Department of Orthopedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan.
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2022 Nov;84(4):799-812. doi: 10.18999/nagjms.84.4.799.
This study aimed to longitudinally evaluate the development of locomotive syndrome (LS) in rheumatoid arthritis (RA) patients during the COVID-19 pandemic using the 25-question Geriatric Locomotive Function Scale (GLFS-25). Subjects were 286 RA patients (female, 70.6%; mean age, 64.2 years) who had GLFS-25 and Clinical Disease Activity Index (CDAI) data available for a 1-year period during the COVID-19 pandemic and who did not have LS at baseline. Associations between subject characteristics and development of LS were determined using logistic regression analysis. Among the 286 patients, 38 (13.3%, LS group) developed LS at 1 year after baseline. In the LS group, scores of the GLFS-25 categories "GLFS-5" and "Social activities" were significantly increased at 1 year relative to baseline. GLFS-5 is a quick 5-item version of the GLFS-25, including questions regarding the difficulty of going up and down stairs, walking briskly, distance able to walk without rest, difficulty carrying objects weighing 2 kg, and ability to carry out load-bearing tasks and housework. A significant correlation was also observed between changes in "Social activities" and that of "GLFS-5." Multivariable logistic regression analysis revealed that the development of LS was significantly associated with BMI (OR: 1.11 [95% confidence interval (CI): 1.00-1.22]) and CDAI (OR: 1.08 [95%CI: 1.00-1.16]) at baseline. Adequate exercise and tight control of RA disease activity are important for preventing the development of LS in view of restrictions on going out imposed during the COVID-19 pandemic. GLFS-5 is useful for evaluating the physical function of RA patients.
本研究旨在使用 25 项老年机能量表(GLFS-25),对 COVID-19 大流行期间类风湿关节炎(RA)患者的运动机能综合征(LS)的发展进行纵向评估。研究对象为 286 名 RA 患者(女性,70.6%;平均年龄,64.2 岁),他们在 COVID-19 大流行期间有 1 年的 GLFS-25 和临床疾病活动指数(CDAI)数据,且基线时无 LS。采用 logistic 回归分析确定受试者特征与 LS 发展之间的关系。在 286 名患者中,38 名(13.3%,LS 组)在基线后 1 年发展为 LS。在 LS 组中,GLFS-25 类别“GLFS-5”和“社会活动”的评分在 1 年时与基线相比显著增加。GLFS-5 是 GLFS-25 的一个快速的 5 项版本,包括有关上下楼梯困难、快步走、无需休息即可行走的距离、携带 2 公斤重的物品的困难以及进行负重任务和家务的能力的问题。还观察到“社会活动”的变化与“GLFS-5”的变化之间存在显著相关性。多变量 logistic 回归分析显示,LS 的发展与基线时的 BMI(OR:1.11[95%置信区间(CI):1.00-1.22])和 CDAI(OR:1.08[95%CI:1.00-1.16])显著相关。考虑到 COVID-19 大流行期间对外出的限制,适当的运动和严格控制 RA 疾病活动对于预防 LS 的发展很重要。GLFS-5 对于评估 RA 患者的身体功能很有用。