1
Garrido-Castro, et al: Reproducibility of UCOASMI
Personal non-commercial use only. The Journal of Rheumatology Copyright © 2018. All rights reserved.
High Reproducibility of an Automated Measurement of
Mobility for Patients with Axial Spondyloarthritis
Juan L. Garrido-Castro, Rafael Curbelo, Ramón Mazzucchelli, María E. Domínguez-González,
Cristina Gonzalez-Navas, Bryan J. Flores Robles, Pedro Zarco, Juan Mulero, Luis Cea-Calvo,
María J. Arteaga, Pilar Font-Ugalde, Loreto Carmona, and Eduardo Collantes-Estevez
ABSTRACT. Objective. Conventional measures of spinal mobility used in the assessment of patients with axial
spondyloarthritis (axSpA), such as the Bath Ankylosing Spondylitis Metrology Index and its compo-
nents, are subject to interobserver variability. The University of Córdoba Ankylosing Spondylitis
Metrology Index (UCOASMI) is a validated composite index based on a motion video-capture system,
UCOTrack. Our objective was to assess its reproducibility in clinical practice settings.
Methods. We carried out an observational study of repeated measures in 3 centers. Video-capture
systems were installed and adapted to clinical rooms. Patients with axSpA and stable disease were
selected by consecutive stratified sampling [disease duration, sex, and the Bath Ankylosing Spondylitis
Disease Activity Index (BASDAI)]. Intraobserver reliability of the UCOASMI and of conventional
measures was tested 3–5 days apart. For interobserver reliability, 3 patients from each center were
evaluated in the other centers, within 3–7 days. The intraclass correlation coefficients (ICC) were
calculated.
Results. Thirty patients were included (73% men, mean age 53 yrs, mean BASDAI 3.0). Interobserver
and intraobserver ICC of the UCOASMI was 0.98. Conventional measurements showed lower but
adequate reproducibility as well, except for interobserver reliability of lateral flexion (0.41), cervical
rotation (0.61), and Schöber test (0.07), and intraobserver reliability of tragus-to-wall distance (0.30).
Conclusion. Reproducibility of the UCOASMI seems very high, and apparently more reliable than
conventional measures of mobility. (J Rheumatol First Release June 15 2018; doi:10.3899/
jrheum.170941)
Key Indexing Terms:
SPONDYLOARTHROPATHY OUTCOME ASSESSMENT SPINE
From the Instituto Maimónides de Investigación Biomédica de Córdoba
(IMIBIC); Department of Rheumatology, Hospital Universitario Reina
Sofía; Department of Medicine, Universidad de Córdoba, Córdoba;
Instituto de Salud Musculoesquelética; Department of Rheumatology,
Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology,
Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp
& Dohme, Madrid, Spain.
Study funded by Merck Sharp & Dohme of Spain. Dr. L. Cea-Calvo and
Dr. M.J. Arteaga are full-time employees at Merck Sharp & Dohme of
Spain. UCOTrack is owned by the University of Córdoba and the
Andalusian Health Service.
J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de
Salud Musculoesquelética; R. Mazzucchelli, MD, Department of
Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González,
RN, Department of Rheumatology, Hospital Fundación Alcorcón;
C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology,
Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department
of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD,
Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero,
MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro;
L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme;
M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme;
P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology,
Hospital Universitario Reina Sofía, and Department of Medicine,
Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud
Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and
Department of Rheumatology, Hospital Universitario Reina Sofía, and
Department of Medicine, Universidad de Córdoba.
Address correspondence to Dr. J.L. Garrido-Castro, Instituto Maimónides
de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.
E-mail: cc0juanl@uco.es
Accepted for publication February 28, 2018.
Axial spondyloarthritis (axSpA) is characterized by structural
damage
1
, dependent on the inflammatory process, and
manifested as bone erosions, resorption, and new bone
formation
2,3
. The result is a significant reduction of joint
mobility and pain, which in turn lead to disability and deteri-
oration of quality of life
4,5,6
. The objective of therapy in
axSpA is 2-fold: halting the inflammatory process at present,
and avoiding structural damage and disability in the future
while improving patients’ quality of life. The field of
measurement in axSpA has evolved in parallel to the devel-
opment of new drugs, and measures of disease activity and
structural damage are reasonably well accepted for use in
clinical trials and in clinical practice. The measurement of
damaged mobility, on the contrary, has problems. Spinal
mobility can be assessed by 2 types of instruments: (1)
standardized measures of range of motion and distance, in
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