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Background Ankylosing spondylitis produces a progressive decrease in spinal mobility with the evolution of the disease. This decrease is due to inflammation and structural damage at radiological level that occurs in neck and spine. Several indices have been validated to quantify this grade of affectation. The most used index to assess structural damage is the mSASSS. This index is evaluated between 0 to 72 points and it measures equally the affectation grade of the neck and lower back. Recently a new index based on motion analysis has been defined wich produces accurate and objective information about mobility, the UCOASMI [1] index. For calculating this index, two cervical mobility and three lumbar mobility measures are used, so cervical UCOASMI and lumbar UCOASMI can be defined. With the evolution of the disease UCOASMI and mSASSS indexes increases with more structural damage and loss of mobility, but what is the relation between lumbar and cervical damage with the evolution of AS? Objectives To analyze the evolution of AS in terms of radiological damage and mobility at the cervical and lumbar area. Methods 76 patients diagnosed with AS (75% male, age 44.1±11.5 years, duration 13.6±9.4 years) were analyzed. A radiologist assessed radiographs for calculating mSASSS. At the Motion Analysis Laboratory of the Reina Sofia University Hospital, UCOTrack system was used to calculate UCOASMI index. For both indices, coefficient cervical/lumbar ratio was calculated to identify which part was more affected. Results Table shows affectation grade in mobility (UCOASMI) and radiographic damage (mSASSS) in total sample and grouped by gender, duration, and affectation grade in mobility. Differences between groups are also showed indicating whether these are statistically significant. Conclusions The relation between affectation of cervical and lumbar part seems to be balanced around 50% according to both structural damage and mobility. Mobility differences in genre were not appreciated. While there are differences in the structural damage between male and female, this difference appears similarly in both areas. According to our results, only at initial stages of the disease, lower back is most affected, especially as far as mobility is concerned. References Garrido-Castro JL, Escudero A, Medina-Carnicer R, Galisteo AM, Gonzalez-Navas C, Carmona L, Collantes-Estevez E. Validation of a new objective index to measure spinal mobility: the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI). Rheumatol Int. 2013 Dec 20. [Epub ahead of print] Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.3280

Background Osteoarthritis of the knee (OA) is the most common disease affecting the musculoskeletal system and one of the most important causes of disability among elderly population. Patients are assessed by questionnaires whose response may be influenced to some subjectivity (WOMAC, VAS, SF36). Gait analysis and ground reaction forces (GRF) produce objective and quantitative results of patient status with well-defined patterns. Vertical force curves are characterized by showing two peaks and a valley, showing a graph like an inverted W. Intra-articular injections of hyaluronic acid for the treatment of knee OA have been shown to reduce pain and improve joint function. In this work we have used GRF as evaluation tool in patients with knee OA before and after applying intra-articular treatments. Objectives To analyze ground reaction forces in patients with knee OA before and after intraarticular treatment. Methods 26 patients with knee OA (57.68±8.06 years, 1.65±0.88 m, 87.74±13.06 kg) with a high level of affectation (grade II-III according to Kellgren and Lawrence scale) and 6 healthy subjects as control group with similar characteristics (55.33±5.07 years, 1.70±0.77 m,. 88.52±10.15 kg) were analyzed. Intraarticular injections of hyaluronic acid were applied to patients before and after measurements (one and three months). Vertical, mediolateral and anteroposterior GRF were evaluated using a triaxial force plate (Bertec ® FP4060) Results GRF in three axis and some temporary values as support time and first peak time in vertical force are showed in table. Significant differences between patients and control group in almost all parameters analyzed were found, showing a biomechanical altered gait. Regarding treatment sensitive measures, we could highlight first time peak in vertical force, force in the valley and difference between peak and valley. Sensitive measures also appear in the other two axis with larger braking and impulse forces. Also a shorter support time appears. Conclusions Our study shows that GRF clearly improved approximating to values obtained for control group after intraarticular treatment. The evaluation of GRF in gait could be used as an evaluation tool, not only to demonstrate the biomechanical alteration produced by knee OA, but also as a tool for evaluating the effectiveness of treatment. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3313

Background Ankylosing spondylitis (AS) is a chronic inflammatory disease which causes a reduction in the patient mobility. Several studies show that, at radiological level, structural damage is much higher in men. There are few studies about gender differences in spinal mobility. Recently new technologies as motion capture have been introduced for assessing spinal mobility[1]. Objectives To analyze, using measures obtained by a motion capture system, gender differences in spinal mobility of patients with AS in the medium and long term. Methods 70 AS patients were analized (76.7% men). Two groups of patients were defined: medium and long term according disease duration (long term > 10 years). Cervical and spinal mobility were assessed using a motion capture system, the UCOTrack© [1]. Questionnaries about function and activity, conventional metrology (BASMI), and radiological scores (mSASSS) were also obtained. From motion capture several measurements were analyzed included a metrological index, the UCOASMI, based on motion capture measurements. Results No significant differences between men and women in self-rated questionnaires were found, although women obtain worse scores particularly in the medium term. Occiput-wall distance differences was found between sexes. Some measures obtained by the motion capture system were different between genders: UCOASMI, lateral spinal flexion and cervical flexion. Conclusions Results obtained by motion analysis corroborate similarities between genders as shown by several authors. Men have better mobility at medium term, inverting this difference at long term due mainly to structural damage. Motion capture provided additional accuracy information that can be useful in the diagnosis and therapeutic management of the disease. References Assessment of spinal mobility in ankylosing spondylitis using a video-based motion capture system. Garrido-Castro J.L, Medina-Carnicer R, Schiottis R., Galisteo A.M, Collantes E., Gonzalez-Navas C. Manual Therapy 2012 Oct;17(5):422-6. Disclosure of Interest None Declared

Background Knee osteoarthritis (OA) is the most common disease affecting human locomotion, and one of the most important causes of disability among the elderly population. In order to assess health status of patients self-evaluated questionnaires are commonly used, wich may be influenced by certain degree of subjectivity. Hialuronic acid is a common used treatment to improve knee OA. A force plate connected to a computer allows to analyze postural stability evaluating the center of pressure (CoP) sway in the lateral and sagittal planes. These methods of assessment the postural stability have shown excellent reliability in previous studies. Objectives Analyze the assessment of postural stability in patients with Knee OA using a triaxial force plate. Methods 10 patients with knee OA were analyzed (6 women and 4 men, age 55.3±3.2 years, weight 82.5±12.9 Kgr.) and 6 healthy subjects (4 women and 6 men, age 53.1±1.6 years, weight 78.3±10.4 Kgr.) as control group. Patients had a II-II degree of knee OA according to Kellgren and Lawrence scale. Hyaluronic acid injections were applied into the affected knee. Measures were taken before and after (4 weeks) treatment. A triaxial force plate (Bertec © FP5040) was used to assess postural balance. Patiens remained quiet for 10 seconds on the force plate, first with their eyes open (EO) and then another 10 seconds with their eyes closed (EC). Following parameters were recorded: total CoP distance, distance covered in antero-posterior and medio-lateral directions, area covered, and Romberg test (relation between EC and EO area). Patients fulfilled questionnaires in each test in order to calculate indexes: VAS general, VAS pain, WOMAC, SF-36 and OARSI criteria. Results Significant differences were observed in CoP area in both EO and EC, and in Romberg test, between pre and post treatment measures. Differences between control group and patients were significant in almost all parameters. In questionnaires based indexes, improvements were showed, although these differences were not statistically significant. Correlations were found between CoP sway with EC (p Conclusions Despite being a pilot study, with a very reduced sample, measurements of postural stability obtained from the force plate were sensitive to treatment. It was also interesting correlations between balance and pain level according to VAS, wich seems to show that pain in knee OA produces certain postural imbalance, as previous studies shown. Future studies with larger sample size may demonstrate our hypothesis, so this kind of technology can be used to assess outcome in knee OA patients and to show effectiveness treatments. Disclosure of Interest None Declared