Kikuchi Kazuko, Komachi Toshiharu, Honma Yoshinori, Endo Tomoyuki, Watabe Keiko, Yokomaku Yoshiyuki, Hashiba Chieko, Yamamoto Masahiro, Nagayo Yukiko, Ito Toshihiro, Imamura Junji, Suzuki Tomoko, Fujitani Junko
Japan Foundation for AIDS Prevention, Tokyo, Japan.
Department of Rehabilitation Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
GHM Open. 2021 Aug 31;1(1):20-27. doi: 10.35772/ghmo.2021.01007.
This study aimed to clarify the current status of motor function, activities of daily living (ADL), and instrumental ADL (IADL) in hemophilia patients with HIV infection due to treatment with non-heat-treated blood products as they now enter middle and old age. Participants were 70 such patients (mean age, 52.1 years), and their range of motion (ROM), muscle strength, extremity circumference, walking speed, ADL, and IADL were evaluated at checkups of motor function, ADL, and IADL that were held during patients' association meetings. Results showed that ROM was limited in all joints. Ankle dorsiflexion, hip abduction, and shoulder abduction were particularly restricted. Decreased muscle strength was most frequent in ankle plantarflexion, followed by hip extension. The proportion of patients with walking speed and grip strength below reference values increased with age. Walking speed was 73.9-110.9% of reference values. Factors affecting walking speed were knee flexion, ankle dorsiflexion, and hip extension muscle strength. Grip strength was 58.0-83.5% of reference values. Thigh girth most greatly differed between the patients and healthy individuals. Among the ADL items, "standing up from the floor" was reported as "difficult"/"cannot do" by 45.7% of the patients. The most common IADL problem was "putting away futons", which 17.2% responded was "difficult"/"cannot do". Parents were the most common helpers with household tasks (12.9%). "Decreased muscle strength/limited ROM" was the most frequently reported troublesome problem (35.7%). These results reveal the current status of motor function, ADL, and IADL limitations in hemophilia patients with HIV.
本研究旨在阐明因使用未经热处理的血液制品进行治疗而感染艾滋病毒的血友病患者步入中老年后的运动功能、日常生活活动(ADL)及工具性日常生活活动(IADL)的现状。研究对象为70例此类患者(平均年龄52.1岁),在患者协会会议期间举行的运动功能、ADL及IADL检查中,对其关节活动范围(ROM)、肌肉力量、肢体周长、步行速度、ADL及IADL进行了评估。结果显示,所有关节的ROM均受限。踝关节背屈、髋关节外展和肩关节外展受限尤为明显。肌肉力量下降最常见于踝关节跖屈,其次是髋关节伸展。步行速度和握力低于参考值的患者比例随年龄增加而上升。步行速度为参考值的73.9%至110.9%。影响步行速度的因素为膝关节屈曲、踝关节背屈和髋关节伸展肌肉力量。握力为参考值的58.0%至83.5%。患者与健康个体之间大腿围差异最大。在ADL项目中,45.7%的患者表示“从地面站起”“困难”/“无法完成”。最常见的IADL问题是“收起被子”,17.2%的患者回答“困难”/“无法完成”。父母是最常见的家务帮手(12.9%)。“肌肉力量下降/ROM受限”是最常报告的麻烦问题(35.7%)。这些结果揭示了感染艾滋病毒的血友病患者运动功能、ADL及IADL受限的现状。