The Gaps Between the Capability and the Performance Among Children with Disabilities in Taiwan

Abstract

Objective: To assess 3 aspects of functioning in the osteoarthritis population from a Maya-Yucateco community. Design: Cross-sectional, census-based study. Setting: Municipality of Chankom, Yucatan, Mexico. Participants: Adults 18 years with hand, hip and/or knee osteoarthritis. Interventions: Local staff applied a cross-culturally validated questionnaire to detect people with musculoskeletal (MSK) symptoms throughout the Municipality. Family physicians established MSK-disease diagnoses. A physiatrist confirmed OA diagnoses, evaluated risk factors for progression and assessed functioning. Main Outcome Measure(s): Three aspects of functioning were assessed: capacity-what a person believes “can do”, through the Health Assessment Questionnaire Disability Index (HAQ-DI); capabilitywhat a person “could do” in standardized conditions, through the 6-minute walk test (6MWT) and the Functional Dexterity Test (FDT); and performancewhat a person “does do” in real life, through self-reported personal care, work and leisure activities. Results: Osteoarthritis was confirmed in 144/588 cases [24% (95%C.I. 21%-28%)]. Mean age was 64 years (s 12.64), 56% were female. Capacity: 60% reported mild-to-moderate disability (HAQ-DI 1). Capability: The mean distance walked in the 6MWT was 206.37 m (s 76.93), while the mean FDT score was 63.98 seconds (s 33.22). Performance: 74%, 59%, and 33% of participants reported difficulties in their work, leisure and personal care activities. Regression models showed gender, number of co-morbidities, socioeconomic status and muscle strength as significantly associated with capacity, whereas muscle strength and selfefficacy were predominantly associated with capability and performance, respectively. Conclusions: The frequency of functioning problems detected in this population differed according to the aspect explored. Different risk factors were associated with different aspects of functioning.