Education of Physical Therapy, Amsterdam School of Health Professions, University of Applied Sciences (Hogeschool van Amsterdam), Amsterdam, The Netherlands.
Int Orthop. 2011 May;35(5):767-76. doi: 10.1007/s00264-010-1043-3. Epub 2010 Jun 11.
The purpose of this study was to investigate the influence of body function, activities and pain on the level of activity in adults with Kashin Beck Disease (KBD). Seventy-five KBD patients with a mean age of 54.8 years (SD 11.3) participated. Anthropometrics, range of joint motion (ROM) and muscle strength were measured as well as the time-up-and-go test and functional tests for the lower and upper extremities. Activity was assessed with the participation scale and the WHO DAS II. In the shoulder, elbow, hip and knee joints, a severe decrease in ROM and bilateral pain was noted. A decrease in muscle strength was observed in almost all muscles. The timed-up-and-go test scores decreased. No or mild restriction in activity was found in 35%, and 33% experienced a moderate restriction whereas 32% had severe to extreme restriction. Activities in the lower extremities were mildly to moderately correlated to ROM and muscle strength, whereas in the upper extremities activities were correlated to range of joint motion. Activity was significantly associated with ROM after correction for muscle strength, gender and age. Participation was borderline significantly associated with ROM after correction for muscle strength, gender, age and the activity time-up-and-go. In KBD adults, a severe decrease in activity is primarily caused by decrease in ROM. These findings have strong influence on rehabilitation and surgical intervention.
本研究旨在探讨身体功能、活动和疼痛对大骨节病（KBD）成人活动水平的影响。共纳入 75 名 KBD 患者，平均年龄为 54.8 岁（SD 11.3）。测量了人体测量学、关节活动范围（ROM）和肌肉力量，以及计时起立行走测试和上下肢功能测试。采用参与量表和世界卫生组织残疾评定量表第二版（WHO DAS II）评估活动。在肩部、肘部、髋关节和膝关节，ROM 严重受限且双侧疼痛。几乎所有肌肉的力量都下降。计时起立行走测试评分降低。35%的患者无或轻度活动受限，33%的患者中度受限，32%的患者严重至极度受限。下肢活动与 ROM 和肌肉力量呈轻度至中度相关，而上肢活动与关节活动范围相关。在纠正肌肉力量、性别和年龄后，活动与 ROM 显著相关。在纠正肌肉力量、性别、年龄和活动时间-起立行走后，参与度与 ROM 呈边缘显著相关。在 KBD 成人中，活动的严重下降主要是由于 ROM 的下降引起的。这些发现对康复和手术干预有重要影响。
