Physical Assessment in axSpA, Spinal Mobility Tests and the ASPI

Bas lists options for symptoms, mobility, fitness, strength, disease activity (BASDAI), function (BASFI, ASPI, Patient Specific Functional Scale) and quality of life, and advises picking only what fits the patient's needs from the interview. He demonstrates the ASAS core set mobility tests with norms: chest expansion of at least 5 cm, cervical rotation of at least 70 degrees to each side (20 to 70 moderately limited, under 20 severely limited), lateral spinal flexion of at least 10 cm (5 to 10 moderate, under 5 severe), the occiput to wall test, where touching the wall means no kyphosis, and a modified Schober test with at least 5 cm increase. The ASPI turns three BASFI activities into timed tasks: picking up six pens one by one from the floor, putting on both socks, and rising from lying on the back to standing. Pain and Borg exertion are recorded for each task. Improvement means at least 20% better on one task without 20% worsening on another, giving an objective measure to repeat over weeks or months.