Rheumatology and Rehabilitation Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Physical Medicine and Rehabilitation Department, Security Forces Hospital, Makkah, Saudia Arabia.
Curr Rheumatol Rev. 2022;18(3):257-265. doi: 10.2174/1573397117666211130150241.
Disability in patients with scleroderma (SSc) has been associated with poor health-related quality of life (HRQoL) in all dimensions, including physical, psychological, and social dimensions.
This study was conducted to examine different factors that may be associated with functional disability and poor HRQoL, with the aim of targeting these factors in the future to improve physical activity, functional outcomes, and HRQoL.
A single-center cross-sectional study was conducted on 38 patients with SSc to compare characteristics between patients with and without disability using the Health Assessment Questionnaire Disability Index (HAQ-DI). Quality of life was assessed using the Short Form-36 (SF-36). Linear regressions were performed to examine variables contributing to functional disability.
Almost 65.78% (n = 25) of patients in the study group reported functional disability. The presence of functional disability was associated with reduced HRQoL, as reflected by physical function (P = 0.0001), physical role (P = 0.016), bodily pain (P = 0.001), general health (P = 0.002), social functional (P = 0.002), emotional role (P = 0.042), and mental health (P = 0.025) domains of the SF-36 score. Multiple linear regression indicated that the main predictive factors associated with HAQ-DI were the modified Hand Mobility in Scleroderma, modified Rodnan skin score, DIstance walked in 6 minutes, BOrg dyspnea index, and SAturation of oxygen at 6 minutes (DIBOSA), and Fatigue Severity Scale among patients with SSc.
In patients with SSc, recognizing the relationships between clinical findings and functional disability will allow the development of further management strategies to minimize disease severity and enhance HRQoL.
硬皮病（SSc）患者的残疾与所有维度（包括身体、心理和社会维度）的健康相关生活质量（HRQoL）下降有关。
本研究旨在探讨可能与功能障碍和较差 HRQoL 相关的不同因素，以期在未来针对这些因素，改善身体活动、功能结果和 HRQoL。
对 38 例 SSc 患者进行单中心横断面研究，使用健康评估问卷残疾指数（HAQ-DI）比较有和无残疾患者的特征。使用 36 项简短健康调查问卷（SF-36）评估生活质量。进行线性回归以检验与功能障碍相关的变量。
研究组中近 65.78%（n=25）的患者报告存在功能障碍。功能障碍的存在与 HRQoL 下降有关，表现在身体功能（P=0.0001）、身体角色（P=0.016）、身体疼痛（P=0.001）、一般健康（P=0.002）、社会功能（P=0.002）、情感角色（P=0.042）和心理健康（P=0.025）等 SF-36 评分领域。多元线性回归表明，与 HAQ-DI 相关的主要预测因素是硬皮病改良手部运动、改良罗登皮肤评分、6 分钟步行距离、 Borg 呼吸困难指数和 6 分钟血氧饱和度（DIBOSA）以及 SSc 患者的疲劳严重程度量表。
在 SSc 患者中，认识到临床发现与功能障碍之间的关系将有助于制定进一步的管理策略，以最大限度地减少疾病严重程度并提高 HRQoL。
