Elliott A L, Kraus V B, Fang F, Renner J B, Schwartz T A, Salazar A, Huguenin T, Hochberg M C, Helmick C G, Jordan J M
Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Division of Rheumatology, Allergy, and Immunology, 3300 Thurston Building, CB#7280, Chapel Hill, NC 27599-7280, USA.
Ann Rheum Dis. 2007 Dec;66(12):1622-6. doi: 10.1136/ard.2006.057422. Epub 2007 May 15.
To assess associations between joint-specific hand symptoms and self-reported and performance-based functional status.
Participants were from the population-based Johnston County Osteoarthritis Project. Symptoms in the distal interphalangeal (DIP), proximal interphalangeal (PIP), first carpometacarpal (CMC), and metacarpophalangeal (MCP) joints were assessed on a 30-joint diagram of both hands. Self-reported function was assessed by Health Assessment Questionnaire (HAQ) and performance-based function by timed repeated chair stands and 8-foot walk time. Separate multiple logistic regression models examined associations between symptoms in specific hand joint groups, symptoms in >/=2 hand joint groups and number of symptomatic hand joints, and functional status measures, controlling for age, race/ethnicity, sex, body mass index, radiographic knee and hip OA, knee and hip symptoms and depressive symptoms.
Those with symptomatic hand joint groups were more likely than those without these complaints to report more difficulty and require longer times for performance measures. Those with 2 or more symptomatic hand joint groups were more likely to have higher HAQ scores (OR = 1.97 (1.53 to 2.53)) and require more time to complete 5 chair stands (OR = 1.98 (1.23 to 3.18)) and the 8 foot walk test (OR = 1.49 (1.12 to 1.99)).
Joint-specific hand symptoms are associated with difficulty performing upper- or lower-extremity tasks, independent of knee and hip OA and symptoms, suggesting that studies examining functional status in OA should not ignore symptomatic joints beyond the joint site of interest, even when functional measures appear to be specific for the joint site under study.
评估特定关节手部症状与自我报告及基于表现的功能状态之间的关联。
参与者来自基于人群的约翰斯顿县骨关节炎项目。通过双手的30关节图评估远端指间关节(DIP)、近端指间关节(PIP)、第一腕掌关节(CMC)和掌指关节(MCP)的症状。自我报告的功能通过健康评估问卷(HAQ)进行评估,基于表现的功能通过定时重复从椅子上站起和8英尺步行时间进行评估。分别采用多元逻辑回归模型,在控制年龄、种族/民族、性别、体重指数、膝关节和髋关节放射学骨关节炎、膝关节和髋关节症状以及抑郁症状的情况下,检验特定手部关节组症状、≥2个手部关节组症状和有症状手部关节数量与功能状态指标之间的关联。
有症状手部关节组的人比没有这些症状的人更有可能报告更多困难,并且在表现测量中需要更长时间。有2个或更多有症状手部关节组的人更有可能有更高的HAQ评分(OR = 1.97(1.53至2.53)),并且需要更多时间完成5次从椅子上站起(OR = 1.98(1.23至3.18))和8英尺步行测试(OR = 1.49(1.12至1.99))。
特定关节手部症状与上肢或下肢任务执行困难相关,独立于膝关节和髋关节骨关节炎及症状,这表明在骨关节炎中检查功能状态的研究不应忽视感兴趣关节部位以外的有症状关节,即使功能测量似乎特定于所研究的关节部位。