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Rheumatology Advance Access originally published online on July 28, 2009
Rheumatology 2009 48(10):1254-1260; doi:10.1093/rheumatology/kep190
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Reproducibility of performance measures of physical function based on the BASFI, in ankylosing spondylitis

Salima F. E. van Weely1, Christiaan J. van Denderen1, Irene E. van der Horst-Bruinsma2, Michael T. Nurmohamed1,2, Ben A. C. Dijkmans1,2, Joost Dekker1,3 and Martijn P. M. Steultjens1,3

1Jan van Breemen Institute, Centre for Rheumatology and Rehabilitation, 2Department of Rheumatology and 3Department of Rehabilitation Medicine, VU University Medical Center, EMGO Institute, Amsterdam, The Netherlands.

Correspondence to: Salima F. E. van Weely, Jan van Breemen Institute, Centre for Rheumatology and Rehabilitation, Dr Jan van Breemenstraat 2, 1056 AB, Amsterdam, The Netherlands. E-mail: s.v.weelij{at}janvanbreemen.nl


  Abstract

Objective. To establish the test–retest reproducibility of performance measures of physical function based on the Bath Ankylosing Spondylitis Functional Index (BASFI) questionnaire in patients with AS.

Methods. Data were obtained from 65 AS patients. They were tested on two occasions by one assessor with a 1-week interval. Physical function was assessed via eight performance measures based on items used in the BASFI questionnaire, representing activities of daily life, which AS patients frequently report to be problematic. For each activity, a performance score was determined. Pain and exertion were measured using a 10-cm horizontal visual analogue scale (VAS) and Borg's modified scale, respectively. Test–retest reproducibility was assessed for all measurements using intraclass correlation coefficients (ICCs) and by calculating the standard error of measurement (SEM).

Results. Adequate intrarater reliability was found. For performance scores, ICCs ranged from 0.73 to 0.96. Measurements of exertion and pain also showed adequate intrarater reliability, with the exception of one performance measure, namely the test for the ability to look over one's shoulder. For this test, the ICCs were 0.66 and 0.69 for exertion and pain, respectively. The remaining ICCs for exertion ranged from 0.71 to 0.88 and for pain from 0.74 to 0.83. The SEM for performance scores ranged from 4 to 9% of the observed score. The SEM for exertion ranged from 8 to 11% and for pain from 10 to 15%.

Conclusions. Performance measures of physical function based on the BASFI questionnaire have adequate to excellent test–retest reproducibility. Due to the presence of measurement error, measurements are accurate for group assessment; repeated measurements are advised for an adequate assessment of individual patients.

KEY WORDS: Ankylosing spondylitis, Performance test, Physical function, Reproducibility, BASFI

Submitted 3 March 2009; revised version accepted 4 June 2009.
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