轴向型脊柱关节炎患者在行为测试中具有临床相关的缺陷。
Clinically Relevant Deficits in Performance Tests in Patients With Axial Spondyloarthritis.
机构信息
U. Kiltz, PhD, D. Kiefer, MD, X. Baraliakos, MD, Professor, J. Braun, MD, Professor, Rheumazentrum Ruhrgebiet, Herne and Ruhr-Universität Bochum, Herne, Germany;
E.P. Ahomaa, MD, St. Franziskus Hospital Köln, Cologne, Germany.
出版信息
J Rheumatol. 2023 Mar;50(3):351-358. doi: 10.3899/jrheum.220239. Epub 2022 Sep 1.
OBJECTIVE
To assess the association between self-reported and performance-based physical functioning and to evaluate which performance tests are most frequently impaired in patients with axial spondyloarthritis (axSpA).
METHODS
Consecutive patients with axSpA underwent standardized assessments including patient and disease characteristics; patient-reported outcomes for disease activity, functioning, depression, mobility, and physical activity; and performance tests. Patients were defined as being impaired if they were not able to perform ≥ 1 of the performance tests. Validated cut-offs were used to define impaired physical performance. Impairment of performance tests as well as discrimination between subgroups were analyzed.
RESULTS
A total of 200 patients (radiographic axSpA 66.5%, nonradiographic axSpA 33.5%) were included: 69% males, mean age 44.3 (SD 12.5) years, and mean symptom duration 17.9 (SD 12.6) years. The 2 most frequently impaired performance tests were the repeated chair stand test (n = 75, 37.5%) and putting on socks (n = 44, 22%). An impairment in ≥ 1 performance test was seen in 91 patients (45.5%). Patients with impairments were older (49.1 yrs vs 40.3 yrs); had a higher BMI (28.9 kg/m vs 25.8 kg/m); a more active disease (Ankylosing Spondylitis Disease Activity Score, 3.0 vs 2.1); higher Bath Ankylosing Spondylitis Functional Index (BASFI; 5.8 vs 2.7), Bath Ankylosing Spondylitis Metrology Index (BASMI; 4.4 vs 2.7), and Assessment of Spondyloarthritis international Society Health Index scores (9.5 vs 4.9); and higher depression screen values (9-item Patient Health Questionnaire, 11.6 vs 6.5; all < 0.01).
CONCLUSION
Many patients with axSpA had impairments in physical performance tests. Importantly, this was frequently seen in tasks requiring coordination and muscle power of the lower extremity. Performance tests provide qualitatively different information than BASFI and BASMI assessments in patients with axSpA.
目的
评估自我报告和基于表现的身体功能之间的关联，并评估在患有中轴型脊柱关节炎（axSpA）的患者中哪些表现测试最常受损。
方法
连续纳入 axSpA 患者，进行包括患者和疾病特征；疾病活动、功能、抑郁、移动性和体力活动的患者报告结局；以及表现测试的标准化评估。如果患者无法进行≥1 项表现测试，则将其定义为受损。使用验证过的截断值来定义表现受损。分析了表现测试的受损情况以及亚组之间的区分能力。
结果
共纳入 200 例患者（放射学 axSpA 占 66.5%，非放射学 axSpA 占 33.5%）：男性占 69%，平均年龄 44.3（12.5）岁，平均症状持续时间 17.9（12.6）年。最常受损的两项表现测试是反复坐立测试（n=75，37.5%）和穿袜子（n=44，22%）。≥1 项表现测试受损的患者有 91 例（45.5%）。有受损的患者年龄更大（49.1 岁 vs 40.3 岁）；BMI 更高（28.9kg/m vs 25.8kg/m）；疾病活动度更高（强直性脊柱炎疾病活动评分，3.0 vs 2.1）；Bath 强直性脊柱炎功能指数（BASFI；5.8 vs 2.7）、Bath 强直性脊柱炎计量指数（BASMI；4.4 vs 2.7）和评估强直性脊柱炎国际协会健康指数评分（9.5 vs 4.9）更高；抑郁筛查值更高（9 项患者健康问卷，11.6 vs 6.5；均<0.01）。
结论
许多 axSpA 患者的身体表现测试受损。重要的是，这在需要协调和下肢肌肉力量的任务中经常出现。与 BASFI 和 BASMI 评估相比，表现测试在 axSpA 患者中提供了定性不同的信息。
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