The Bath Indices are outcome measures used with ankylosing spondylitis Index; 2 BASDAI: Bath AS Disease Activity Index; 3 BASMI: Bath AS Metrology Index. The Bath Ankylosing Spondylitis Metrology Index Varies Significantly During the Daytime. de Freitas, Leonardo Vinicius, MD *; Rodrigues, Igor Kunze, MD, MSc. BASMI(lin) (Bath Ankylosing Spondylitis Metrology Index). Record raw scores in spaces provided. Scores will be calculated automatically. Click on a.

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A cross-sectional study of volunteers stratified by gender and age was completed. Exclusion criteria comprised factors potentially influencing spinal mobility. Each component of the BASMI was assessed, with the total score computed using the point scoring system. Measurements were taken by physiotherapists following an agreed protocol.

Data were summarized and analysed with age-specific centiles and CIs calculated.

The Bath Indices

The estimated median score for an individual age 25 years was 0. There was a corresponding increase in component BASMI scores, which was more pronounced for some components than others. Our data sponrylitis that it is unusual for healthy individuals to score zero on the BASMI, which has implications for the interpretation of scores, especially at baseline. The generation of normative values has the potential to ankylosimg clinical assessment of spinal mobility and assist patients in understanding how their spinal mobility compares with that of a healthy age-matched population.

The loss of spinal mobility is widely recognized as an important clinical sign, and this is reflected by its inclusion in the Modified New York Criteria for diagnosis indez 2 ], and more recently as a core domain in the evaluation of patients in clinical practice and trials by the Assessment of SpondyloArthritis international Society ASAS [ 3 ]. The BASMI [ 4 ], a composite index of spinal mobility, is used internationally in research and clinical practice and is the measure of spinal mobility recommended by the ASAS [ 3 ].

The BASMI is used clinically to bqth a mefrology measurement and monitor change over time [ 4 ] and to assess the impact of clinical interventions [ 3 ]. The scale of the BASMI ranges from 0 to 10, where 0 is no mobility limitation and 10 is very severe limitation [ 5 ].

With this scale in mind, clinicians and patients may have bxth that a score of zero is representative of normal spinal movement in a healthy population. However, as a number of studies have demonstrated age-dependent changes in isolated spinal mobility measurements indexx 6—11 ], it would seem reasonable to assume that there are similar changes in the total BASMI score with age, suggesting that it may be more appropriate to interpret BASMI values and changes in values over time in relation to age-specific centiles.

This therefore highlighted the need for further work to explore if this was a coincidental finding or if in fact this should spondylotis expected. When receiving a diagnosis and being informed about the meaning of clinical measures, patients are keen to understand the implications and relevance of their measurements.

As well as helping patients to interpret their BASMI scores, clinicians may find age- and gender-related reference values helpful to inform their understanding and interpretation of spinal mobility in the patients they treat. Ethical approval was obtained from the Faculty of Health and Medicine Ethics Committee at Meyrology University and written informed consent was obtained from all participants according to the Declaration of Helsinki.


This was based on simulations from a uniform distribution consistent with pilot data [ metrologgy ]. In total, participants were recruited from a UK population, stratified by gender and age, between September and December To address possible inconsistencies in measurement, the ASSIGNw consensus of measurement for each domain was followed [ 12 ]. For cervical rotation, tragus-to-wall and lumbar side flexion, the average of the right and left measurements was taken [ 4 ].

BASMI(lin) (Bath Ankylosing Spondylitis Metrology Index)

Additional data collected included gender, ethnicity, date of birth and history of back problems. Current evidence suggests that the diagnosis of AS most commonly occurs between the ages of 25 and 34 years [ 1516 ].

A total of participants with a mean age of The majority of participants were white Caucasian In contrast, tragus-to-wall distance did not deteriorate, consistently scoring 1 on the component BASMI score across all three age groups Table 2.

Given their clinical relevance, summary statistics are presented for the total BASMI score, component scores and raw measurements Table 2. No clear differences were identified between sexes Table 2.

Our findings suggest that zero is not a normal score for an individual from a healthy population, with only 1. Our results also indicate that the magnitude of increase in the BASMI nath is more apparent with increasing age. This is in nath with previous research undertaken on spinal mobility by Finnsback and Mannerkorpi [ 8 ] and Intolo et al. With respect to component BASMI scores, there was a corresponding increase with age that was more pronounced for some spinal mobility measures indsx others.

With regard to lateral lumbar flexion, Finnsback and Mannerkorpi [ 8 ], using a measurement technique consistent with ours batn a healthy population, found median scores of 20 cm for both males and females ages 20—49 years, and scores of The only published normative data for tragus-to-wall measurements used a seated tragus-to-wall measurement in a population of healthy men and women, and found results consistent with ours, that there is no age-related deterioration [ 8 ].

Clinically this is of interest, as it appears that the tragus-to-wall measure does not deteriorate with age to the same extent as other component measures, suggesting this measure is truly disease specific.

Although in our study measurements were taken by a number of different therapists, a sensitivity analysis was conducted on the summary statistics to determine if those individuals who were more experienced obtained different results, and no important differences were identified. The data we have presented provide important initial data to aid clinicians in their interpretation of BASMI scores and subsequent clinical management of patients and add strength to our previous observation that some healthy people have the potential to obtain BASMI scores higher than patients with AS.

It remains to be determined how our centiles can be applied to other populations, particularly as the participants were predominantly white Ankkylosing. We would therefore bxth similar studies using larger samples in inded UK and other populations. Future research should also take into account the influence of factors other than age and sex.


Therefore measures of both height and weight and lifestyle factors such as occupation should be included in future research to develop our findings. Such information is ankyloisng to someone who is newly diagnosed and being assessed clinically for the first time, potentially informing their expectations about treatment effects.

Furthermore, such information has the potential to take into account the influence of age, guarding against spodnylitis being interpreted purely as being associated with the disease process. We would like to acknowledge the members of the ASSIGNw, who undertook the measurements for this project, and the volunteers who participated. All other authors have declared no conflicts of interest.

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Materials and methods Ethical approval was obtained from psondylitis Faculty of Health and Medicine Ethics Committee at Lancaster University and written informed consent was obtained from all participants according to the Declaration of Helsinki. Mefrology To address possible inconsistencies in measurement, the ASSIGNw consensus of measurement for each domain was followed [ 12 ]. Results A total of participants with a mean age of Age, years 5th 50th 95th 25 0.

Open in a separate window. Acknowledgements We would ankyloaing to acknowledge the members of the ASSIGNw, who undertook the measurements for this project, and the volunteers who participated. This work was funded by the National Institute of Health Research.

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