Nordenskiöld U, Grimby G
Department of Rehabilitation Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Disabil Rehabil. 1997 Jan;19(1):13-9. doi: 10.3109/09638289709166440.
The aim of this study was to assess disability with the Health Assessment Questionnaire (HAQ) and to evaluate the relationships between grip force, pain and difficulty in daily activities. Twenty women with rheumatoid arthritis were assessed with measurements of grip force and pain before and after grip test. Both the original HAQ version and an alternative rating model, not taking the use of assistive devices into account, were used. All patients reported pain which significantly increased after grip test and with a significant inverse correlation to grip force. All patients had assistive devices, on average 15 devices (range 1-27). Ninety-one per cent of the patient's devices were in continued use, most frequently in the categories; Eating, Grip and Hygiene. Disability was significantly correlated to pain, grip force and use of assistive devices. When using the alternative ratings of 20 questions in HAQ, 8 of the 20 questions showed significantly (p = 0.0003-0.0339) lower scoring, and the number of questions with significant correlations between grip force and disability increasing from 9 (r = 0.48-0.74, p = 0.039-0.001) to 14 questions (r = 0.47-0.74, p = 0.047-0.001). Difference between intrinsic disability (without assistive devices) and actual disability (with such assistance) is not reflected in original HAQ. The present study indicates that assessment of actual disability by the alternative rating model is more often correlated to impairment (grip force) than disability assessed by original HAQ and can be considered to give a better assessment of actual disability than the original HAQ model.
本研究旨在使用健康评估问卷（HAQ）评估残疾情况，并评估握力、疼痛与日常活动困难之间的关系。对20名类风湿性关节炎女性患者在握力测试前后进行了握力和疼痛测量评估。使用了HAQ的原始版本以及一个未考虑辅助设备使用情况的替代评分模型。所有患者均报告有疼痛，且在握力测试后疼痛显著增加，并且与握力呈显著负相关。所有患者都有辅助设备，平均有15种设备（范围为1 - 27种）。91%的患者的设备在持续使用，最常使用的类别为：进食、抓握和卫生。残疾与疼痛、握力及辅助设备的使用显著相关。当使用HAQ中20个问题的替代评分时，20个问题中有8个显示得分显著更低（p = 0.0003 - 至0.0339），并且握力与残疾之间具有显著相关性的问题数量从9个（r = 0.48 - 0.74，p = 0.039 - 0.001）增加到14个问题（r = 0.47 - 0.74，p = 0.047 - 0.001）。原始HAQ未反映内在残疾（无辅助设备）与实际残疾（有此类辅助）之间的差异。本研究表明，与原始HAQ评估的残疾相比，替代评分模型对实际残疾的评估更常与损伤（握力）相关，并且可以认为比原始HAQ模型能更好地评估实际残疾情况。
