Nicholls Elaine E, van der Windt Danielle A W M, Jordan Joanne L, Dziedzic Krysia S, Thomas Elaine
Arthritis Research UK Primary Care Centre, Keele University, Keele, UK.
Musculoskeletal Care. 2012 Mar;10(1):51-62. doi: 10.1002/msc.1007. Epub 2012 Jan 31.
Hand problems are common in older adults and cause significant pain and disruption to everyday living. The aim of this systematic review was to summarize evidence on the factors associated with the severity and progression of self-reported hand pain and functional difficulty in population-based studies of older adults.
MEDLINE, EMBASE, CINAL, BNI, AMED, HMIC, PsycINFO and ISI Web of Knowledge were searched up to January 2011 for relevant articles. The search strategy combined text words for hand, pain, function and epidemiological study. Inclusion criteria were applied and articles in the review assessed for quality using the QUality In Prognosis Studies (QUIPS) assessment tool. Data extraction included: author, year of publication, study location, participant inclusion criteria, risk factor and outcome measurement, and association with hand pain and/or function.
Seven articles from five studies met the inclusion criteria from 5,679 citations. All studies were cross-sectional and provided no information on progression of hand pain and function over time. Factors associated with limited hand function were older age, female gender, manual occupation, neck or shoulder pain, clinical and radiographic osteoarthritis, weaker hand strength, hand pain, history of Parkinson's disease, stroke, diabetes or rheumatoid arthritis, and illness perceptions (namely, frustration, impact and symptom count). Key factors associated with hand pain severity were age, impact, frustration, patient expectation of a long disease time course and self-reported diagnosis of the cause of the hand problem.
Both demographic and clinical factors were found to be related to self-reported hand pain severity and functional difficulty in older adults; however, the results were derived from a small number of studies, with no information on progression of hand pain and functional difficulty over time.
手部问题在老年人中很常见，会给日常生活带来严重疼痛和不便。本系统评价的目的是总结在基于人群的老年人研究中，与自我报告的手部疼痛严重程度和功能障碍的严重程度及进展相关因素的证据。
检索截至2011年1月的MEDLINE、EMBASE、CINAL、BNI、AMED、HMIC、PsycINFO和ISI Web of Knowledge等数据库，查找相关文章。检索策略结合了关于手部、疼痛、功能和流行病学研究的文本词汇。应用纳入标准，并使用预后研究质量（QUIPS）评估工具对综述中的文章进行质量评估。数据提取内容包括：作者、发表年份、研究地点、参与者纳入标准、危险因素和结局测量，以及与手部疼痛和/或功能的关联。
从5679篇被引文献中，五项研究的七篇文章符合纳入标准。所有研究均为横断面研究，未提供手部疼痛和功能随时间进展的信息。与手部功能受限相关的因素包括：年龄较大、女性、体力劳动职业、颈部或肩部疼痛、临床和影像学骨关节炎、手部力量较弱、手部疼痛、帕金森病、中风、糖尿病或类风湿关节炎病史，以及疾病认知（即挫折感、影响和症状数量）。与手部疼痛严重程度相关的关键因素包括：年龄、影响、挫折感、患者对疾病病程较长的预期以及自我报告的手部问题病因诊断。
人口统计学和临床因素均与老年人自我报告的手部疼痛严重程度和功能障碍有关；然而，结果来自少数研究，且未提供手部疼痛和功能障碍随时间进展的信息。
