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Objective. The purpose of this study was to validate a maximum inspiratory pressure (MIP) test protocol based on the principles of the 1-repetition maximum (1RM) test, assess its test-retest reliability, and establish minimal detectable change (MDC) in individuals with chronic obstructive pulmonary disease (COPD). Methods. Forty-nine individuals with COPD were included in the study, of whom 44 individuals attended 2 appointments separated by 7 to 10 days for test-retest reliability. The MIP test was performed using a threshold valve device (1RM-based protocol) and the digital manometer (reference test). The 1RM-based protocol consisted of an incremental phase (inspiratory load increase [10 cm [H.sub.2]O] to achieve respiratory failure) and an approach phase (load halfway between the lowest failed attempt and the last valid attempt was prescribed). Results. The concurrent validity of the 1RM-based protocol for the MIP test was good with respect to the reference test (day 1, intraclass correlation coefficient [ICC] = 0.81; day 2, ICC = 0.85). The test-retest reliability was excellent (ICC = 0.92), with a standard error of measurement of 6.3 cm [H.sub.2]O and a MDC of 17.5 cm [H.sub.2]O. Conclusion. This study validated a new 1RM-based protocol for the MIP test using an inspiratory muscle training (IMT) device in individuals with COPD, showing good concurrent validity compared with the reference test, as well as excellent test-retest reliability. The MDC reported can be interpreted and applied in the clinical setting. Impact. There was a need for developing new, inexpensive, simple, and feasible methods for the MIP test. The validation of the 1RM-based protocol addresses this issue, allowing for the appropriate prescription of IMT, favoring its widespread use in people with COPD, and therefore improving their physical therapist care. Keywords: Chronic Obstructive Pulmonary Disease, Maximal Respiratory Pressures, Muscle Strength, Patient Outcome Assessment, Reproducibility of Results, Introduction There are an estimated 400 million individuals worldwide with chronic obstructive pulmonary disease (COPD), (1) representing a significant socioeconomic burden. COPD significantly diminishes exercise tolerance and quality of life, [...]

To describe the radiographic phenotype of axial spondyloarthritis (SpA) according to the presence of HLA–B27. An international collaboration compared the radiographic phenotype of axial SpA according to HLA–B27 status. Patients with ankylosing spondylitis (AS) and axial psoriatic arthritis (PsA) were collected. Radiographs were read centrally, blinded to clinical details. The symmetry of the sacroiliac joints and lumbar syndesmophytes and the morphology of syndesmophytes (typical marginal versus atypical chunky), together with the modified Stoke Ankylosing Spondylitis Spine Score and the Psoriatic Arthritis Spondylitis Radiographic Index, were recorded. A total of 244 patients with PsA and 198 patients with AS were included. In PsA, 60 patients (25%) were HLA–B27 positive while in AS, 148 patients (75%) were HLA–B27 positive. Patients with HLA–B27 were younger and more often male and had a longer duration of disease. In multivariable logistic regression, HLA–B27 was significantly associated with syndesmophyte symmetry (odds ratio [OR] 3.02 [95% confidence interval (95% CI) 1.38, 6.61]) and marginal syndesmophytes (OR 1.97 [95% CI 1.16, 3.36]) but not with sacroiliac symmetry. Mean radiographic scores were higher for patients with HLA–B27. Patients with axial SpA who are positive for HLA–B27 have more severe radiographic damage, more marginal syndesmophytes, and more frequent syndesmophyte symmetry compared to patients who are negative for HLA–B27.

To evaluate the impact of comorbidities on physical function in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA). This was a cross‐sectional analysis of the baseline visit from the Cardiovascular in Rheumatology study. Multivariate models with physical function as the dependent variable (Bath Ankylosing Spondylitis Functional Index and Health Assessment Questionnaire for AS and PsA, respectively) were performed. Independent variables were a proxy for the Charlson Comorbidity Index (CCIp; range 0–27), sociodemographic data, disease activity (erythrocyte sedimentation rate [ESR] and Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] in AS; Disease Activity Score in 28 joints [DAS28] using the ESR in PsA), disease duration, radiographic damage, and treatments. Results were reported as beta coefficients, 95% confidence intervals (95% CIs), and Pvalues. We included 738 patients with AS and 721 with PsA; 21% of patients had >1 comorbidity. Comorbidity burden (CCIp) was independently associated with worse adjusted physical function in patients with PsA (β = 0.11). Also, female sex (β = 0.14), disease duration (β = 0.01), disease activity (DAS28‐ESR; β = 0.19), and the use of nonsteroidal antiinflammatory drugs (β = 0.09), glucocorticoids (β = 0.11), and biologics (β = 0.15) were associated with worse function in patients with PsA. A higher education level was associated with less disability (β = –0.14). In patients with AS, age (β = 0.03), disease activity (BASDAI; β = 0.81), radiographic damage (β = 0.61), and the use of biologics (β = 0.51) were independently associated with worse function on multivariate analyses, but CCIp was not. The presence of comorbidities in patients with PsA is independently associated with worse physical function. The detection and control of the comorbidities may yield an integral management of the disease.