Kojima Toshihisa, Ishikawa Hajime, Tanaka Sakae, Haga Nobuhiko, Nishida Keiichiro, Yukioka Masao, Hashimoto Jun, Miyahara Hisaaki, Niki Yasuo, Kimura Tomoatsu, Oda Hiromi, Asai Shuji, Funahashi Koji, Kojima Masayo, Ishiguro Naoki
Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan.
Department of Rheumatology, Niigata Rheumatic Center, Niigata, Japan.
Int J Rheum Dis. 2018 Oct;21(10):1793-1800. doi: 10.1111/1756-185X.13237. Epub 2017 Dec 5.
This study aimed to validate the Timed Up and Go test (TUG) for measuring objective functional impairment in patients with established rheumatoid arthritis (RA) based on a prospective observational cohort of RA patients undergoing joint surgery.
We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and associations between TUG and HAQ-DI and other patient-reported outcomes, including European Quality of life scale (EQ-5D) were determined. Cut-off values of TUG for HAQ remission (HAQ-DI ≤0.5), normal HAQ (HAQ-DI ≤0.25), and the absence of disability in each HAQ-DI category were also determined by age.
A total of 435 patients were enrolled and analyzed. Mean age was 64.2 years, mean disease duration was 17.1 years, mean HAQ-DI was 1.14, and mean TUG was 11.1 sec. TUG was significantly correlated with aging, EQ-5D, and HAQ-DI categories related to lower limb function (arising, walking, reach and activity). After adjusting for age and sex, mean TUG values were 9.0 sec (95% CI, 7.7-10.3) in patients with HAQ remission and 8.7 sec (7.4-10.4) in those with normal HAQ. By age, mean TUG values for HAQ remission were 7.2 sec (5.9-8.5) in young patients (≤61 years), 9.1 sec (7.6-10.5) in middle-aged patients (62-70 years) and 10.0 sec (5.7-14.2) in old patients (≥71 years).
TUG was significantly associated with functional impairment and aging in patients with long-standing RA. Thus, TUG could be useful in setting treatment goals for joint surgery and rehabilitation in established RA patients.
本研究旨在基于接受关节手术的类风湿关节炎(RA)患者的前瞻性观察队列,验证定时起立行走测试(TUG)在测量已确诊RA患者客观功能损害方面的作用。
我们收集了人口统计学数据、健康评估问卷残疾指数(HAQ-DI),并确定了TUG与HAQ-DI之间的关联以及其他患者报告的结局,包括欧洲生活质量量表(EQ-5D)。还按年龄确定了HAQ缓解(HAQ-DI≤0.5)、正常HAQ(HAQ-DI≤0.25)以及各HAQ-DI类别无残疾情况下的TUG临界值。
共纳入435例患者并进行分析。平均年龄为64.2岁,平均病程为17.1年,平均HAQ-DI为1.14,平均TUG为11.1秒。TUG与年龄、EQ-5D以及与下肢功能(起身、行走、够物和活动)相关的HAQ-DI类别显著相关。在调整年龄和性别后,HAQ缓解患者的平均TUG值为9.0秒(95%CI,7.7 - 10.3),HAQ正常患者的平均TUG值为8.7秒(7.4 - 10.4)。按年龄划分,年轻患者(≤61岁)HAQ缓解时的平均TUG值为7.2秒(5.9 - 8.5),中年患者(62 - 70岁)为9.1秒(7.6 - 10.5),老年患者(≥71岁)为10.0秒(5.7 - 14.2)。
TUG与长期RA患者的功能损害和年龄显著相关。因此,TUG可有助于为已确诊RA患者的关节手术和康复设定治疗目标。