultsCompared to woman headache-free, women with migraine (MD = -12° [CI95% = −19°, -5°] and chronic migraine (MD = -15° [CI95% = −21°, -8°] present reduced mobility in the neck extensor muscle chain. Also, in the back extensor muscle chain, migraine vs headache-free (MD = -9° [CI95% = −15°, -2°]) and chronic migraine vs headache-free (MD = -10° [CI95% = −16°, -4°]) and in the back flexor muscle chain, migraine vs headache-free (MD = -6° [CI95% = −10°, −0.1°]) and chronic migraine vs headache-free (MD = -7 [CI95% = −11°, -2°]), with an effect sizes varying between 1.19 e 2.38. No difference was found between groups for neck flexor muscle chain. Conclusion: Women with migraine and chronic migraine have hypomobility of the neck and back extensor muscle chains, and of the back flexor chain.

Rater agreement for assessment of equine back mobility at walk and trot compared to quantitative gait analysis.

BackgroundLameness assessment in horses is still predominantly performed using subjective methods. Visual assessment is known to have moderate to good intra-rater agreement but relatively poor inter-rater agreement. Little is known about inter- and intra-rater agreement on the evaluation of back motion, for which no objective measurement technique in a clinical setting is available thus far.ObjectivesTo describe inter- and intra-rater agreement of visual evaluation of equine back mobility.Study designRater reliability study using a fully crossed design in which all horses are rated by all observers. This data is compared with objective gait analysis.MethodsSeventy equine professionals (veterinarians and physiotherapists) and veterinary students evaluated videos of 12 healthy horses at walk and trot on a hard, straight line. Nine parameters related to back mobility were scored: general mobility, thoracic, lumbar, lumbosacral flexion and extension and left and right thoracolumbar latero-flexion. All parameters were compared with simultaneously measured quantitative motion parameters. After 1 month, six randomly chosen horses were re-evaluated by 57 observers.ResultsFor each parameter inter- and intra-rater agreements were calculated using intra-class correlation coefficients. For all parameters, inter-rater agreement was very poor (<0.2). The mean intra-rater agreement of all observers and for all parameters was poor (~0.4) but varied between 0.0 and 0.96 for individual observers. There was no correlation between the visual subjective scoring and objective gait analysis measurements.Main limitationsHorses were scored from videos and by lack of any existing (semi-) quantitative system, a custom-made system had to be used.ConclusionsThe poor inter- and intra-rater agreements of visual scoring of mobility of the equine back and the disagreement between subjective and objective gait analysis data, demonstrate the need for the development and introduction of objective, quantitative and repeatable techniques to assess equine back motion.

Long Term Lumbosacral Bracing and Its Adverse Effects on Low Back

Chronic low back pain CLBP is defined ldquoas the pain or stiffness localized below the costal margins and above the inferior gluteal folds which may be accompanied with sciatica and persist for ge 12 weeks.rdquo Most of these patients present with non-specific and gradually progressive back pain. Low back pain is found to be the most debilitating condition leading to low level of quality of life QOL and disability among women with this complaint. Usually it has been observed that in chronic cases of low back pain patients get used to wearing lumbar corset or brace or belt on long term basis which can have a lot of adverse effects on their back. This causes the soft tissues of the region to shorten adapt and restrict the motion further in the spinal segments. A 63-year-old female presented with disabling low back pain that inhibited her from bending forwards and backwards. Visual Analog Scale Oswestry Low Back Pain Disability Questionnaire and Fear Avoidance Beliefs questionnaire FABQ were taken as baseline information for outcome measures. Range of trunk forward flexion was measured using Schoberrsquos test and the difference was less than 1cm. She was treated in our physiotherapy department with Ultrasound UST and Interferential Current Therapy IFT over lower back region. The patient and her relatives were taught how to wean-off lumbosacral belt gradually by keeping it on for few hours a day initially. Forward-bending exercises in sitting position to stretch the back muscles and other home exercises like mobility exercises along with back muscle isometrics using the wall were taught. After seven days of treatment there was a significant improvement in VAS Oswestry Low Back Pain Disability Questionnaire and FABQ scores. From this it can be noted that back mobility exercises are the key to improve chronic back pain. Studies have highlighted the importance of strengthening especially of the lumbar spine extensors in CLBP patients and had also emphasized on abdominal strengthening to facilitate trunk stabilization. The patientsrsquo mobility in the lumbar region improved and her dependency on the belt reduced gradually. Based on this study we infer that prolonged use of lumbar corsets lumbosacral belts lead to lumbar immobility which further can lead to weakness of back and core muscles. Educating the patient regarding the same and emphasizing more on lumbar mobility exercises on a regular basis can reduce pain improve the range of motion along with decrease in fear avoidance behavior.

Comparison of low back mobility and stability exercises from Pilates in non-specific low back pain: A randomized controlled trial

Spinal fusion surgery can now be performed through the endoscopic approach. Adequate endplate preparation and sufficient contact between bone graft or bone graft substitutes with the surfaces of the vertebral endplates are main factors to achieve <em>successful arthrodesis</em>. The purpose of this study are to compare the bone graft area, ratio of allograft-bonegraft (allo-bone) to total disc area, fusion rate, functional and radiographic outcomes between Endoscopic and Mini-open TLIF and to introduce the endoscopic technique of endplate preparation and implantation.

Comparison of low back mobility and stability exercises from Pilates in non-specific low back pain: A randomized controlled trial

Objectives: Compare the effects of the low back mobility and stability exercises from Pilates Method on low back pain, disability and movement functionality in individuals with non-specific chronic low back pain. Methods: 28 participants were randomized into two exercise protocol from Pilates methods, one focusing on low back stability and other on low back mobility. Low back pain (visual analogic scale), low back disability (Oswestry) and movement functionality (7 functional movement tasks) were evaluated before and after 10 sessions of Pilates exercise by the same trained assessor. A mixed designed ANOVA with two factors was used.

A distinct gut microbiota composition in patients with ankylosing spondylitis is associated with increased levels of fecal calprotectin

BackgroundAnkylosing spondylitis (AS) shares many characteristics with inflammatory bowel disease (IBD). Intestinal microbiota most likely plays an important role in the development of IBDs and may also be involved in the pathogenesis of AS. We aimed to define and compare the fecal microbiota composition in patients with AS, ulcerative colitis (UC), and healthy controls (HC) and to determine relationships between fecal microbiota, fecal calprotectin, and disease-related variables in AS.MethodsFecal microbiota composition was assessed with GA-map™ Dysbiosis Test (Genetic Analysis, Oslo, Norway), which also reports the degree of deviation of the microbiota composition compared with a healthy control population, a Dysbiosis Index (DI) score 1–5. The AS patients were assessed with questionnaires, back mobility tests, fecal calprotectin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).ResultsTotally, 150 patients with AS (55% men, median age 55.5 years, median BASDAI 3.2), 18 patients with UC (56% men, median age 30.5 years), and 17 HC (65% men, median age 22 years) were included. Principal component analysis showed highly separate clustering of fecal microbiota from the patients with AS, UC, and HC. Compared with HC, fecal microbiota in AS was characterized by a higher abundance of Proteobacteria, Enterobacteriaceae, Bacilli, Streptococcus species, and Actinobacteria, but lower abundance of Bacteroides and Lachnospiraceae.Further, fecal microbiota composition differed between patients with normal (≤ 50 mg/kg, n = 57) and increased (≥ 200 mg/kg, n = 36) fecal calprotectin. Patients with increased fecal calprotectin had lower abundance of bacteria with anti-inflammatory properties such as Faecalibacterium prausnitzii and Clostridium and higher abundance of the genus Streptococcus. No association was found between the fecal microbiota composition and HLAB27 status, disease activity, function, or medication. Dysbiosis (defined as DI ≥ 3) was found in 87% of AS patients.ConclusionsPatients with AS have a distinct fecal microbiota signature, which is linked to fecal calprotectin levels, a marker of intestinal inflammation, but not to other clinical parameters. These findings suggest a local interplay between intestinal microbiota and gut inflammation in AS.Trial registrationClinicalTrials.gov, NCT00858819. Registered March 9, 2009.

The effect of Pilates exercises on treating low back pain

Introduction: Back pain is now a common problem. The study aimed to examine the effectiveness of Pilates exercises on the subjective spinal pain discomfort, degree of quality-of-life impairment and the lower back mobility. Material and methods: It was conducted in a group of 30 participants with chronic low back pain in whom, before and after the twelve-week Pilates exercise interventions, the level of subjective pain tolerance (VAS scale), lumbar spine mobility and the degree of quality-of-life impairment were assessed. Results: Involvement in the Pilates exercise programme helped to reduce subjective pain complaints, improved the spinal range of motion in all planes and enhanced the quality of life in all participants. Conclusions: The Pilates method is an effective tool in treating chronic low back pain.

Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university's employees with non-specific low back pain: A pilot study.

Objective:Non-specific low back pain (non-specific LBP) is common problem between office-work employees. This study aimed to evaluate the short-term impacts of Pulsed Electromagnetic Field (PEMF) therapy in the treatment of non-specific LBP symptoms as pain, back mobility, LBP disabilities, and Health–Related Quality of Life (HRQOL).Methods:Forty-two University’s employees with non-specific LBP and aged from 35 to 55 years who participated in this study from January to June 2018 were divided into two groups: group A; received PEMF therapy and group B; received sham treatment. The outcome measures were; numerical rating scale, Modified Oswestry LBP Disability Score, Modified Schober test, and the Short Form-36 questionnaire. Evaluations were performed for both groups before and after finishing treatment.Results:All outcome measures were significantly improved statistically in the experimental group at the end of the intervention (p<0.05). On the other hand, there were non-significant differences in all outcome measures in the sham group (p>0.05).Conclusions:PEMT therapy may decrease pain, LBP disability, increase lumbar spine mobility, and improve HRQOL in middle-aged university’s employees with nonspecific LBP.

Prospective validation of the Juvenile Spondyloarthritis Disease Activity Index in children with enthesitis-related arthritis

To measure disease activity in children with enthesitis-related arthritis the Juvenile Spondyloarthritis Disease Activity Index (JSpADA) was developed and retrospectively validated. We prospectively validated JSpADA and also assessed performance of adult SpA scores. Children with enthesitis-related arthritis (ILAR criteria) less than 18 years of age were enrolled. Baseline characteristics and different disease activity measures (JSpADA, BASDAI, Ankylosing Spondylitis Disease Activity Score-ESR, juvenile arthritis DAS-10 joints), and Childhood HAQ, physician global assessment and patient global assessment were recorded at baseline. In some children follow-up was also done. The mean (s.d.) age of 127 children (116 boys) was 14.3 (2.4) years and disease duration was 36.9 (3) months. Ninety of 104 (86.5%) children were HLA-B27 positive. JSpADA showed high correlation with physician global assessment (r = 0.87; P < 0.0001), patient global assessment (r = 0.80, P < 0.0001), juvenile arthritis DAS-10 joints (r = 0.89; P < 0.0001) and Childhood HAQ (r = 0.83, P < 0.0001). The JSpADA scores showed good internal consistency, discriminative validity and sensitivity to change. In 15% of children back mobility could not be tested due to active arthritis in lower limbs. The 7-variable JSpADA excluding back mobility performed as well as the original JSpADA. Adult scores showed good construct validity, discriminative capacity and sensitivity to change, and had good correlation with JSpADA (BASDAI, r = 0.84; Ankylosing Spondylitis Disease Activity Score-ESR, r = 0.84). JSpADA is a valid score for measuring disease activity in enthesitis-related arthritis. Adult scores also performed well. Excluding back mobility needs to be assessed in future to improve JSpADA performance.

Vitamin D levels in patients with ankylosing spondylitis: Is it related to disease activity?

Objective:Ankylosing Spondylitis (AS) is an inflammatory rheumatic disease that mainly affects the axial spine. Osteopenia and osteoporosis are the main complications of AS. Vitamin D has functions on the immune system. In this study, we aimed to compare vitamin D levels and Bone Mineral Density (BMD) values between AS patients and controls.Methods:A total of 68 patients with axial AS and 34 healthy controls were enrolled in this study conducted between March 2018 and May 2018. Vitamin D concentrations, BMD values, disease activity, back mobility, functionality and radiologic damage were evaluated.Results:Vitamin D concentrations, the total BMD-femur and BMD-femur neck values were significantly lower in AS patients (p = 0.001, p = 0.011 and p = 0.003). No significant correlations were detected between vitamin D levels and BMD-femur total, BMD-femur neck values, disease activity, back mobility, functionality and radiologic damage scores (p > 0.05). Disease activity parameters were significantly and negatively correlated with total BMD-femur and BMD-femur neck values (p < 0.05).Conclusion:Our study demonstrates that AS patients have lower vitamin D levels, total BMD-femur and BMD-femur neck values. Higher disease activity increases bone loss in AS. Regular measurement of BMD and vitamin D should be kept in mind when planning a treatment in AS.

Comparison of low back mobility and stability exercises from Pilates in non-specific low back pain: A study protocol of a randomized controlled trial

BackgroundThere is some evidence in the literature about the effectiveness of the Pilates methods in the low back pain. Moreover, Pilates focus on exercises that empathizes the stability and/or mobility of the spine. Therefore, it is discussed in the literature whether higher levels of stability or mobility of the lumbar spine generates better results, both in performance and rehabilitation for low back pain. ObjectivesCompare the effects of the low back mobility and stability exercises from Pilates Method on low back pain, disability and movement functionality in individuals with non-specific chronic low back pain. Methods28 participants will be randomized into two exercise protocol from Pilates methods, one focusing on low back stability and other on low back mobility. Low back pain (visual analogic scale), low back disability (Oswestry) and movement functionality (7 functional movement tasks) will be evaluated before and after 10 sessions of Pilates exercise by the same trained assessor. A mixed designed ANOVA with two factors will be used. This study is the first to compare these outcomes for chronic low back pain participants with two exercises protocol focusing on low back mobility and stability and the results will evaluate what to prioritize with Pilates exercises to give better results for that population.