Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
Department of Physiotherapy, College of Medical Sciences, University of Benin, Edo State, Nigeria.
Int J Rheum Dis. 2020 Apr;23(4):559-568. doi: 10.1111/1756-185X.13797. Epub 2020 Jan 28.
The aim of the study was to identify sociodemographic, disease-related, physical and mental health-related determinants of fatigue at 2-year follow-up in individuals with symptomatic knee osteoarthritis (OA).
A longitudinal analysis of participants with symptomatic knee OA from the Multicenter Osteoarthritis Study (MOST) was conducted to identify predictors of fatigue at 2-year follow-up. Participants self-reported fatigue at baseline for the first time in the MOST cohort and at follow-up using a 0-10 visual analog scale. At baseline, questionnaires on sociodemographics, disease-related symptoms, physical and mental health factors were completed. Data were analyzed using linear regressions with a backwards elimination approach.
Of the 2330 individuals in the MOST cohort at baseline, 576 had symptomatic knee OA and of these, 449 with complete fatigue values at baseline and follow-up were included in this analysis. Minimally important fatigue change (ie, worsening [≥1.13], no change [<0.82 or <1.13] and improvement [≥-0.82]) from baseline to follow-up were unequal within the population (34.5%, 26.9%, 38.5%; χ [2, N = 449] = 9.32, P = .009). The multiple linear regression showed that baseline fatigue (unstandardized coefficient [Β] = 0.435; 95% confidence interval [CI] 0.348-0.523, P < .001), slow gait speed (Β = -1.124; 95% CI -1.962 to -0.285, P = .009), depressive symptoms (Β = 0.049; 95% CI 0.024-0.075, P < .001) and higher numbers of comorbidities (Β = 0.242; 95% CI 0.045-0.439, P = .016) were significant predictors of greater fatigue at follow-up.
Fatigue is strongly associated with physical- and mental-related health factors. Individualized treatments that include combined psychological and physical function rehabilitation might be modalities for fatigue management.
本研究旨在确定膝关节骨关节炎(OA)患者在 2 年随访时出现乏力的社会人口学、疾病相关、身心健康相关决定因素。
对多中心骨关节炎研究(MOST)中患有膝关节 OA 的患者进行纵向分析,以确定 2 年随访时乏力的预测因素。参与者在 MOST 队列中首次自我报告基线时的乏力,并在随访时使用 0-10 视觉模拟量表进行报告。基线时,参与者完成了关于社会人口统计学、疾病相关症状、身心健康因素的问卷。使用向后消除方法的线性回归分析数据。
在 MOST 队列的 2330 名参与者中,有 576 名患有膝关节 OA,其中有 449 名在基线和随访时具有完整的乏力值,被纳入本分析。从基线到随访,人群内最小重要变化(即恶化[≥1.13]、无变化[<0.82 或 <1.13]和改善[≥-0.82])不均衡(34.5%、26.9%、38.5%;χ[2,N=449]=9.32,P=0.009)。多元线性回归显示,基线乏力(未标准化系数[B]=0.435;95%置信区间[CI]0.348-0.523,P<0.001)、缓慢的步行速度(B=-1.124;95%CI-1.962 至-0.285,P=0.009)、抑郁症状(B=0.049;95%CI0.024-0.075,P<0.001)和更多的合并症(B=0.242;95%CI0.045-0.439,P=0.016)是随访时乏力程度增加的显著预测因素。
乏力与身心健康相关因素密切相关。包含心理和身体功能康复的个体化治疗可能是乏力管理的一种方式。