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Deformity in Ankylosing Spondylitis
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Pain on palpation of the cervicothoracic spine in AS should lead to a suspicion of fracture even if there has been no documented history of trauma. Schober’s test is used to evaluate lumbar stiffness—with the patient standing, mark the skin overlying the 5th lumbar spinous process (usually at the level of the ‘Dimples of Venus’) and a level 10cm above. On forward flexion, this should increase to >15cm.
Examination of Hip Joint in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Nirmal Raj Gopinathan, Reet Mukopadhya, Karthick Rangasamy, Ramesh Kumar Sen
The Schober’s and modified Schober’s test13 are used to diagnose the restriction of lumbar spine flexion in patients with inflammatory arthropathy, particularly ankylosing spondylitis. We will describe the modified Schober’s test. With the patient standing, the examiner marks the level of the lumbosacral junction. Then mark two points, one 10 cm above (a) and the other 5 cm below (b) the level of the lumbosacral junction (distance between the two points (a and b) being 15 cm). The patient is asked to bend forwards and attempt to touch their toes with the knees kept straight. Measure the distance between the two points, a and b, and if the distance does not increase by at least 5 cm, the test is said to be positive, indicating restriction of lumbar spine flexion (Figure 9.29).
The spine
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Palpation is useful to locate specific areas of tenderness. Ranges of motion should be assessed. The normal range of motion in the cervical spine is 45° of flexion, 55° of extension, 70° of rotation and 40° of lateral bend. The normal range of motion in the lumbar spine is 40-60° of flexion, 20-35° of extension, 15-20° of lateral bending and 3-18° of rotation. Schober’s test is a simple clinical test to evaluate spinal mobility. A tape measure is used to mark the skin midway between the posterior superior iliac spines and at points 10 cm proximal and 5 cm distal to this mark while the patient is standing. The patient is then asked to bend forward as far as possible and the distance between the two points is measured with the patient in the flexed position. Normally one would expect to see an increase of at least 5 cm between the two points in the erect and flexed positions. A distance of less than 5 cm between these points may indicate ankylosing spondylitis.
Do pain, function, range of motion, fear and distress differ according to symptom duration and work status in patients with low back pain? A cross-sectional study
Published in European Journal of Physiotherapy, 2022
Lumbar mobility: The modified Schober test (mSchober), a validated method for measurement of lumbar flexion, was used to estimate lumbar mobility [25,26]. It was originally designed for measuring specific lumbar mobility and primarily as a diagnostic tool for ankylosing spondylitis, but has also been widely used as an outcome measure in LBP patients, both as a clinical and as a scientific instrument. mSchober measures lumbar mobility very locally and does not f.ex take hamstring’s flexibility into account, in contrast to finger-tip-to-floor [27]. Studies of the validity of mSchober differs; Macrae found a very high correlation (Pearson r = 0.97) to X-rays [25], whereas other studies reported lower correlation (r = 0.67). Both studies estimated the intra- and intertest-reliability as excellent. A study of lumbar mobility in patients with LBP and pelvic related pain concluded that mSchober was best suited for measuring isolated lumbar mobility [28].
Novel imaging modalities in detection of cardiovascular involvement in ankylosing spondylitis
Published in Scandinavian Cardiovascular Journal, 2018
Demet Ozkaramanli Gur, Derya Necmiye Ozaltun, Savas Guzel, Banu Sarifakioglu, Aydin Akyuz, Seref Alpsoy, Ozge Aycicek, Derya Baykiz
In this prospective observational study, 75 AS patients diagnosed using modified New York criteria who were free of cardiovascular disease or overt cardiovascular involvement were compared with 30 healthy control subjects. The study protocol conformed to 1975 Declaration of Helsinki and was approved by the local Ethics committee. Patients were recruited consecutively among AS patients who attended a routine follow up visit at the rheumatology clinic. For comparisons, 30 age- and sex-matched individuals who were free of any known disease were consecutively recruited. After recording the demographic data of patients; physical examination was conducted to determine limitations in thorax expansion, lumbar lateral flexion, tragus wall distance, cervical rotation and the Schober test. The medications taken by each patient were recorded and then categorized into three groups with respect to mode of action as follows: Nonsteriodal anti-inflammatory drugs (NSAID), disease-modifying antirheumatic drugs (DMARD) or tumor necrosing factor inhibitors (antiTNF). Next, fasting blood samples were collected to determine hsCRP, sST2 and Gal-3 concentrations. All patients completed Bath ankylosing spondylitis disease activity index (BASFI), Bath ankylosing spondylitis disease activity index (BASDAI) and ankylosing spondylitis quality of life (ASQoL) questionnaires with the help of a physiotherapist. cPWV was determined for each patient oscillometrically. Body surface area (BSA) was calculated using Du Bois formula and body mass index (BMI) was calculated as weight (kg), divided by height square (m2) [9].
Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: a randomized controlled trial
Published in Disability and Rehabilitation, 2022
Lorena Bellido-Fernández, José-Jesús Jiménez-Rejano, Raquel Chillón-Martínez, Almudena Lorenzo-Muñoz, Elena Pinero-Pinto, Manuel Rebollo-Salas
Quality of life was assessed using the SF-12 questionnaire. A shortened version of the SF-36, which evaluates two dimensions of health: Physical Component Summary (PCS), and Mental Component Summary (MCS). It is transculturally adapted to Spanish [20] and consists of 12 items of the SF-36 obtained from multiple regression. It can measure patients’ health and quality of life [20].Lumbar mobility was measured using Schober’s test. This test is a valid and reliable tool to assess the range of motion of lumbar flexion in patients with low back pain [21].