Abstract
Objective The aim of the present study was to assess the association between muscle strength, lower extremity function, employment status, and work ability in RA patients. Methods One hundred seropositive RA outpatients of working age were included in this cross-sectional study. Employment status was assessed by interview and work ability by the Work Ability Index-Single Item Scale (WAS). Muscle strength was determined using dynamometer measurement of isometric hand grip and knee extensor strength. Lower extremity function was measured using the short physical performance battery (SPPB). Regression models estimate the association between unemployment, work ability and muscle strength, and lower extremity function, controlling for sociodemographic and disease-related factors. Results Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables. Conclusions The association of employment status and work ability with parameters of physical fitness suggests that improvement in muscle strength and lower extremity function may positively influence work ability and employment in individuals with RA.
Highlights
Work disability is a major burden of rheumatic conditions [1, 2], and a substantial amount of rheumatoid arthritis- (RA-) associated work disability occurs early in the course of the disease [3]
They were considered eligible if they matched the following inclusion criteria: were of working age (≥18 and ≤65 years); had RA according to the 2010 European League Against Rheumatism (EULAR) classification for seropositive RA [23]; had sufficient knowledge of German, English, SerboCroatian, or Turkish to fill in the questionnaire
One hundred and forty patients with seropositive RA visiting the rheumatology outpatient clinic were consecutively screened for eligibility, with a total of 100 patients being included in the present study
Summary
Work disability is a major burden of rheumatic conditions [1, 2], and a substantial amount of rheumatoid arthritis- (RA-) associated work disability occurs early in the course of the disease [3]. As a result of novel therapeutic concepts, RAinduced work disability rates appear to have decreased [4, 5]; the risk of work disability and unemployment is still high in RA patients [5, 6], with disability rates of 20% to 30% in the first 2 to 3 years of the disease [7]. Even greater than treatment costs are work disability and unemployment, which pose an economic burden to both patients and society [6], making work ability and employment crucial outcomes in RA. A number of sociodemographic and work-related factors, such as age or type of work, have been found to be associated with work disability or unemployment in both cross-sectional and longitudinal studies [9]. Disease-related variables, including symptoms such as pain, swelling, joint stiffness
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