Criterion-concurrent validity of spinal mobility tests in ankylosing spondylitis: a systematic review of the literature.
OBJECTIVE
To examine the level of evidence for criterion-concurrent validity of spinal mobility assessments in patients with ankylosing spondylitis (AS).


METHODS
Guidelines proposed in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to undertake a search strategy involving 3 sets of keywords: accura*, truth, valid*; ankylosing spondylitis, spondyloarthritis, spondyloarthropathy, spondylarthritis; mobility, spinal measure*, (a further 16 keywords with similar meaning were used). Seven databases were searched from their inception to February 2014: AMED, Embase, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Quality Assessment of Diagnostic Accuracy Studies (with modifications) was used to assess the quality of articles reviewed. An article was considered high quality when it received "yes" in at least 9 of the 13 items.


RESULTS
From the 741 records initially identified, 10 articles were retained for our systematic review. Only 1 article was classified as high quality, and this article suggests that 3 variants of the Schober test (original, modified, and modified-modified) poorly reflect lumbar range of motion where radiographs were used as the reference standard.


CONCLUSIONS
The level of evidence considering criterion-concurrent validity of clinical tests used to assess spinal mobility in patients with AS is low. Clinicians should be aware that current practice when measuring spinal mobility in AS may not accurately reflect true spinal mobility.
From the School of Physical Education, Sport and Exercise Science, and the Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; the School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.M.P. Castro, PhD, School of Physical Education, Sport and Exercise Science, and Dunedin School of Medicine, University of Otago; S.M. Stebbings, MD, Dunedin School of Medicine, University of Otago; S. Milosavljevic, PhD, School of Physical Therapy, University of Saskatchewan; M.D. Bussey, PhD, School of Physical Education, Sport and Exercise Science, University of Otago. marcelo.peduzzi.castro@gmail.com.
Marcelo P
MP
Castro
From the School of Physical Education, Sport and Exercise Science, and the Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; the School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.M.P. Castro, PhD, School of Physical Education, Sport and Exercise Science, and Dunedin School of Medicine, University of Otago; S.M. Stebbings, MD, Dunedin School of Medicine, University of Otago; S. Milosavljevic, PhD, School of Physical Therapy, University of Saskatchewan; M.D. Bussey, PhD, School of Physical Education, Sport and Exercise Science, University of Otago.
Simon M
SM
Stebbings
From the School of Physical Education, Sport and Exercise Science, and the Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; the School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.M.P. Castro, PhD, School of Physical Education, Sport and Exercise Science, and Dunedin School of Medicine, University of Otago; S.M. Stebbings, MD, Dunedin School of Medicine, University of Otago; S. Milosavljevic, PhD, School of Physical Therapy, University of Saskatchewan; M.D. Bussey, PhD, School of Physical Education, Sport and Exercise Science, University of Otago.
Stephan
S
Milosavljevic
From the School of Physical Education, Sport and Exercise Science, and the Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; the School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.M.P. Castro, PhD, School of Physical Education, Sport and Exercise Science, and Dunedin School of Medicine, University of Otago; S.M. Stebbings, MD, Dunedin School of Medicine, University of Otago; S. Milosavljevic, PhD, School of Physical Therapy, University of Saskatchewan; M.D. Bussey, PhD, School of Physical Education, Sport and Exercise Science, University of Otago.
Melanie D
MD
Bussey
D006801:Humans; D010808:Physical Examination; D016059:Range of Motion, Articular / Q000502:physiology*; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000503:physiopathology*
ANKYLOSING SPONDYLITIS; SPINAL MOBILITY; SPONDYLOARTHRITIS; SYSTEMATIC REVIEW; VALIDATION STUDY