评估类风湿关节炎患者足部受累对其功能的影响。

Assessment of the functional impact of foot involvement in patients with rheumatoid arthritis.

机构信息

University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; Rheumatology Department, Mongi Slim Hospital, La Marsa, Tunisia.

University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; Rheumatology Department, Mohamed Kassab National Institute, La Manouba, Tunisia.

出版信息

Foot (Edinb). 2022 Sep;52:101907. doi: 10.1016/j.foot.2022.101907. Epub 2022 Jan 7.

DOI:10.1016/j.foot.2022.101907

PMID:36049267

Abstract

AIM OF THE WORK

We aimed to evaluate the impact of foot involvement in patients with rheumatoid arthritis (RA) using the functional foot index (FFI) and to identify predictive factors of the functional impact of foot abnormalities in RA patients.

PATIENTS AND METHODS

This was a cross-sectional study including patients with RA meeting the criteria of the American College of Rheumatology and the European League Against Rheumatism 2010. The main epidemiological data, results of podoscopic and clinical examination of the foot and ankle, biological tests and radiological findings were collected. The presence of foot pain was assessed by a visual analogic scale (0-10), and the functional impact of foot involvement was assessed based on the validated French version of the FFI.

RESULTS

Fifty RA patients with an average age of 59.3 ± 9.9 years [39-79] were included, and 80% of them had foot involvement. Foot pain was present in 32 patients (64%), most frequently situated in the forefoot (56%). The average FFI score was 33.67 ± 30.53 [0-92.67]. The following factors had a significant association with the FFI score: an occupation soliciting the feet (p = 0.001), disease duration (p = 0.033, r = 0,302), the Health Assessment Questionnaire (p = 0.0001, r = 0,480), body mass index (p = 0.0001, r = 0,654), the presence of podiatric abnormalities (p = 0.0001) and Visual Analog Scale foot pain (p = 0.0001, r = 0,854). A significant association was also found between the FFI score and the presence of a hallux valgus (p = 0.004), a spread of the forefoot (p = 0.029), a claw of the toes (p = 0.002), a triangular forefoot (p = 0.0001), a quintus varus (p = 0.002), flat feet (p = 0.0001) and a valgus of the hindfoot (p = 0.001).

CONCLUSION

Due to the high frequency of foot involvement and its significant functional impact, meticulous examination of the feet and assessment of their functional impact must be one of the parameters for monitoring the disease. Its impact on one's quality of life can be important.

LEVEL OF CLINICAL EVIDENCE

4 (cohort studies, non experimental, observational studies).

摘要

目的

本研究旨在使用功能性足部指数（FFI）评估类风湿关节炎（RA）患者足部受累的情况，并确定预测 RA 患者足部异常功能影响的因素。

方法

这是一项横断面研究，纳入符合美国风湿病学会和欧洲抗风湿病联盟 2010 年标准的 RA 患者。收集主要的流行病学资料、足踝部的足部检查和临床检查结果、生物检查和影像学检查结果。采用视觉模拟评分（0-10）评估足部疼痛，采用经过验证的 FFI 法语版本评估足部受累的功能影响。

结果

共纳入 50 例平均年龄 59.3±9.9 岁[39-79]的 RA 患者，其中 80%存在足部受累。32 例（64%）患者存在足部疼痛，最常见于前足（56%）。FFI 平均评分为 33.67±30.53[0-92.67]。以下因素与 FFI 评分有显著相关性：需要足部活动的职业（p=0.001）、疾病持续时间（p=0.033，r=0.302）、健康评估问卷（p=0.0001，r=0.480）、体重指数（p=0.0001，r=0.654）、足病异常（p=0.0001）和足部视觉模拟评分疼痛（p=0.0001，r=0.854）。FFI 评分与拇外翻（p=0.004）、前足外展（p=0.029）、爪形趾（p=0.002）、三角前足（p=0.0001）、第五跖骨内翻（p=0.002）、平足（p=0.0001）和后足外翻（p=0.001）也有显著相关性。