Arthritis Impact Measurement Scales Research Articles

An Alternative Approach to the Treatment of Arthritis

Arthritis, also known as joint inflammation, is the swelling and tenderness of one or more joints in the body. With the main symptoms being stiffness of joints and pain, arthritis can severely affect the quality of life. It worsens with age and typically shows itself in adult ages. This case study is of a very young, 19-year-old woman, who was diagnosed with rheumatoid arthritis at the age of 18. After Ayurvedic assessment, she was recommended the use of herbal blends, oils, Ayurvedic diet, and lifestyle changes. This was done in gradual phases and lasted for about six months. The American College of Rheumatology’s Arthritis Impact Measurement Scales were used for pre and post assessment. Post Ayurvedic management, the client’s situation is greatly improved after Ayurvedic management and she still follows ayurvedic recommendations for maintenance. This case study provides positive insights and alternatives into the management of Arthritis.

Tree-Based Reinforcement Learning for Identifying Optimal Personalized Treatment Decisions for Hand Deformity in Rheumatoid Arthritis.

Silicone metacarpophalangeal joint arthroplasty (SMPA) can reconstruct metacarpophalangeal (MCP) joint deformities in the rheumatoid hand, but patient selection criteria for the procedure remains unclear. We used statistical learning to elucidate patient selection criteria that will enhance long-term patient-reported and functional outcomes in patients with severe hand rheumatoid arthritis (RA). This is a secondary analysis of a prospective study of 169 adults with severe hand RA (average combined ulnar deviation (UD) and extensor lag (EL) at the MCP joint ≥ 50 degrees, per finger) with one-year follow-up, conducted at three centers in the United States and England from January 1, 2004, to December 31, 2011. Primary outcomes were Michigan Hand Outcomes Questionnaire (MHQ) pain sub-score, changes in EL, UD, and Arthritis Impact Measurement Scale (AIMS2) score. A tree-based reinforcement learning (T-RL) model was used to estimate clinical decision rules for treatment. 132 patients (mean[SD], 61[9] years; 108[72%] female) were included in the SMPA (n=50) and non-SMPA (n=82) cohorts. To minimize EL and UD, patients should undergo SMPA. To minimize pain, patients older than 55 should undergo SMPA. To increase hand-related quality-of-life (QOL), patients with grip strength <12 kg should undergo SMPA. Estimations with imputed missing data were similar, aside from a lower grip strength (<8 kg) threshold for hand-related QOL. Unless there is significant comorbidity that precludes surgery, most patients older than 55 with severe hand RA will have improved QOL, pain, and function after SMPA. Patients with preserved grip strength may benefit from continued medical management.

Quality of Life Assessment and Its Relationship with Fatigue Symptom, Demographic and Clinical Factors in Rheumatoid Arthritis Polish Patients

The variety of clinical symptoms occurring during rheumatoid arthritis may reduce patients’ quality of life. Hence, the study aimed to assess RA patients’ quality of life and determine its relationship with fatigue, demographic and clinical factors. The study group consisted of 128 RA patients diagnosed according to ACR/EULAR criteria and treated in rheumatology departments. The Arthritis Impact Measurement Scales-2 (AIMS-2) scale was used to assess the quality of life. The Functional Assessment of Chronic Illness Therapy - Fatigue Scale was used to assess the symptom of fatigue. The analyzed variables were sex, age, pharmacological treatment, arthritis pain, morning stiffness, hemoglobin, CRP, rheumatoid factor, Ritchie Articular Index, and DAS28 disease activity. In the AIMS-2 scale, the patients had the lowest quality of life in the following subscales: arthritis pain (average 6.25±2.52 points), walking and bending (average 5.63±2.71 points), and emotional tension (average 4.99±1.92 points); while patients presented the highest quality of life for the following subscales: support from family and friends (average 1.39±2.21 points) and self-care (average 2.11±2.45 points). There was a correlation between the level of quality of life and age (r=0.24), morning stiffness (r=0.45), CRP concentration (r=0.29), joint tenderness (r=0.34), and disease activity (r=0.39). Increasing the values of parameters such as arthritis pain, disease activity, morning stiffness, and CRP level may cause a decrease in the level of quality of life. Assessment of the quality of life should be a permanent element of assessing patients with RA.

Influencing Factors in Tunisian Rheumatoid Arthritis Patients' Quality of Life: Burden and Solutions.

Rheumatoid Arthritis (RA) is a disease with a heavy functional, psychological, and socioeconomic impact. The management of Quality of Life (QoL) as a therapeutic objective is a fairly recent notion, especially in Tunisia. We aimed to evaluate QoL in RA patients and to identify its affecting factors. This was a cross-sectional study in a Tunisian rheumatology center. To assess QoL, we used the Short Form Health Survey (SF-36) and the Arthritis Impact Measurement Scales Short Form (AIMS2-SF). Health Assessment Questionnaire Disability Index (HAQ), the Hospital Anxiety and Depression Scale (HAD) for psychological disorders, Visual Analog Scale for Pain (VAS Pain), and for fatigue (VAS Fatigue) were also used. Disease activity was assessed by the Disease Activity Score (DAS28 CRP). We enrolled 120 established RA, the mean age of our patients was 56.9 ± 11.4 years, with a predominance of women (83.3%). The mean disease duration was 10.97 ± 7.7 years. According to the HAD scale, 27% of our patients presented anxiety, and 26.7% had depressive disorders. There was significantly impaired QoL in patients with low educational level, dependent financial situation, long disease duration, high disease activity, high pain and fatigue levels, poor therapeutic education, functional disability, and psychological disorders (p < 0.001). A strong negative correlation was detected between inflammatory markers, structural damage, and the scores of QoL. Patients under biologics scored significantly higher in the SF36 mental health domain (p < 0.001). QoL is significantly poor in Tunisian RA. These patients should be managed using a multidisciplinary approach involving the patients themselves.

Perceived Usability of Tablet Crushers: Comparison of Devices by People with and without Limited Hand Functions

Tablet crushing is a common practice used by patients and their carers, mainly to facilitate swallowing. Various tablet-crushing devices with different designs are currently available on the market. This study aimed to compare the usability of different tablet-crushing devices in people with and without limited hand functions. The hand function of 100 adults recruited from the general community (40 of whom self-reported a limited hand function) was assessed using the hand and finger function subscale of the Arthritis Impact Measurement Scale version 2. The hand strength was measured using a dynamometer. Participants crushed tablets using 11 crushing devices and completed a Rapid Assessment of Product Usability and Universal Design questionnaire for each device. Hand-held twist-action crushers with an ergonomic grip received the highest usability scores among both groups, irrespective of the cost (p < 0.05). Crushers with bags were scored lower by those with limited hand functions, although the score improved if the device was automatic. Preferences regarding electronic crushers significantly changed once the cost was revealed. Economical twist-action crushers with ergonomic grips and without bags or cups were the most favoured crushers.

Optimal approach for total endoscopic discectomy and its effect on lumbar and leg function in patients with disc herniation.

Disc herniation (DH) is a fragment of the disc nucleus that is pushed out of the annulus into the spinal canal due to a tear or rupture in the annulus. It is a common cause of lumbar and leg pains. Substantial advancements have been made to determine the cause of DH and to ensure accurate diagnosis, imaging, and treatment of this condition. Total endoscopic discectomy is an alternative surgical technique that is less invasive. To study the optimal approach for a total endoscopic discectomy and its influence on lumbar and leg function in DH patients. This prospective study enrolled 120 patients with lumbar DH who were treated in our hospital from February 2018 to January 2021. All patients were randomly divided into the following two groups: The observation group, comprising 62 patients who underwent surgery using the interlaminar approach, and the control group, comprising 58 patients who were operated through the foramina approach. The treatment effects, perioperative indicators, functional recovery, pain, and quality of life were compared between the two groups. The treatment effect in the observation group (93.55%) was significantly better than that in the control group (77.59%). There was no difference in the operative time and intraoperative blood loss amount between the two groups (P > 0.05). The hospitalization time of the observation group (4.34 ± 1.33 d) was significantly shorter than that of the control group (5.38 ± 1.57 days) (P < 0.05). The Japanese Orthopaedic Association and Oswestry Disability Index scores decreased significantly in both groups after treatment, but the scores were lower in the observation group than in the control group. The visual analog scale scores of the lower back and legs of the two groups were significantly reduced after treatment, but scores were lower in the observation group (2.18 ± 0.88 in the lower back and 1.42 ± 0.50 in the leg) than in the control group (3.53 ± 0.50 in the lower back and 2.21 ± 0.52 in the leg). A short form of the Arthritis Impact Measurement Scales 2 measurement scale (AIMS2-SF) score and Barthel index of the lower back of the two groups increased significantly after treatment, with the observation group having a significantly higher AIMS2-SF score (95.16 ± 1.74) and Barthel index (97.29 ± 1.75) than the control group (84.95 ± 2.14 and 89.16 ± 2.71, respectively) (P < 0.05). Through total endoscopic discectomy with the interlaminar approach, the degree of pain in the waist and leg was reduced, and the lumbar function considerably recovered.

The validity and reliability of the Turkish version of the Arthritis Impact Measurement Scale 2-Short Form (AIMS2-SF) for rheumatoid arthritis.

The objective of this study is to investigate the validity and reliability of the Turkish version of the Arthritis Impact Measurement Scale 2-Short Form (AIMS2-SF). Subjects fulfilling the ACR 2010 classification criteria for RA were enrolled into the study. Scale reliability was investigated using test-retest reliability (intra-class correlation coefficient-ICC) and internal consistency approaches (Cronbach's α). Spearman's rank correlation coefficients evaluated relationships between quantitative parameters and validity. Construct validity was assessed by correlating AIMS2-SF with clinical parameters and functional parameters including, Nottingham Health Profile (NHP), Health Assessment Questionnaire (HAQ), Beck Depression Inventory (BDI) and Duruöz Hand Index (DHI). One hundred and sixteen patients (105 females and 11 males) were recruited. The mean age ± standard deviation (SD) was 52.45 ± 11.48years. Cronbach's α was 0.88 and the ICC was 0.91. There were significant correlations (rho and p values) with parameters directly related to health-related quality of life (HRQoL); NHP subscales (energy levels: 0.54, pain: 0.62, emotional reaction: 0.50, sleep 0.44, social interaction: 0.51, physical activity: 0.61; p < 0.0005), HAQ (0.60, p < 0.0005), BDI (0.63, p < 0.001) and DHI (0.63, p < 0.0005). Poor or non-significant correlations were found for parameters not directly related to QoL, such as age (0.07, p = 0.45) and disease duration (0.12, p = 0.21); however, disease activity (0.43, p < 0.0005) and NRS pain (0.46, p < 0.0005) were correlated with AIMS2-SF as moderate. The Turkish AIMS2-SF version is a reliable and valid tool that may be used to evaluate QoL for RA. The scale can be easily used in daily practice.

Static Foot Disturbances and the Quality of Life of Older Person with Rheumatoid Arthritis.

Disturbed static foot function is one of the main causes of impaired quality of life, which may be related to the frailty syndrome of older adult patients with Rheumatoid Arthitis (RA). The aim of the study was to evaluate the relationship between parameters of static foot function disturbances and quality of life of older adult patients with RA. The study was performed among 102 patients with RA diagnosed according to the American College of Rheumatology (ACR) and EULAR 2010 criteria. Patients were divided into four subgroups depending on radiological evaluation according to the Steinbrocker classification. Plantoconturography examination was conducted using a podoscope with a 3D scanner and software for computer foot examination CQ ST2K. Quality of life of patients with RA was evaluated using the Arthritis Impact Measurement Scales-2 (AIMS-2). A statistically significant relationship between AIMS-2 and parameters of static foot function disturbances was observed. The study revealed correlations between parameters of disturbed static foot function and RA severity in comparison to disease duration. Our results indicate a relationship between static foot function disturbances and quality of life of patients with RA, not only in the area of physical activity, but also in the social an emotional domain. Study results indicate that plantoconturography and assessment of quality of life using AIMS-2 could be useful as a diagnostic and prognostic tool in RA.

Factors influencing depression in community-dwelling elderly patients with osteoarthritis of the knee in China: a cross-sectional study

BackgroundKnee osteoarthritis (OA) and depression are both major health issues influencing the quality of elderly life. The aim of the present study was to explore the prevalence of depression and the factors influencing depression in community-dwelling elderly patients with OA of the knee in China.MethodsWe conducted a cross-sectional descriptive study. The study included 214 participants aged 60 and older diagnosed with OA of the knee. The depression of the elderly was measured by using the Geriatric Depression Scale (GDS). Participants were asked to complete a demographic questionnaire, the GDS, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the society dimension of Arthritis Impact Measurement Scales 2 (AIMS2). In addition, the participants performed a timed up and go test (TUG) and the stair-climb test (SCT).ResultsThe average age of the participants was 69.2 ± 7.63 years old, their body mass index (BMI) was 25.2 ± 3.85, and their disease duration was 5.9 ± 7.72 years. The mean total score of the GDS was 4.43 ± 2.89, and the GDS scores correlated positively with pain (r = 0.45, P < 0.001), stiffness (r = 0.40, P < 0.001), physical function (r = 0.52, P < 0.001),TUG (r = 0.35, P < 0.001), and SCT (r = 0.47, P < 0.001) and negatively with social support (r = − 0.35, P < 0.001).Analysis using multiple regression demonstrated that physical function, social support, and SCT explained 36.8% of the variance in depression.ConclusionsOur findings suggested that physical function, social support, and lower extremity strength were predictors of depressive symptoms in community-dwelling elderly people with OA of the knee. Focusing on this elderly group with increasing functional exercise, positive social interaction and support, and lower limb muscle strength training should help in the prevention of depression.

Health, Psychological and Demographic Predictors of Depression in People with Fibromyalgia and Osteoarthritis.

Depression is common in people with fibromyalgia (FM) and osteoarthritis (OA) and has been linked to adverse health outcomes in these conditions. The purpose of this study was to examine differences in predictors of depression among individuals with FM and OA using a range of health, demographic, and psychological variables. Of the total 963 participants, 600 were diagnosed with FM, and 363 with OA. The Quality of Well-Being Scale (QWB) was used to assess health status. The Fibromyalgia Impact Questionnaire (FIQ) and the Arthritis Impact Measurement Scale (AIMS) were used to measure disease-specific impact. Additionally, participants completed self-efficacy and helplessness assessments. Depression was measured using the Center for Epidemiological Studies Scale (CES-D). The results of a moderated linear regression showed that higher depression scores were associated with lower health status and a greater condition impact, especially in the FM group. Self-efficacy and helplessness predicted depression in both groups, but more strongly in FM. White participants with OA were more depressed than their non-White counterparts, while the opposite was true for FM. These findings indicate that improving health status and psychological well-being might alleviate depression in both FM and OA.

A Comparative study on the assessment of dual task performance in rheumatic diseases

BackgroundIn task-oriented studies showed that the chronic pain is effective on dual tasks. Chronic pain is the main health problem that prevents mobility restriction and participation in most rheumatic diseases. Research questionDo rheumatic diseases have an effect on dual task gait performance? MethodsThis comparative-descriptive study included 75 individuals who aged 18–65 years and divided in two groups as Rheumatic Disease Group (RG; 23 women, 14 men) and Control Group (CG; 20 women, 18 men). The individuals have a chronic pain (> 3.4 cm according to Visual Analogue Scale, VAS) and Standardized Mini Mental State Examination score above 24 were included in this study as the RG. The individuals who were did not have any known disease were included in the CG. The health status of RG was evaluated with the Arthritis Impact Measurement Scale 2 (AIMS-2). The 10-meter Walk Test was applied under single and dual task conditions (dual task cognitive, DTcognitive; dual task motor, DTmotor) for assessing gait performance. Results and significanceThe mean age of the individuals in the study was 40.6 ± 11.34 years (RG=43.08 ± 11.30; CG=38.18 ± 11.00). There was a significant difference in favor of CG between the groups both in terms of gait speed in DTcognitive and its cost (p < 0.05). VAS scores correlate with single and DTcognitive and DTmotor gait parameters (p < 0.05). Many subdivisions of AIMS-2 were associated with single, DTcognitive and DTmotor gait parameters (p < 0.05). This study concluded that rheumatic diseases may reduce gait performance in concurrent motor-cognitive dual task conditions due to chronic pain. Single and dual task gait parameters may be related with psychosocial factors. Therefore, applications including pain control and biopsychosocial approach may be beneficial in the management gait disturbances and falls due to a rheumatic disease.

Sex-Based Differences in the Cytokine Production and Intracellular Signaling Pathways in Patients With Rheumatoid Arthritis.

Objectives This study aims to investigate lymphoproliferation, cytokine production, and intracellular signaling molecules in peripheral blood mononuclear cells (PBMCs) isolated from healthy individuals and rheumatoid arthritis (RA) patients to understand the extent of the involvement of these pathways in the pathogenesis of RA.Patients and methods The study included 65 participants (29 males, 36 females; mean age 51.8±10.3 years; range, 37 to 71 years) who were categorized into four groups as healthy males (n=22, mean age 49.8±10.6 years; range, 39 to 65 years), male RA patients (n=7, mean age 51.8±13.9 years; range, 37 to 68 years), healthy females (n=20, mean age 53.7±8.8 years; range, 42 to 67 years), and female RA patients (n=16, mean age 52.9±10.4 years; range, 40 to 71 years). PBMCs were collected from the participants and analyzed for Concanavalin A (Con A)-induced lymphoproliferation using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, cytokine production, and phospho-signal transducer and activator of transcription 3 (p-STAT-3), phospho-extracellular-signal-regulated kinase (p-ERK), phospho-cAMP response element binding (p-CREB), and phospho-protein kinase B expressions using enzyme-linked immunosorbent assay. Short form of the Arthritis Impact Measurement Scales 2 and multidimensional health assessment questionnaire were used to measure the level of disability and the quality of life.Results In RA patients, production of Con A-induced interleukin (IL)-2 and IL-17 was higher in both sexes while interferon-gamma levels decreased in RA females alone. Expression of p-STAT-3 in PBMCs increased in RA males while it was unaltered in RA females. p-ERK expression was not altered while p-CREB expression was enhanced in RA males and females. Protein-protein interaction analyses demonstrated that these and other key signaling molecules were dysregulated in RA patients.Conclusion Our results suggest that sex-based differences in RA pathogenesis result from differential alterations in signaling pathways to influence the inflammatory process.

Do new and old biomarkers of early undifferentiated arthritis correlate with Arthritis Impact Measurement Scales?

In early undifferentiated arthritis (EUA), the relationship between inflammatory biomarkers and disability is still unclear. The aim of this study was to correlate inflammatory biomarkers with the Arthritis Impact Measurement Scales (AIMS) in EUA. Seventy patients with EUA were compared with 20 patients with established rheumatoid arthritis (RA). The association of AIMS [mobility, physical impairment (PI), dexterity, household activities, activities of daily living (ADL), social activity, pain, anxiety, depression] with serum laboratory [phase acute reactants, calprotectin, interleukin-6, tumour necrosis factor (TNF)-α, rheumatoid factor, anti-nuclear and anti-citrullinated peptide antibodies, HLA-DRB], clinical [Clinical Disease Activity Index (CDAI), fatigue, pain and stiffness NRS], x-ray and ultrasound biomarkers was analysed with non-parametric Spearman's rank correlation and Mann-Whitney U tests. No differences in AIMS were found between EUA and established RA patients, or between EUA patients that evolved into early RA (n=17) and those that remained EUA (n=53) at six months of follow-up. In EUA, erythrocyte sedimentation rate correlated with mobility impairment, PI and depression (p=0.04, p=0.03 and p=0.022, respectively), TNF-α correlated with PI (p=0.01) and calprotectin with anxiety (p=0.02). HLA-DRB1*11-positive EUA patients had lower ADL deficiency (p=0.006), depression (p=0.0004) and anxiety (p=0.01). CDAI correlated with PI (p=0.01) and pain (p=0.01), fatigue with PI (p=0.0001) and ADL (p=0.009), stiffness with PI (p=0.01), and Power Doppler ultrasound synovitis with PI (p=0.02) and pain (p=0.007). In EUA, physical and mood disorders are associated with new and old inflammatory serological, clinical and imaging biomarkers. HLA-DRB1*11-positivity may be protective against these disease-related features.

Abstract P5-14-17: Musculoskeletal side effects over time and association with adherence in women taking neoadjuvant letrozole for estrogen receptor positive DCIS: CALGB 40903 (Alliance)

Abstract Background: Side effects of and adherence to aromatase inhibitors in women with ductal carcinoma in situ are not well described. Methods: Postmenopausal women in a prospective phase II study of neoadjuvant letrozole for estrogen receptor positive DCIS completed questionnaires on side effects [Menopause Specific Quality of Life Questionnaire (MENQOL), Brief Pain Inventory-short form (BPI-SF), Arthritis Impact Measurement Scales (AIMS2)], well-being (FACT-G), and adherence [Medication-Taking questionnaire] at baseline, 1, 3 and 6 months (mo), and study completion. We used descriptive statistics and paired t-tests to compare 1, 3 and 6 mo results to baseline. Hierarchical linear mixed modeling, controlling for baseline symptom or well-being level, was used to examine effect of symptoms and well-being on intentional and nonintentional nonadherence, based on the Medication-Taking Questionnaire. Results: Included were 84 women, mean age 63 (39-83) years. In univariate analyses, compared to baseline, menopausal symptoms increased [physical (p=0.001 at 3, p&amp;lt;0.001 at 6 mo); vasomotor (p&amp;lt;0.001 at 1, 3, 6 mo), psychosocial (p=0.006 at 6 mo) and sexual (p=0.01 at 6 mo)]. Joint pain and stiffness increased [BPI-SF pain subscale (p=0.048 at 3, p=0.01 at 6 mo); AIMS2 joint pain subscale (p=0.03 at 1, p&amp;lt;0.001 at 3 and 6 mo); AIMS2 stiffness subscale (p=0.004 at 3, p=0.01 at 6 mo)]. Intentional and nonintentional adherence did not significantly change over time (p&amp;gt;0.05). Lower emotional (p=0.049) and functional (p=0.002) well-being by FACT-G and higher joint pain (p=0.03) by AIMS2 were associated with higher nonintentional nonadherence; higher physical side effects of menopause (p=0.001) by MENQOL were associated with lower intentional nonadherence. Conclusions: Among women taking letrozole for DCIS, menopausal symptoms and joint pain/stiffness increased over time with most differences noted at 3 and 6 mo. Lower well-being and higher symptom levels were associated with higher nonintentional nonadherence. NCT01439711.U10CA180821, U10CA180882, UG1CA189823, Breast Cancer Research Foundation, https://acknowledgments.alliancefound.org. Citation Format: Gretchen Kimmick, Amylou C Dueck, Rebecca Shelby, Michelle Naughton, Abigail Caudle, Briant Fruth, E. Shelley Hwang. Musculoskeletal side effects over time and association with adherence in women taking neoadjuvant letrozole for estrogen receptor positive DCIS: CALGB 40903 (Alliance) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-14-17.

Assessing the diet quality of individuals with rheumatic conditions: a cross-sectional study.

Arthritis is a significant cause of chronic pain and disability, affecting around 3.5 million Australians. However, little is known regarding the overall diet quality of those living with arthritis. This study aimed to assess the dietary quality of Australians living in the Australian Capital Territory region with arthritis. This cross-sectional study analysed dietary intake data of individuals living with arthritis using a validated food frequency questionnaire. Dietary quality was assessed using the Healthy Eating Index-2015 (HEI-2015) to examine associations between diet composition, age, income and arthritis impact using the short form of the Arthritis Impact Measurement Scales 2 (AIMS2-SF). Participants, predominantly female (82.6%), were grouped by age: 18-50years (n = 32), 50-64years (n = 31), and 65 + years (n = 23). Significant correlations were observed between age and HEI-2015 (rs = 0.337, p = 0.002) and income and AIMS2-SF (rs = -0.353, p < 0.001). The mean HEI-2015 score for the 18-49years group was fair (72.1 ± 12.3), lower than both the 50-64years group score of good (81.5 ± 9.72) (p = 0.004), and the 65 + years group score of good (81.8 ± 12.1) (p = 0.007). Dietary fibre, seafood and plant protein, fatty acids, and refined grains were identified as dietary components of concern for the 18-49years group, and total fruit and added sugar were components of concern for people in the worst tertile for the AIMS2-SF. People aged between 18 and 49years are consuming a lower quality diet compared to people aged 50years and over. Further research is needed to understand why this association is occurring in this high socioeconomic region of Australia (a high-income country).

Factors influencing health status in older people with knee osteoarthritis.

To examine a causal model of health status among older people with knee osteoarthritis. A cross-sectional, correlational design was used with a convenience sample of 220 older Thai people with knee osteoarthritis (mean age 68.96 years; SD = 6.22). Participants were asked to complete a demographic questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, The Medical Outcomes Study Social Support Survey, and the Arthritis Impact Measurement Scales 2-Short Form. Structural Equation Model was used to examine a hypothesized model. Using Chi-square, hypothesized model was statistically nonsignificant. A model of health status fitted with the empirical data and explained 19.2% of variance. Pain catastrophizing had negative direct effect on self-efficacy and health status. Pain catastrophizing also had negative indirect effect on health status through self-efficacy. Self-efficacy and social support had positive direct effects on health status. However, pain-related fear had no direct or indirect effect on health status. Lower level of pain catastrophizing can improve self-efficacy. Increasing of self-efficacy and social support can then lead to improvement on health status. This study highlighted the effect of psychosocial factors on health status. It is necessary to develop a program to minimize pain catastrophizing, improve social support, and promote self-efficacy to improve the health status of older people with knee osteoarthritis.

The prognostic factors affecting quality of life in patients with knee osteoarthritis: a cohort study

Objective To investigate the quality of life (QOL) and risk factors for progression of knee osteoarthritis. Methods A prospective study of knee OA was conducted from April 2015 to August 2016. Two hundred and fifty patients with knee OA were recruited in this study and followed up for 18 months, during which there were five visits, i.e. baseline, 1st month, 6th month, 12th month and 18th month. QOL was assessed by the Arthritis Impact Measurement Scale 2 (AIMS2), which includes five dimensions (physical function, symptom, affect, social interaction and social role). Trajectories of QOL change were identified from a group-based trajectory model (PROC TRAJ). Risk factors associated with the QOL of OA were analyzed using chi square test followed by a multivariate logistic regression. Results Two hundred and thirty-nine participants had at least two follow-up visits. Each dimension of AIMS2 has deteriorated over time (Lower score indicates better health status): Physical function (1.9 points, (95%CI, 0.1 to 3.9; P=0.011), Symptom (2.0 points, 95%CI, 0.2 to 3.8; P=0.045), Affect (1.5 points, 95%CI 0.3 to 2.5; P=0.01), Social interaction (0.7 points, 95%CI, -0.1 to 1.5; P=0.065) and Social role (1.6 points, 95%CI, 0.5 to 2.7; P=0.01). Three trajectories of QOL were identified. Participants in Subgroup 1 (poor QoL; n=153) displayed bad QOL at baseline and deteriorated over time. Participants in Subgroup 2 (moderate QOL; n=65) developed or displayed moderate QOL over time. Participants in Subgroup 3 (good QOL; n=21) displayed good QOL at baseline and developed slightly better outcome over time. Baseline characteristics such as: female, higher body mass index, greater knee pain, longer duration of disease, lower education level, lower yearly income and more comorbidities were associated with the deterioration of QOL of knee OA. Conclusion Knee OA had impacts on patients' QOL. We identified three distinct trajectories of QOL change: good QOL group, moderate QOL group and poor QOL group. Baseline characteristics such as: female, higher body mass index, greater knee pain, longer duration of disease, lower education level, lower yearly income and more comorbidities were associated with the deterioration of QOL of OA. Key words: Osteoarthritis, knee; Quality of life; Root cause analysis

Health-Related Quality of Life Outcomes of Young Adults with Juvenile Idiopathic Arthritis in Turkish Population

The aim of the present study is to evaluate the functional status, life quality, mood and functionality of the adult patients with juvenile idiopathic arthritis (JIA) in Turkish population. Forty-seven patients with JIA were included in the study. Demographic features, disease characteristics, number of tender and swollen joints, pain score according to visual analogue scale and disease activity according to Disease Activity Score 28 (DAS28) were calculated and recorded. Functional disability was evaluated with a modified Health Assessment Questionnaire (m-HAQ). Quality of life was evaluated with Arthritis Impact Measurement Scale-2 (AIMS-2). Mood status was evaluated with Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The average DAS28 score of the patients was 4.37. Mean m-HAQ score was 1.25. According to AIMS-2 subscales, the average mobility level score was 5.5, walking and bending score was 6.0, hand and finger function score was 5.0, arm function score was 3.5, self-care score was 2.5, household tasks score was 3.75, social activities score was 6.0, support from family and friends score was 3.13, arthritis pain score was 6.0, level of tension score was 5.5, mood score was 6.0, satisfactory of health score was 7.31, and the general perception of health score was 5.0. The average BDI score was 19.0 while BAI score was 20.0. Although patients have mild disease activity and functional disability, their mood status and life quality are better. Patients may adapt to their disability status and survive their functional independence.

Expectations and depression in patients who have undergone total hip arthroplasty in Japan: A prospective cohort study

BackgroundPatients with hip osteoarthritis may be severely depressed preoperatively due to pain and limited daily-living activities. Hence, evaluating their expectations preoperatively might underestimate their true hopes regarding the upcoming total hip arthroplasty (THA). AimWe aimed to assess changes in patients’ level of depression, understand their expectations and fulfillment, and identify factors affecting fulfillment. MethodWe performed a longitudinal study of 366 Japanese patients who had undergone THA during 2005–2006. Those with THA of the contralateral hip were excluded. Patients’ expectations, fulfillment, depression, and physical function were assessed perperative and at 6 weeks and one year postoperatively using our own questionnaire, the Arthritis Impact Measurement Scale 2, and by the Oxford Hip Score . Logistic regression analysis was applied to identify independent predictors of expectation fulfillment. ResultsAt 6 weeks, 78.1% expressed expectation fulfillment and drastic alleviation of depression. Preoperative depression and fulfillment of patient expectations at 6 weeks were significant predictors of expectation fulfillment at 1 year (95% confidence intervals: 1.01–2.48 and 2.30–9.92, respectively. ConclusionsIt is worthwhile for health providers to investigate patients’ expectations early in the postoperative period by considering their preoperative depression to confirm fulfillment of expectations.

The Effect of Kinesiotaping on Hand Function in Patients with Rheumatoid Arthritis

Research background. Physical therapy is one of the main methods of rehabilitation in order to maintain and improve hand function for patients with rheumatoid arthritis. It is supposed that kinesiotaping method can be successfully used in patients with RA during the physical therapy to improve hand function. The aim of the research was to evaluate the effect of kinesiotaping on hand function in patients with Rheumatoid Arthritis. Methods. The study involved 22 subjects (100% women) who had Rheumatoid Arthritis. Subjects were randomly divided into two groups: the research group consisted of 10 individuals, they received kinesiotaping and exercise program, and the control group consisted of 12 individuals, only exercise was applied to them. The study lasted for 2 months, the procedures were performed three times a week. Range of motion of the wrist was measured using the goniometry method, the handgrip strength was assessed using a dynamometer. Modifed Keitel Function test and Modifed Arthritis Impact Measurement Scale (AIMS II) were used to evaluate hand function. Results. Range of motion of the wrist after physical therapy increased in both groups, but in the research group the right and the left wrist flexion and the left wrist extension were signifcantly higher than in the control group (p &lt; 0.05). The hand grip strength after physical therapy signifcantly increased in the control and in the research groups (p &lt; 0.05), but in the research group, it was significantly higher than in the control group (p &lt; 0.05 ). Hand functional status assessed by using a modifed Keitel index improved in both groups (p &lt; 0.05) was significantly better in the research group (p &lt; 0.05). The hand function assessed by the Arthritis Impact Measure Scale signifcantly improved in both groups (p &lt; 0.05), but no signifcant difference between the groups was observed (p &gt; 0.05). Conclusion. Kinesiotaping in conjunction with physical therapy is more effective method than just physical therapy in order to increase the range of motion of the wrist, the hand grip strength and hand functional status of patients with RA.Keywords: rheumatoid arthritis, physical therapy, kinesiotaping.