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通过智能手机应用程序进行类风湿关节炎疾病活动度的自我评估工具。

Self-assessment tool of disease activity of rheumatoid arthritis by using a smartphone application.

作者信息

Nishiguchi Shu, Ito Hiromu, Yamada Minoru, Yoshitomi Hiroyuki, Furu Moritoshi, Ito Tatsuaki, Shinohara Akio, Ura Tetsuya, Okamoto Kazuya, Aoyama Tomoki

机构信息

1 Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine , Kyoto, Japan .

出版信息

Telemed J E Health. 2014 Mar;20(3):235-40. doi: 10.1089/tmj.2013.0162. Epub 2014 Jan 3.

Abstract

OBJECTIVES

The disease activities of rheumatoid arthritis (RA) tend to fluctuate between visits to doctors, and a self-assessment tool can help patients accommodate to their current status at home. The aim of the present study was to develop a novel modality to assess the disease activity of RA by a smartphone without the need to visit a doctor.

SUBJECTS AND METHODS

This study included 65 patients with RA, 63.1 ± 11.9 years of age. The 28-joint disease activity score (DAS28) was measured for all participants at each clinic visit. The patients assessed their status with the modified Health Assessment Questionnaire (mHAQ), a self-assessed tender joint count (sTJC), and a self-assessed swollen joint count (sSJC) in a smartphone application. The patients' trunk acceleration while walking was also measured with a smartphone application. The peak frequency, autocorrelation (AC) peak, and coefficient of variance of the acceleration peak intervals were calculated as the gait parameters.

RESULTS

Univariate analyses showed that the DAS28 was associated with mHAQ, sTJC, sSJC, and AC (p<0.05). In a stepwise linear regression analysis, mHAQ (β = 0.264, p<0.05), sTJC (β = 0.581, p<0.001), and AC (β = -0.157, p<0.05) were significantly associated with DAS28 in the final model, and the predictive model explained 67% of the DAS28 variance.

CONCLUSIONS

The results suggest that noninvasive self-assessment of a combination of joint symptoms, limitations of daily activities, and walking ability can adequately predict disease activity of RA with a smartphone application.

摘要

目的

类风湿关节炎(RA)的疾病活动度在就诊期间往往会波动,一种自我评估工具可以帮助患者在家中适应其当前状况。本研究的目的是开发一种无需就医即可通过智能手机评估RA疾病活动度的新方法。

对象与方法

本研究纳入了65例RA患者,年龄为63.1±11.9岁。每次门诊就诊时对所有参与者测量28个关节的疾病活动评分(DAS28)。患者通过智能手机应用程序,使用改良健康评估问卷(mHAQ)、自我评估压痛关节计数(sTJC)和自我评估肿胀关节计数(sSJC)来评估自身状况。还通过智能手机应用程序测量患者行走时的躯干加速度。计算加速度峰值间隔的峰值频率、自相关(AC)峰值和变异系数作为步态参数。

结果

单因素分析显示,DAS28与mHAQ、sTJC、sSJC和AC相关(p<0.05)。在逐步线性回归分析中,最终模型中mHAQ(β = 0.264,p<0.05)、sTJC(β = 0.581,p<0.001)和AC(β = -0.157,p<0.05)与DAS28显著相关,预测模型解释了DAS28变异的67%。

结论

结果表明,通过智能手机应用程序对关节症状、日常活动受限和行走能力进行无创自我评估,可以充分预测RA的疾病活动度。

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