Andersen U, Døssing A, Gudbergsen H, Hagelskjaer V, Bliddal H, Wæhrens E E
Occupation-Centered Occupational Therapy, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Occupational Science, User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Scand J Rheumatol. 2025 Apr 24:1-9. doi: 10.1080/03009742.2025.2484127.
People with hand osteoarthritis (OA) report decreased ability to perform activities of daily living (ADL). However, few are referred to occupational therapy by their general practitioner. This study aimed to identify clinical predictors of decreased ADL ability in people with hand OA as markers of the need for referral to occupational therapy.
A cross-sectional study was conducted as an independent add-on to a randomized controlled trial of adults with hand OA (the COLOR trial). Measures of self-reported (ADL Interview) and observed (Assessment of Motor and Process Skills) ADL ability were collected. Data representing potential predictors identified by stakeholders were extracted from the COLOR trial: age, sex, symptom duration, hand OA type, grip strength, pain, stiffness, function, illness perception, and health-related quality of life. Correlational analyses and prediction models were used.
Correlations between ADL ability and potential predictors in the 62 participants were low to negligible (r < 0.5). Based on root mean square error (RMSE) estimates, prediction models for observed ADL motor (RMSE = 0.3) and ADL process (RMSE = 0.2) ability were more accurate than for self-reported ADL ability (RMSE = 0.6). However, these variables only predicted observed ADL motor and ADL process ability with 16% (adjusted R = 0.163) and 12% (adjusted R = 0.120) accuracy, respectively.
The findings suggest that variables representing body functions, perceived health, and quality of life do not predict ADL ability among people living with hand OA. An adequately powered study is recommended to explore this topic further.
手部骨关节炎（OA）患者报告其进行日常生活活动（ADL）的能力下降。然而，很少有患者被全科医生转介去接受职业治疗。本研究旨在确定手部OA患者ADL能力下降的临床预测因素，作为转介至职业治疗需求的标志。
作为一项针对手部OA成人患者的随机对照试验（COLOR试验）的独立附加研究，开展了一项横断面研究。收集了自我报告的（ADL访谈）和观察到的（运动与过程技能评估）ADL能力的测量数据。从COLOR试验中提取了代表利益相关者确定的潜在预测因素的数据：年龄、性别、症状持续时间、手部OA类型、握力、疼痛、僵硬、功能、疾病认知以及与健康相关的生活质量。使用了相关性分析和预测模型。
62名参与者中，ADL能力与潜在预测因素之间的相关性较低至可忽略不计（r < 0.5）。基于均方根误差（RMSE）估计，观察到的ADL运动能力（RMSE = 0.3）和ADL过程能力（RMSE = 0.2）的预测模型比自我报告的ADL能力（RMSE = 0.6）更准确。然而，这些变量仅分别以16%（调整后R = 0.163）和12%（调整后R = 0.120）的准确率预测观察到的ADL运动能力和ADL过程能力。
研究结果表明，代表身体功能、感知健康和生活质量的变量无法预测手部OA患者的ADL能力。建议开展一项有足够样本量的研究以进一步探讨该主题。
