Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI.
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI.
Arch Phys Med Rehabil. 2019 Apr;100(4):606-612. doi: 10.1016/j.apmr.2018.04.034. Epub 2018 Sep 8.
Determine the relationship between functional status and degree of specific organ involvement, physical performance, and subjective well-being chronic graft-vs-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation.
Observational cohort.
Outpatient clinic.
Adult patients (N=121) with cGVHD with 634 assessments.
Not applicable.
Karnofsky Performance Status (KPS). Skin, fascia/joints, lungs, upper and lower extremity range of motion, liver, eye, mucosal, and gastrointestinal involvement were measured using the National Institutes of Health GVHD scale. Physical performance was assessed with the 2-minute walk test (2MWT) and hand grip strength. Subjective measures were the Patient Health Questionnaire 9 (PHQ-9) and Lee Symptom Burden (LSB) scale.
Myofascial (P<.001) and lung (P=.001) involvement, 2MWT (P<.001), LSB (P<.001), and PHQ-9 (P=.03) had the largest associations with KPS with liver (P=.05) and hand grip strength (P<.001) more modest associations with KPS.
Patients with cGVHD experience multifactorial impairment in function associated with potentially modifiable symptoms physiatrists have the expertise to address to enhance function. More research is needed to determine rehabilitation interventions to mitigate the impact of cGVHD on function.
确定功能状态与特定器官受累程度、身体表现和慢性移植物抗宿主病（cGVHD）后的主观幸福感之间的关系。
观察性队列。
门诊诊所。
患有 cGVHD 的成年患者（N=121），共进行了 634 次评估。
不适用。
卡诺夫斯基表现状态（KPS）。使用国家卫生研究院（NIH）GVHD 量表测量皮肤、筋膜/关节、肺部、上下肢活动范围、肝脏、眼睛、粘膜和胃肠道受累情况。身体表现通过 2 分钟步行试验（2MWT）和手握力评估。主观指标为患者健康问卷 9（PHQ-9）和李症状负担（LSB）量表。
肌筋膜（P<.001）和肺部（P=.001）受累、2MWT（P<.001）、LSB（P<.001）和 PHQ-9（P=.03）与 KPS 具有最大关联，而肝脏（P=.05）和手握力（P<.001）与 KPS 的关联则较小。
患有 cGVHD 的患者会经历与功能相关的多因素损伤，这些损伤与潜在可治疗的症状有关，物理治疗师具备改善功能的专业知识。需要进一步研究以确定康复干预措施，减轻 cGVHD 对功能的影响。
