POS0952 RESPONSIVENESS OF SPINAL MOBILITY MEASUREMENTS IN AXIAL SPONDYLOARTHRITIS USING CONVENTIONAL AND ADVANCED METROLOGY: A PILOT STUDY
Authors: J. L. Garrido-Castro, I. C. Aranda-Valera, P. Gardiner, P. Machado, J. Condell, C. Gonzalez-Navas, E. Collantes Estevez
Journal: Annals of the Rheumatic Diseases (2021)

Background: Spinal mobility is an important outcome in axial spondyloarthritis (axSpA). Standardized metrology tests have been defined and validated. Nevertheless, conventional metrology measures lack responsiveness, particularly in the context of assessing short term response to treatments. Advanced metrology devices have also been used in axSpA, namely optical motion capture systems (MoCap) and Inertial Measurement Systems (IMU). These systems have better psychometric properties in terms of accuracy and reliability for analysing spinal mobility. Objectives: To compare the responsiveness of spinal mobility using conventional and advanced metrology. Methods: Spinal mobility was measured using an IMU based system (ViMove©) with sensors located at: occiput and T3 for cervical mobility, L1 and sacrum for lumbar mobility, and T3 and sacrum for thoracic+lumbar mobility. A MoCap system (UCOTrack©) using 13 markers was also used to record the movements in 3 planes (flexion+extension, rotation, and lateral flexion). The UCOASMI [1] index was calculated using measures obtained by MoCap and by the IMU system. Other metrology indexes based on IMU measures developed by the authors [2} were also calculated. Patients were assessed before (PRE) and 3 months after (POST) TNF blocker treatment. The Wilcoxon signed-rank test was used to test differences between pairs of pre- and post-treatment. Cohen’s d was use for calculating the effect size of improvement. Results: 12 axSpA patients were recruited from the CASTRO cohort (42% female, age 46±11 years, disease duration 16±13 years). Results PRE and POST are shown in Table 1: means (sd), statistical significance, and effect size. Disease activity and functional indexes were lower in POST and these differences were significant, especially in ASDAS. Conventional metrology lacked responsiveness, except for cervical rotation. MoCap showed moderate responsiveness in cervical rotation, in thoracolumbar mobility and with regards to the UCOASMI. Using IMU measures, responsiveness was good in terms of cervical flexion and rotation. For Lumbar (L_) and Lumbar Thoracic (LT_), lateral flexion shown significant improvement and lumbar rotation shown the best responsiveness. PRE POST Sign ES PRE POST Sign ES Activity IMU BASDAI 6.5 (1.6) 4.9 (2.7) * 0.64 C_FLEX 77 (22) 83 (19) * -0.25 BASFI 6.5 (2.3) 4.8 (3.2) * 0.58 C_ROT 78 (25) 84 (22) * -0.22 ASDAS 3.6 (1.0) 2.5 (1.2) ** 0.87 C_FL 54 (19) 54 (17) NS Metrology L_FLEX 46 (16) 44 (19) NS LatFlex 9.3 (4.1) 10.6 (3.3) NS L_ROT 21 (9) 27 (9) *** -0.66 TWD 13.2 (4.2) 12.8 (3.6) * 0.06 L_FL 32 (1) 38 (10) * -0.52 Schober 4.7 (1.5) 4.9 (1.5) NS LT_FLEX 62 (28) 63 (24) NS IMD 89 (15) 90 (15) NS LT_ROT 63 (19) 70 (19) NS CervRot 104 (28) 118 (24) ** -0.51 LT_FL 52 (15) 60 (15) ** -0.51 BASMI 3.8 (1.3) 3.4 (1.2) NS Trk_FLEX 109 (28) 112 (24) NS MoCap Trk_ROT 98 (31) 116 (21) ** -0.59 C_FLEX 81 (22) 87 (20) * -0.28 Trk_FL 39 (9) 46 (10) ** -0.7 C_ROT 101 (28) 112 (25) *** -0.38 TTrk_FLEX 119 (36) 128 (30) NS C_FL 58 (20) 58 (18) NS TTrk_ROT 137 (34) 161 (35) ** -0.67 L_FLEX 107 (24) 114 (21) *** -0.26 TTrk_FL 59 (15) 69 (16) ** -0.6 L_ROT 67 (21) 73 (20) NS iUCOASMIL 5.7 (1.5) 5.0 (1.4) *** 0.48 L_FL 57 (18) 65 (20) ** -0.41 iUCOASMILT 6.0 (1.5) 5.4 (1.3) ** 0.39 UCOASMI 6.1 (1.6) 5.3 (1.6) ** 0.50 iCxLPASMI 3.9 (1.8) 3.2 (1.5) ** 0.40 iCxLuASMI 3.2 (1.4) 2.7 (1.3) *** 0.40 NS, not significant; *, p&lt;0.05; **, p&lt;0.01 Conclusion: Conventional metrology lacks short-term responsiveness. Advanced metrology using MoCap and IMU showed, in this pilot study, better responsiveness compared to conventional measures. Furthermore, IMU provide a feasibility similar to conventional metrology, and could be easily implemented in the context of clinical trials and observational studies. References: [1]Validation of a new objective index to measure spinal mobility: the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI). Rheumatol Int. 2014 Mar;34(3):401-6. [2]Validity and Reliability of a Sensor-Based Electronic Spinal Mobility Index for Axial Spondyloarthritis. Rheumatology (Oxford). 2020 Apr 28;keaa122. Disclosure of Interests: None declared