Löfkvist U B, Brattström M, Geborek P, Lidgren L
Department of Rheumatology, University Hospital of Lund, Sweden.
Scand J Rheumatol. 1988;17(3):167-73. doi: 10.3109/03009748809098779.
Patients with severely deforming rheumatoid arthritis and impaired function of the upper extremity are often unable to use conventional walking aids. This report describes 42 such patients who were equipped with altogether 75 individually manufactured, lightweight walking aids (12 crutches, 12 forearm-crutches, 39 crutch-sticks and 12 sticks). A plaster cast of the patient's grip as well as analysis of the integrated function of the shoulder-elbow-wrist was used when preparing the walking aid. It was thereby possible to produce suitable walking aids for all but one patient. At follow-up after 12-18 months, of use, most patients belonging to functional classes II and III were satisfied with their walking aid(s) and 22 considered it/them indispensable. However, in 4 patients, progressive disease with increased disease activity/deteriorating hand function and in 3 patients increasing shoulder pain reduced their usability. Lack of motivation was one reason for low use intensity. Follow-up demonstrated that most patients were able to use these walking aids without detectable negative effects on the upper extremity. The durability of the walking aid was satisfactory. Thus an individually moulded handle on an adapted lightweight walking aid is important helping patients with severely deforming arthritis to maintain independent ambulation, and should be made more widely obtainable.
患有严重变形性类风湿关节炎且上肢功能受损的患者往往无法使用传统的助行器。本报告描述了42例此类患者，他们共配备了75个单独制作的轻质助行器（12个腋杖、12个前臂拐杖、39个肘拐杖和12根手杖）。在制作助行器时，使用了患者握持的石膏模型以及对肩-肘-腕综合功能的分析。因此，除1例患者外，为所有患者都制作了合适的助行器。在使用12至18个月后的随访中，大多数属于功能II级和III级的患者对其助行器感到满意，22例患者认为助行器不可或缺。然而，4例患者病情进展、疾病活动增加/手部功能恶化，3例患者肩部疼痛加剧，降低了助行器的可用性。缺乏动力是使用强度低的一个原因。随访表明，大多数患者能够使用这些助行器，且未发现对上肢有明显负面影响。助行器的耐用性令人满意。因此，在适配的轻质助行器上采用单独模制的手柄对于帮助患有严重变形性关节炎的患者维持独立行走很重要，且应更广泛地提供。
