青少年特发性关节炎患儿的握力与疾病活动度、残疾和生活质量的相关性。

Association of hand grip strength with disease activity, disability and quality of life in children and adolescents with Juvenile Idiopathic Arthritis.

机构信息

Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

Section of Rheumatology and Clinical Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

出版信息

Adv Rheumatol. 2018 Jun 28;58(1):11. doi: 10.1186/s42358-018-0012-1.

DOI:10.1186/s42358-018-0012-1

PMID:30657067

Abstract

BACKGROUND

Juvenile idiopathic arthritis (JIA) affects wrist and hand joints leading to decrease hand function and patients' daily living activities. The assessment of hand grip strength (HGS) in children and adolescents with JIA is of major importance, and the association of HGS with JIA disease activity, disability and quality of life has not been explored. The primary objective of this study was to evaluate hand grip strength (HGS) in children and adolescents with Juvenile Idiopathic Arthritis (JIA) compared to matched healthy peers. The secondary objective was to explore the relationship between HGS and JIA disease activity, disability, and quality of life.

METHODS

This study involved 23 patients with JIA and 46 age and sex matched healthy controls. Hand held dynamometer was used to evaluate HGS for all study participants. Anthropometric parameters for all study participants were measured. Disease activity, physical function, and quality of life were assessed for the JIA group using juvenile arthritis disease activity score (JADAS-27), juvenile arthritis functionality scale (JAFS), and pediatric quality of life inventory (PedsQL) respectively. Laboratory marker of inflammation, erythrocyte sedimentation rate (ESR), and plain radiography of hands were performed for all patients.

RESULTS

Hand grip strength of children and adolescents with JIA was significantly weaker compared to matched controls (p < 0.001). Hand grip strength had a significant inverse correlation with JADAS-27 (r = - 0.467, p = 0.025), JAFS (r = - 0.650, p = 0.001) and a significant direct correlation with PedsQL (r = 0.438, p = 0.036). In addition, HGS was negatively correlated with ESR and duration of morning stiffness (r = - 0.489, p = 0.018 and r = - 0.201, p = 0.359, respectively). HGS was detected as an independent predictor of disease activity, disability, and quality of life in JIA patients in multivariate linear regression.

CONCLUSIONS

Assessment of HGS could be a simple non-invasive tool for assessing disease activity, disability and quality of life in JIA patients in clinical practice.

摘要

背景

幼年特发性关节炎（JIA）会影响手腕和手部关节，导致手部功能下降和患者日常活动能力受限。评估 JIA 患儿的手握力（HGS）非常重要，但是 HGS 与 JIA 疾病活动度、残疾和生活质量之间的关系尚未得到探索。本研究的主要目的是评估与匹配的健康同龄人相比，JIA 患儿的手握力（HGS）。次要目的是探讨 HGS 与 JIA 疾病活动度、残疾和生活质量之间的关系。

方法

本研究纳入了 23 名 JIA 患儿和 46 名年龄和性别匹配的健康对照者。使用手持测力计评估所有研究参与者的 HGS。为所有研究参与者测量人体测量参数。使用青少年关节炎疾病活动评分（JADAS-27）、青少年关节炎功能量表（JAFS）和儿童生活质量量表（PedsQL）分别评估 JIA 组的疾病活动度、身体功能和生活质量。对所有患者进行炎症的实验室标志物、红细胞沉降率（ESR）和手部平片检查。

结果

与匹配的对照组相比，JIA 患儿的手握力明显较弱（p<0.001）。HGS 与 JADAS-27（r=-0.467，p=0.025）、JAFS（r=-0.650，p=0.001）呈显著负相关，与 PedsQL 呈显著正相关（r=0.438，p=0.036）。此外，HGS 与 ESR 和晨僵时间呈负相关（r=-0.489，p=0.018 和 r=-0.201，p=0.359）。多元线性回归分析显示，HGS 是 JIA 患者疾病活动度、残疾和生活质量的独立预测因子。