COSMIN database

Construct validity of clinical spinal mobility tests in ankylosing spondylitis: a systematic review and meta-analysis

Castro, M. P., Stebbings, S. M., Milosavljevic, S., and Bussey, M. D.
The study aimed to determine, using systematic review and meta-analysis, the level of evidence supporting the construct validity of spinal mobility tests for assessing patients with ankylosing spondylitis. Following the guidelines proposed in the Preferred Reporting Items for Systematic reviews and Meta-Analyses, three sets of keywords were used for data searching: (i) ankylosing spondylitis, spondyloarthritis, spondyloarthropathy, spondylarthritis; (ii) accuracy, association, construct, correlation, Outcome Measures in Rheumatoid Arthritis Clinical Trials, OMERACT, truth, validity; (iii) mobility, Bath Ankylosing Spondylitis Metrology Index-BASMI, radiography, spinal measures, cervical rotation, Schober (a further 19 keywords were used). Initially, 2558 records were identified, and from these, 21 studies were retained. Fourteen of these studies were considered high level of evidence. Compound indexes of spinal mobility showed mostly substantial to excellent levels of agreement with global structural damage. Individual mobility tests for the cervico-thoracic spine showed only moderate agreements with cervical structural damage, and considering structural damage at the lumbar spine, the original Schober was the only test that presented consistently substantial levels of agreement. Three studies assessed the construct validity of mobility measures for inflammation and low to fair levels of agreement were observed. Two meta-analyses were conducted, with assessment of agreement between BASMI and two radiological indexes of global structural damage. The spinal mobility indexes and the original Schober test show acceptable construct validity for inferring the extent of structural damage when assessing patients with ankylosing spondylitis. Spinal mobility measures do not reflect levels of inflammation at either the sacroiliac joints and/or the spine.
Clin Rheumatol
1434-9949 (Electronic); 0770-3198 (Linking)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
6 - Clinical rating scales
BASMI - Bath Ankylosing Spondylitis Metrology Index
Chest - Chest Expansion
Chin-manubrium distance
CROM - Cervical Range of Movement
EDASMI - Edmonton Ankysosing Spondylitis Metrology Index
FFD - Finger Floor Distance
Lumbar lateraal flexion
Modified Schober Measure of Spinal Extension
Occiput-wall Distance
Schober test
Tragus-wall distance
UCOASMI - University of Cordoba Ankylosing Spondylitis Metrology Index