Patterson Kara K, Sibley Kathryn M
Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
Toronto Rehab, University Health Network, Toronto, ON, Canada.
BMC Neurol. 2016 Jul 26;16:114. doi: 10.1186/s12883-016-0636-x.
Residual impairments and gait deviations post-stroke may lead to secondary musculoskeletal complications such as arthritis. This study explored the prevalence of arthritis and associated functional limitations in community-dwelling Canadians with and without stroke.
Secondary analysis of the Canadian Community Health Survey; a population-based, cross-sectional survey conducted by Statistics Canada in 2011 and 2012. Respondents >50 years old who reported a stroke diagnosis (n = 1892) were age- and gender-matched with controls randomly selected from survey respondents who did not report a stroke (n = 1892). Stroke and control groups were compared on presence of arthritis (yes/no) and secondary variables including pain, perceived health and assistance required (5 point scales) using the Rao-Scott X(2) test. Within the stroke group, logistic regression was used to investigate the effect of arthritis on life satisfaction, pain limiting activities and perceived health with age, gender, BMI, comorbidities and socioeconomic status used as covariates in the model.
A greater proportion of the stroke group (53%) reported arthritis compared to controls (43%). These groups also differed in reports of perceived health and pain. Within the stroke group, those with arthritis were significantly more likely to report pain limiting activities (OR 3.89) and less likely to report satisfaction with life (OR 0.59).
This preliminary work suggests that arthritis is more prevalent in individuals with stroke compared to individuals without stroke and that this co-morbidity is associated with worse reports of pain and perceived health. A limitation is that it is not possible to determine if the arthritis pre-dated or followed the stroke. This work provides support for a longitudinal investigation of the development of secondary musculoskeletal issues post-stroke.
中风后残留的损伤和步态偏差可能导致继发性肌肉骨骼并发症，如关节炎。本研究探讨了有中风和无中风的加拿大社区居民中关节炎的患病率及相关功能限制。
对加拿大社区健康调查进行二次分析；这是加拿大统计局在2011年和2012年开展的一项基于人群的横断面调查。报告有中风诊断的50岁以上受访者（n = 1892）与从未报告中风的调查受访者中随机选取的对照组（n = 1892）进行年龄和性别匹配。使用Rao-Scott X²检验比较中风组和对照组的关节炎情况（是/否）以及包括疼痛、自我感知健康和所需帮助（5分量表）等次要变量。在中风组中，采用逻辑回归研究关节炎对生活满意度、疼痛限制活动和自我感知健康的影响，模型中使用年龄、性别、体重指数、合并症和社会经济地位作为协变量。
与对照组（43%）相比，中风组中报告患有关节炎的比例更高（53%）。这些组在自我感知健康和疼痛报告方面也存在差异。在中风组中，患有关节炎的人更有可能报告疼痛限制活动（比值比3.89），而报告对生活满意的可能性较小（比值比0.59）。
这项初步研究表明，与无中风个体相比，中风个体患关节炎的情况更普遍，且这种合并症与更严重的疼痛和自我感知健康状况相关。一个局限性是无法确定关节炎是中风之前还是之后出现的。这项研究为中风后继发性肌肉骨骼问题发展的纵向研究提供了支持。
