Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon

Axial spondyloarthritis (axSpA) is a chronic rheumatic disease characterized by the presence of inflammatory back pain. In patients with chronic low back pain, the lumbar flexion relaxation phenomenon measured by surface electromyography (sEMG) differs from that in healthy individuals. However, sEMG...

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Main Authors: I. Concepción Aranda-Valera, Juan Luis Garrido-Castro, Alfonso Martínez-Galisteo, José Peña-Amaro, Cristina González-Navas, Antonio Cuesta-Vargas, Luis Jiménez-Reina, Eduardo Collantes-Estévez, Clementina López-Medina
Format: Article
Language:English
Published: MDPI AG 2021-04-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/11/5/810
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author I. Concepción Aranda-Valera
Juan Luis Garrido-Castro
Alfonso Martínez-Galisteo
José Peña-Amaro
Cristina González-Navas
Antonio Cuesta-Vargas
Luis Jiménez-Reina
Eduardo Collantes-Estévez
Clementina López-Medina
author_facet I. Concepción Aranda-Valera
Juan Luis Garrido-Castro
Alfonso Martínez-Galisteo
José Peña-Amaro
Cristina González-Navas
Antonio Cuesta-Vargas
Luis Jiménez-Reina
Eduardo Collantes-Estévez
Clementina López-Medina
author_sort I. Concepción Aranda-Valera
collection DOAJ
description Axial spondyloarthritis (axSpA) is a chronic rheumatic disease characterized by the presence of inflammatory back pain. In patients with chronic low back pain, the lumbar flexion relaxation phenomenon measured by surface electromyography (sEMG) differs from that in healthy individuals. However, sEMG activity in axSpA patients has not been studied. The purpose of this study was to analyze the flexion relaxation phenomenon in axSpA patients. A study evaluating 39 axSpA patients and 35 healthy controls was conducted. sEMG activity at the erector spinae muscles was measured during lumbar full flexion movements. sEMG activity was compared between axSpA patients and the controls, as well as between active (BASDAI ≥ 4) and non-active (BASDAI < 4) patients. The reliability (using intraclass correlation coefficients (ICC)), criterion validity and discriminant validity using the area Under the curve (AUC) for the inverse flexion/relaxation ratio (1/FRR) were evaluated. Significant differences (<i>p</i> < 0.05) were observed between axSpA patients and the control group in lumbar electric activity, especially during flexion, relaxation, and extension and in FRR and 1/FRR (0.66 ± 0.39 vs. 0.25 ± 0.19, respectively). In addition, significant differences were found between active and non-active but also between non-active and healthy subjects. The sEMG showed good reliability (ICC > 0.8 for 1/FRR) and criterion validity. ROC analysis showed good discriminant validity for axSpA patients (AUC = 0.835) vs. the control group using 1/FRR. An abnormal flexion/relaxation phenomenon exists in axSpA patients compared with controls. sEMG could be an additional objective tool in the evaluation of patient function and disease activity status.
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spelling doaj.art-9d120f891911482eb43169ad8a51e5f52023-11-21T17:51:14ZengMDPI AGDiagnostics2075-44182021-04-0111581010.3390/diagnostics11050810Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation PhenomenonI. Concepción Aranda-Valera0Juan Luis Garrido-Castro1Alfonso Martínez-Galisteo2José Peña-Amaro3Cristina González-Navas4Antonio Cuesta-Vargas5Luis Jiménez-Reina6Eduardo Collantes-Estévez7Clementina López-Medina8Rheumatology Department, Reina Sofía University Hospital, 14004 Cordoba, SpainG05 Group, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, SpainUniversity of Cordoba, 14004 Cordoba, SpainUniversity of Cordoba, 14004 Cordoba, SpainG05 Group, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, SpainMalaga Institute of Biomedical Research (IBIMA), University of Malaga, 29016 Malaga, SpainUniversity of Cordoba, 14004 Cordoba, SpainRheumatology Department, Reina Sofía University Hospital, 14004 Cordoba, SpainRheumatology Department, Reina Sofía University Hospital, 14004 Cordoba, SpainAxial spondyloarthritis (axSpA) is a chronic rheumatic disease characterized by the presence of inflammatory back pain. In patients with chronic low back pain, the lumbar flexion relaxation phenomenon measured by surface electromyography (sEMG) differs from that in healthy individuals. However, sEMG activity in axSpA patients has not been studied. The purpose of this study was to analyze the flexion relaxation phenomenon in axSpA patients. A study evaluating 39 axSpA patients and 35 healthy controls was conducted. sEMG activity at the erector spinae muscles was measured during lumbar full flexion movements. sEMG activity was compared between axSpA patients and the controls, as well as between active (BASDAI ≥ 4) and non-active (BASDAI < 4) patients. The reliability (using intraclass correlation coefficients (ICC)), criterion validity and discriminant validity using the area Under the curve (AUC) for the inverse flexion/relaxation ratio (1/FRR) were evaluated. Significant differences (<i>p</i> < 0.05) were observed between axSpA patients and the control group in lumbar electric activity, especially during flexion, relaxation, and extension and in FRR and 1/FRR (0.66 ± 0.39 vs. 0.25 ± 0.19, respectively). In addition, significant differences were found between active and non-active but also between non-active and healthy subjects. The sEMG showed good reliability (ICC > 0.8 for 1/FRR) and criterion validity. ROC analysis showed good discriminant validity for axSpA patients (AUC = 0.835) vs. the control group using 1/FRR. An abnormal flexion/relaxation phenomenon exists in axSpA patients compared with controls. sEMG could be an additional objective tool in the evaluation of patient function and disease activity status.https://www.mdpi.com/2075-4418/11/5/810axial spondyloarthritissurface electromyography (sEMG)flexion relaxation ratiofunctional assessmentclinimetric properties
spellingShingle I. Concepción Aranda-Valera
Juan Luis Garrido-Castro
Alfonso Martínez-Galisteo
José Peña-Amaro
Cristina González-Navas
Antonio Cuesta-Vargas
Luis Jiménez-Reina
Eduardo Collantes-Estévez
Clementina López-Medina
Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon
Diagnostics
axial spondyloarthritis
surface electromyography (sEMG)
flexion relaxation ratio
functional assessment
clinimetric properties
title Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon
title_full Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon
title_fullStr Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon
title_full_unstemmed Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon
title_short Patients with Axial Spondyloarthritis Show an Altered Flexion/Relaxation Phenomenon
title_sort patients with axial spondyloarthritis show an altered flexion relaxation phenomenon
topic axial spondyloarthritis
surface electromyography (sEMG)
flexion relaxation ratio
functional assessment
clinimetric properties
url https://www.mdpi.com/2075-4418/11/5/810
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