Hansmann Sandra, Benseler Susanne M, Kuemmerle-Deschner Jasmin B
Rheumatology, General Pediatrics, Oncology and Hematology University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
Rheumatology, General Pediatrics, Oncology and Hematology University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany ; Rheumatology, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta Canada.
Pediatr Rheumatol Online J. 2015 Mar 13;13:8. doi: 10.1186/s12969-015-0004-1. eCollection 2015.
Juvenile idiopathic arthritis (JIA) is a chronic illness with a high risk of developing long-term disability. Disease activity is currently being monitored and quantified by ACR core set. Here, joint inflammation is determined; however joint function is the crucial component for developing disability. The aim of this study was to quantify and compare dynamic joint function in healthy and arthritic knee joints and to evaluate response to improvement.
A single center cohort study of consecutive children presenting to the rheumatology outpatient clinic was performed to measure dynamic knee joint function. Serial measures were performed if possible. Splint fixed electrogoniometers were used to measure dynamic knee joint function including ROM and flexion and extension torque.
A total of 54 children were tested including 44 with JIA, of whom eight had to be excluded for non-JIA-related knee problems. The study included 36 JIA patients of whom eight had strictly unilateral knee arthritis, and nine controls. Dynamic joint function ROM and torque depended on age and bodyweight, as demonstrated in healthy joints. ROM and torques were significant lower in arthritic compared to unaffected knee joints in children with unilateral arthritis and across the cohort. Importantly, extension torque was the most sensitive marker of impaired joint function. Follow up measurements detected responsiveness to change in disease activity.
Measuring dynamic joint function with electrogoniometers is feasible and objective. Active ROM and torque during flexion and extension of arthritic knee joints were significant lower compared to unaffected. In dynamic joint measurement extension torque is a sensitive marker for disease activity.
幼年特发性关节炎（JIA）是一种慢性疾病，有很高的发展为长期残疾的风险。目前疾病活动通过美国风湿病学会（ACR）核心指标进行监测和量化。在此过程中，关节炎症得以确定；然而关节功能才是导致残疾的关键因素。本研究的目的是量化和比较健康膝关节与患有关节炎膝关节的动态关节功能，并评估改善反应。
对连续就诊于风湿病门诊的儿童进行单中心队列研究，以测量膝关节动态功能。如有可能，进行系列测量。使用夹板固定的电子角度计测量膝关节动态功能，包括活动范围（ROM）以及屈伸扭矩。
共测试了54名儿童，其中44名患有JIA，其中8名因非JIA相关的膝关节问题被排除。该研究纳入了36名JIA患者，其中8名患有严格意义上的单侧膝关节炎，以及9名对照者。如在健康关节中所示，动态关节功能的ROM和扭矩取决于年龄和体重。在单侧关节炎儿童以及整个队列中，患有关节炎的膝关节的ROM和扭矩显著低于未受影响的膝关节。重要的是，伸展扭矩是关节功能受损最敏感的指标。随访测量检测到了对疾病活动变化的反应性。
使用电子角度计测量动态关节功能是可行且客观的。与未受影响的膝关节相比，患有关节炎的膝关节屈伸过程中的主动ROM和扭矩显著更低。在动态关节测量中，伸展扭矩是疾病活动的敏感指标。
