From the *Doctorado de Medicina, Facultad de Ciencias Médicas, Universitat de Barcelona, Barcelona; †Medical Science Faculty, Universidad de Cuenca; and ‡Hospital José Carrasco Arteaga, Cuenca, Ecuador; and §Hospital General de México "Eduardo Liceaga," Mexico City, Mexico.
J Clin Rheumatol. 2017 Sep;23(6):324-329. doi: 10.1097/RHU.0000000000000571.
The aim of this study was to determine the prevalence of disability in patients with musculoskeletal pain and rheumatic diseases in Cuenca, Ecuador.
We performed a cross-sectional analytical study with randomized sampling in 4877 subjects, from urban and rural areas. COPCORD (Community Oriented Program for Control of Rheumatic Diseases)-validated questionnaire was administered house-to-house to identify subjects with nontraumatic musculoskeletal pain and rheumatic diseases. The subjects were assessed by rheumatologists for diagnostic accuracy, and the Health Assessment Questionnaire Disability Index was administered to assess functional capacity. A logistic regression analysis was conducted to determine the association of rheumatic diseases with functional disability.
Functional disability was found in 221 subjects (73.1% women), with mean age 62 (SD, 18.2) years, residing in rural areas (201 [66.5%]), with education of 6.9 (SD, 5.3) years, and of low income (77 [47.2%]). The value of HAQ-DI was a mean of 0.2 (0-2.9). The real prevalence of physical disability was 9.5%. Moderate and severe disability predominated in activities such as kneeling (4.9% and 3.3%), squatting (4.8% and 2.7%), and leaning to pick up objects (3.7% and 0.9%), respectively. Rheumatic diseases associated with physical disabilities were knee osteoarthritis (95 [31.4%]) and hand osteoarthritis (69 [22.8%]), mechanical low-back pain (43 [14.2%]), fibromyalgia (27 [9.5%]), and rheumatoid arthritis (11 [3.6%]; P < 0.001).
Physical disability was associated with older age, female sex, rural residence, lower education, and lower income. Moderate and severe disability predominated in the dimensions of kneeling, squatting, and picking up objects. Rheumatic diseases associated with disability were hand and knee osteoarthritis, back pain, fibromyalgia, and rheumatoid arthritis.
本研究旨在确定厄瓜多尔昆卡患有肌肉骨骼疼痛和风湿性疾病患者的残疾患病率。
我们进行了一项横断面分析研究，对 4877 名城乡居民进行了随机抽样。采用经过 COPCORD（社区为基础的控制风湿性疾病项目）验证的问卷，通过挨家挨户上门的方式，识别出患有非创伤性肌肉骨骼疼痛和风湿性疾病的患者。由风湿病专家对患者进行评估，以确定诊断准确性，并采用健康评估问卷残疾指数（HAQ-DI）评估其功能能力。采用逻辑回归分析确定风湿性疾病与功能障碍的相关性。
221 名（73.1%为女性）患者存在功能障碍，平均年龄为 62（标准差 18.2）岁，居住在农村地区（201 人，66.5%），受教育程度为 6.9（标准差 5.3）年，收入较低（77 人，47.2%）。HAQ-DI 的平均值为 0.2（0-2.9）。实际的身体残疾患病率为 9.5%。在需要蹲下（4.9%和 3.3%）、蹲下（4.8%和 2.7%）和俯身捡东西（3.7%和 0.9%）等活动时，以中重度残疾为主。与身体残疾相关的风湿性疾病为膝骨关节炎（95 人，31.4%）和手骨关节炎（69 人，22.8%）、机械性腰痛（43 人，14.2%）、纤维肌痛（27 人，9.5%）和类风湿关节炎（11 人，3.6%）（P<0.001）。
年龄较大、女性、农村居住、受教育程度较低和收入较低与身体残疾相关。中重度残疾主要出现在蹲下、蹲下和俯身捡东西等方面。与残疾相关的风湿性疾病为手和膝骨关节炎、腰痛、纤维肌痛和类风湿关节炎。
