This Bath Ankylosing Spondylitis Functional Index (BASFI) calculator looks at how the symptoms of the autoimmune AS such as pain and stiffness affect daily activities. Below the form there is in depth information on how the index is administered and interpreted.

Please evaluate on a scale from 0 = easy to 10 = impossible how hard you find the following situations to be:
1Putting on your socks or tights without help or aids (e.g. sock aids)?
2Bending forward from the waist to pick up a pen from the floor without an aid?
3Reaching up to a high shelf without help or aids (e.g. helping hand)?
4Getting up out of an armless dining room chair without using your hands or any other help?
5Getting up off the floor without any help from lying on your back?
6Standing unsupported for 10 minutes without discomfort?
7Climbing 12-15 steps without using a handrail or walking aid (one foot on each step)?
8Looking over your shoulder without turning your body?
9Doing physically demanding activities (e.g. physiotherapy exercises, gardening or sports)?
10Doing a full day activities whether it be at home or work?

## How does this Bath ankylosing spondylitis functional index (BASFI) calculator work?

This is a health tool that assesses functional limitation in patients with the inflammatory autoimmune disease ankylosing spondylitis (AS). There are 10 items comprised in this self administering questionnaire, which are evaluated on a visual analogue scale (VAS).

This Bath Ankylosing Spondylitis Functional Index (BASFI) calculator was developed in Bath England and addresses pain control and functional evolution. The novelty comprises in the fact that this scale is specific for AS. The items in the index are described below:

1. Putting on your socks or tights without help or aids (e.g. sock aids)?
2. Bending forward from the waist to pick up a pen from the floor without an aid?
3. Reaching up to a high shelf without help or aids (e.g. helping hand)?
4. Getting up out of an armless dining room chair without using your hands or any other help?
5. Getting up off the floor without any help from lying on your back?
6. Standing unsupported for 10 minutes without discomfort?
7. Climbing 12-15 steps without using a handrail or walking aid (one foot on each step)?
8. Looking over your shoulder without turning your body?
9. Doing physically demanding activities (e.g. physiotherapy exercises, gardening or sports)?
10. Doing a full day activities whether it be at home or work?

BASFI stresses the importance to acknowledge pain and stiffness as being the most common complaints of patients with spondylitis. By monitoring and comparing the results at certain time intervals, the therapeutic means can be improved, thus improving function and relieving some of the pain.

The original study consisted in a mixed population of outpatients and inpatients and subsequent studies have revealed its accuracy and specificity and also compared it to other disability scales such as the Dougados Functional Index.

## BASFI score intepretation

This result consists of the mean of the user answers to the 10 items in the Bath Ankylosing Spondylitis Functional Index. There isn’t a specific cutting point but the general instruction is that the higher the score, the higher the functional impairment caused by ankylosing spondylitis.

One of the benefits in the way this index is administered resides in the visual analogue scale which is a lot easier and quicker to use for patients, although it requires a bit of interpretation from the clinician.

The visual analogue scale demands the patient to pin point on a physical line from 0 to 10, the position they think their experiences stand. Specifically the scale is from 0 meaning easy to 10 meaning impossible and the patient will assess day to day activities like getting dressed, standing up or climbing up the stairs.

## Ankylosing spondylitis guidelines

This is a long term auto immune condition, due to the HLA-B27 gene, causing the inflammation of the spine, in the form of spinal arthritis that in time and left untreated, leads to the ankylosis of the vertebral and sacroiliac joints.

The most common symptoms include back pain and stiffness unrelieved by rest, fatigue, pain and swelling in the knees or the hips.

Diagnosis comprises of magnetic resonance imaging, MRI, Schober’s test and x-ray. Blood laboratory results show an increase in C-reactive protein and in the erythrocyte segmentation rate due to the inflammation.

Because this is an incurable disease, treatment focuses on relieving the symptoms and re-establishing a degree of normal functioning through organized physical exercise, physiotherapy and painkiller and NSAID medication.

## References

1) Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, Jenkinson T. (1994) . J Rheumatol; 21(12):2281-5.

2) Spoorenberg A, van der Heijde D, de Klerk E, Dougados M et al. (1999) . J Rheumatol; 26(4):961-5.

3) Mori K, Hukuda S, Katsuura A, Saruhashi Y, Matsusue Y. (2004) . J Orthop Sci; 9(1):16-21.

24 Jan, 2016