Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China.
Faculty of Rehabilitation Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Kilimanjaro, Tanzania.
BMC Musculoskelet Disord. 2022 Jul 6;23(1):647. doi: 10.1186/s12891-022-05607-z.
Osteoarthritis (OA) and Rheumatoid arthritis (RA) are the most common joint diseases leading to chronic pain and disability. Given the chronicity and disabling nature of OA and RA, they are likely to influence full participation of individuals in the society. An activity limitation occurs when a person has difficulty executing an activity; a participation restriction is experienced when a person has difficulty participating in a real-life situation. The aim of this study was to examine the associations between OA and RA and the domains of activity limitation and participation restriction.
A cross-sectional study design comprised 3604 adults from the 2009 to 2018 National Health and Nutrition Examination Survey (NHANES). All participants aged ≥ 20 years with complete data were included. Activity limitation and participation restriction were assessed by reported difficulty in performing 14 tasks selected from Physical Functioning Questionnaire. Data on OA and RA were obtained from Medical Conditions Questionnaire. Weighted logistic regression model was used to examine the associations between OA and RA and the selected tasks.
Over 36% of participants had limitations. Both OA (OR = 2.11) and RA (OR = 2.36) were positively associated with activity limitation and participation restriction (p < 0.001). Poor or fair health was associated with difficulty in physical functioning, with highest odds observed in leisure activities (OR = 2.05), followed by difficulty in attending social events (OR = 1.99), walking for a quarter mile (OR = 1.97), preparing meals (OR = 1.93) and walking up ten steps (OR = 1.92).
Adults with OA and RA had nearly similar odds of having activity limitations and participation restrictions. Difficulty in executing most activities of daily living (ADLs) has significant association with poor or fair health. Holistic interdisciplinary care to individuals with OA or RA focusing on ADLs and environmental factors may improve health status.
骨关节炎（OA）和类风湿关节炎（RA）是导致慢性疼痛和残疾的最常见关节疾病。鉴于 OA 和 RA 的慢性和致残性质，它们可能会影响个人在社会中的全面参与。当一个人难以执行某项活动时，就会出现活动受限；当一个人难以参与现实生活中的情况时，就会出现参与受限。本研究旨在探讨 OA 和 RA 与活动受限和参与受限领域之间的关系。
本研究采用横断面研究设计，纳入了 2009 年至 2018 年全国健康与营养调查（NHANES）中的 3604 名成年人。所有年龄≥20 岁且数据完整的参与者均被纳入研究。活动受限和参与受限通过报告在从身体功能问卷中选择的 14 项任务中执行的困难程度来评估。OA 和 RA 的数据来自于医疗状况问卷。采用加权逻辑回归模型来检验 OA 和 RA 与所选任务之间的关系。
超过 36%的参与者存在活动受限。OA（OR=2.11）和 RA（OR=2.36）均与活动受限和参与受限呈正相关（p<0.001）。健康状况较差或一般与身体功能障碍有关，在休闲活动中观察到的可能性最高（OR=2.05），其次是参加社交活动困难（OR=1.99）、步行四分之一英里（OR=1.97）、准备饭菜（OR=1.93）和走十步台阶（OR=1.92）。
患有 OA 和 RA 的成年人出现活动受限和参与受限的几率相近。执行大多数日常生活活动（ADLs）的困难与健康状况较差或一般有显著关联。针对 OA 或 RA 患者的整体跨学科护理，注重 ADLs 和环境因素，可能会改善健康状况。
