The Edmonton Ankylosing Spondylitis Metrology Index (EDASMI)
The EDASMI comprises 4 mobility measures that only require the use of a tape measure:
- Cervical Rotation
The subject is positioned sitting on the examination couch. A pen mark is made in the suprasternal notch. Looking directly ahead, the patient is asked to rotate the head as far as possible towards the right shoulder. The distance between the pen mark in the suprasternal notch and the tragus of the right ear is reucorded using a tape measure (cm) (D1). The subject is then asked to rotate the head as far as possible towards the left shoulder. The distance between the pen mark in the suprasternal notch and the tragus of the right ear is recorded with the tape measure (cm) (D2). Total cervical rotation is recorded as the distance (cm) between the two measurements (cm) (D1-D2).
* View EDASMI cervical rotation tape-based approach.
- Chest expansion
The subject is positioned sitting on the examination couch with the hands on the hips. A pen mark is made at the xiphisternum and a tape measure placed around the circumference of the subject’s chest at this level. Looking directly ahead the subject is asked to take in a deep breath and to exhale as completely as possible. The measurement is noted (M1) (cm). The subject is then asked to inhale as deeply as possible and the measurement is noted (M2) (cm). The difference in the two measurement points (M2-M1) (cm) constitutes the value for chest expansion.
* View chest expansion at the 4th intercostal space.
* View chest expansion measured at the xiphisternum.
- Lateral Lumbar Flexion
The examiner first demonstrates the movement to the subject. The subject is asked to stand straight with the back, heels, buttocks, and shoulders to the wall, hands by the side, all the fingers straight against the thigh, and looking directly forward. A pen mark is made on the thigh adjacent to the tip of the middle finger. The subject is then asked to slide the hand down the right thigh as far as possible without lifting the left foot/heel or flexing the right knee, and maintaining a straight posture with heels, buttocks, and shoulders against the wall. A pen mark is made adjacent to the tip of the middle finger. The difference between the two marks is measured using a tape measure. The maneuver is repeated on the left side and the mean of the two measurements recorded as the final score.
* View Lateral Lumbar flexion EDASMI approach.
- Internal Rotation of the Hip.
The subject is seated on an examining couch with the knees and hips flexed, the knees together against the couch clasping a piece of card paper. The subject is asked to move the ankles apart as far as possible without releasing the card paper between the knees. The distance between the medial malleoli is recorded using a tape measure.
* View internal rotation of the Hip.
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