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Clin Rheumatol. 2011 Feb;30(2):239-43. doi: 10.1007/s10067-010-1615-z. Epub 2010 Nov 6.

Spinal mobility and its impact in Moroccan patients with ankylosing spondylitis.

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Department of Rheumatology (Pr N. Hajjaj-Hassouni), El Ayachi Hospital, University Hospital of Rabat-Sale, 11000, Sale, Morocco.


The main objective of this cross-sectional study was to assess spinal mobility and its relationship with disease-related parameters of activity, severity, and quality of life in Moroccan patients with ankylosing spondylitis (AS). One hundred patients with AS according to New York Classification criteria were recruited. Chest expansion, Schober index, occiput-to-wall distance, and the combined index of Bath Ankylosing Spondylitis Metrology Index (BASMI) were used to assess spinal mobility. Assessment criteria included the evaluation of disease activity (Bath Ankylosing Spondylitis Disease Activity index), functional status (Bath Ankylosing Spondylitis Functional Index), and radiographic damage (Bath Ankylosing Spondylitis Radiologic Index).The short form-36 (SF-36) generic instrument was used to assess health-related quality of life. The mean age of patients was 38 ± 13 years. There were 67% of males in our data. Our patients had moderate disease activity, severe functional disability, and important radiological damage. The mean value of occiput-to-wall distance was 4 ± 6.2 cm, chest expansion was 3.4 ± 1.2 cm, Schober index was 2.7 ± 1.2 cm, and BASMI was 4 ± 3. Impaired spinal mobility, corresponding to higher scores of BASMI, had good statistically significant correlations with prolonged disease duration, severe functional disability (BASFI), important radiological damage (BASRI) and with the deterioration of most domains of SF-36 (p < 0.001). In our study, we state that functional status and radiographic damage are the main factors associated with limited spinal mobility. Also, altered spinal measurements had a negative impact on physical function domain of quality of life. Recognizing relationships between spinal mobility measures and clinical and radiological measures in AS can help us to develop early therapeutic strategies to reduce loss of spinal mobility in Moroccan patients.

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