Sobue Yasumori, Suzuki Mochihito, Ohashi Yoshifumi, Sato Ryo, Kosugiyama Hironobu, Ohno Yusuke, Hasegawa Junya, Sugiura Takaya, Terabe Kenya, Asai Shuji, Imagama Shiro
Department of Orthopedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita, Nakamura, Nagoya, Aichi, 453-8511, Japan.
Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
Osteoporos Sarcopenia. 2024 Sep;10(3):119-125. doi: 10.1016/j.afos.2024.07.001. Epub 2024 Jul 25.
Locomotive syndrome (LS) leads to reduced physical function and a high risk of becoming bedridden. Grip strength serves as an indicator of upper limb and overall physical function. Rheumatoid arthritis (RA) patients with reduced grip strength frequently show finger and wrist joint inflammation. The purpose of this study was to verify grip strength as an evaluation tool for physical function and LS in RA patients.
As part of an ongoing multicenter observational study, 591 consecutive RA patients whose background information was available, including data for the 25-question Geriatric Locomotive Function Scale (GLFS-25) and grip strength, were examined. LS was defined as a GLFS-25 score ≥ 16 points. Finger and wrist joint inflammation were defined as tender or swollen joints.
Among the 591 patients, 244 (41.3%) patients had LS, and 167 (28.3%) were male. Receiver operating characteristic curve analysis yielded cut-off values of grip strength for LS of 24 kg (specificity 72.2%; sensitivity 62.7%) for males and 17 kg (specificity 65.7%; sensitivity 67.6%) for females. Multivariable logistic regression analysis revealed a significant association of grip strength with LS, even after adjusting for finger and wrist joint inflammation.
LS was significantly associated with grip strength, even after adjusting for the presence of finger and wrist joint inflammation. We recommend adopting grip strength measurement as a screening tool for evaluating LS and guiding interventions.
运动机能不全综合征（LS）会导致身体功能下降以及卧床不起的高风险。握力是上肢和整体身体功能的一个指标。握力下降的类风湿关节炎（RA）患者经常出现手指和腕关节炎症。本研究的目的是验证握力作为RA患者身体功能和LS的评估工具。
作为一项正在进行的多中心观察性研究的一部分，对591例连续的RA患者进行了检查，这些患者的背景信息可用，包括25个问题的老年运动功能量表（GLFS - 25）和握力数据。LS被定义为GLFS - 25评分≥16分。手指和腕关节炎症被定义为压痛或肿胀的关节。
在591例患者中，244例（41.3%）患有LS，167例（28.3%）为男性。受试者工作特征曲线分析得出男性LS的握力临界值为24千克（特异性72.2%；敏感性62.7%），女性为17千克（特异性65.7%；敏感性67.6%）。多变量逻辑回归分析显示，即使在调整了手指和腕关节炎症后，握力与LS仍有显著关联。
即使在调整了手指和腕关节炎症的存在后，LS与握力仍有显著关联。我们建议采用握力测量作为评估LS和指导干预的筛查工具。
