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Rutkowski R, Gizińska M, Gałczyńska-Rusin M, Kasprzak MP, Budiman-Mak E. The Importance of Foot Function Assessment Using the Foot Function Index-Revised Short Form (FFI-RS) Questionnaire in the Comprehensive Treatment of Patients with Rheumatoid Arthritis. J Clin Med 2022; 11:2298. [PMID: 35566422 PMCID: PMC9101500 DOI: 10.3390/jcm11092298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Foot problems may have a substantial negative impact on rheumatoid arthritis (RA) patients' mobility. They affect walking and the functional capacity to perform daily tasks. METHODS This study included 61 patients with RA and foot pain or swelling. The study group comprised 37 patients (aged 54.3 ± 9.5 years) with foot lesions, as demonstrated in an ultrasound, and the control group comprised 24 patients (aged 57.3 ± 11.5 years) without foot lesions. The patients' health statuses were evaluated with the Foot Function Index-Revised Short Form (FFI-RS), the Polish version of the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Disease Activity Score 28 (DAS 28). RESULTS The FFI-RS showed significant differences between the study and control groups in total results, as well as in the pain and stiffness subscales. Subsequent analyses showed numerous significant correlations. The FFI-RS total results correlated with the HAQ's standing up, walking, and total results. The FFI-RS pain results correlated with the social issues and HAQ's total results. The FFI-RS difficulty results correlated with the disease's duration. In the study group, there were significant correlations of the FFI-RS stiffness, difficulty, and social issues results with the HAQ's standing up, walking, and total results, and also of the FFI-RS activity limitation results with the HAQ's standing up results. In the control group, there were correlations of the FFI-RS stiffness, difficulty, and activity limitation results with the HAQ's walking and total results. Finally, in the study group, we also found correlations of the FFI-RS total, pain, stiffness, difficulty, and social issues results with the Visual Analog Scale (VAS) results, as well as of the FFI-RS total results with the DAS 28 results. CONCLUSIONS The FFI-RS is an effective tool for assessing RA patients' functional status and can be used to evaluate treatment effects. The FFI-RS detected RA-related changes in the foot joint function in patients without foot lesions, as assessed by ultrasound.
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Affiliation(s)
- Radosław Rutkowski
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznan, Poland;
| | - Małgorzata Gizińska
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznan, Poland;
| | - Małgorzata Gałczyńska-Rusin
- Department of Orthodontics and Temporomandibular Disorders, University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
| | - Magdalena Paulina Kasprzak
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznań, Poland;
| | - Elly Budiman-Mak
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, 5000 South 5th Ave, Hines, IL 60141-3030, USA;
- Department of Medicine, Stritch School of Medicine, Loyola University of Chicago, Maywood, IL 60513, USA
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Ye H, Weng H, Xu Y, Wang L, Wang Q, Xu G. Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials. BMC Sports Sci Med Rehabil 2022; 14:17. [PMID: 35123568 PMCID: PMC8818158 DOI: 10.1186/s13102-022-00408-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/27/2022] [Indexed: 11/15/2022]
Abstract
Background Rheumatoid arthritis (RA) can cause severe physical impairment and a reduced quality of life, and there is limited evidence for any effective intervention. Aerobic exercise may be beneficial for improving symptoms. Therefore, the purpose of this meta-analysis was to evaluate the effectiveness and safety of aerobic exercise for rheumatoid arthritis patients. Methods PubMed, The Cochrane Library, Web of Science, EMBASE, CNKI, WanFang Data and VIP databases were searched. Randomized controlled trials of the effectiveness and safety of aerobic exercise for rheumatoid arthritis were included. Risks of bias were assessed by two independent reviewers using the methods described in the RevMan 5.3, GRADEpro and the Cochrane Handbook. Meta-analyses were performed to investigate the effects of aerobic exercise on rheumatoid arthritis. Results A total of 13 RCTs were included, including 967 rheumatoid arthritis patients. The Meta-analysis results showed that aerobic exercise can improve functional ability [MD = − 0.25, 95% CI (− 0.38, − 0.11), P = 0.0002], relieve pain [SMD = − 0.46, 95% CI (− 0.90, − 0.01), P = 0.04], increase aerobic capacity [MD = 2.41, 95% CI (1.36, 3.45), P < 0.00001] and improve the Sit to Stand test score[MD = 1.60, 95% CI (0.07, 3.13), P = 0.04] with statistically significant differences. Conclusion Generally, aerobic exercise is beneficial and safe for RA patients and has a certain alleviating effect on the disease, such as functional ability improvement, pain relief and aerobic capacity increase. Limited by the quantity and quality of the included studies, future research with higher-quality studies needs to be conducted to verify the above conclusions. Trial registration: PROPERO registration number: CRD42021242953.
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Affiliation(s)
- Hui Ye
- School of Nursing, Nanjing University of Chinese Medicine, No. 138, Xianlin St., Box 064, Nanjing, 210023, People's Republic of China
| | - Heng Weng
- School of Nursing, Nanjing University of Chinese Medicine, No. 138, Xianlin St., Box 064, Nanjing, 210023, People's Republic of China
| | - Yue Xu
- School of Nursing, Nanjing University of Chinese Medicine, No. 138, Xianlin St., Box 064, Nanjing, 210023, People's Republic of China
| | - Lulu Wang
- School of Nursing, Nanjing University of Chinese Medicine, No. 138, Xianlin St., Box 064, Nanjing, 210023, People's Republic of China
| | - Qing Wang
- School of Nursing, Nanjing University of Chinese Medicine, No. 138, Xianlin St., Box 064, Nanjing, 210023, People's Republic of China.
| | - Guihua Xu
- School of Nursing, Nanjing University of Chinese Medicine, No. 138, Xianlin St., Box 064, Nanjing, 210023, People's Republic of China.
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Armagan B, Sari A, Erden A, Kilic L, Erdat EC, Kilickap S, Kiraz S, Bilgen SA, Karadag O, Akdogan A, Ertenli I, Kalyoncu U. Starting of biological disease modifying antirheumatic drugs may be postponed in rheumatoid arthritis patients with multimorbidity: Single center real life results. Medicine (Baltimore) 2018; 97:e9930. [PMID: 29595700 PMCID: PMC5895384 DOI: 10.1097/md.0000000000009930] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The objective of this study was to assess the frequency of comorbidities and multimorbidities in rheumatoid arthritis (RA) patients under biologic therapy and their effects on biological disease modifying antirheumatic drugs (DMARDs) choice, timing, and response.Hacettepe University Biologic Registry (HUR-BIO) is single center biological DMARD registry. Cardiovascular, infectious, cancer, and other comorbidities were recorded with face to face interviews. Multimorbidity is defined as >1 comorbidity. Disease duration, initial date of biological DMARDs, initial and overall biological DMARD choice were recorded. Disease activity score-28 (DAS-28) responses were compared to comorbidity presence and multimorbidity.Total of 998 RA patients were enrolled into the study. The mean age was 53.1 (12.5) and mean disease duration (standard deviation [SD]) was 11.7 (7.5) years. At least 1 comorbidity was detected in 689 (69.1%) patients, 375 (37.9%) patients had multimorbidity. Patients had mean 1.36 ± 1.32 comorbidity. The median durations of first biological DMARDs prescription were 60 (3-552) months after RA diagnosis. For multimorbidity patients, the median first biological prescription duration was longer than the duration for patients without multimorbidity (72 [3-552] vs 60 [3-396] months, P < .001). The physicians prescribe tumor necrosis factor inhibitor (TNFi) biological drugs less frequently than other biological DMARDs in patients with at least 1 comorbidity (66.2% vs 74.5%, P = .007) or multimorbidity (34.6% vs 43.5%, P = .006). Patients with comorbidities and multimorbidity achieved DAS-28 remission less frequently than patients without comorbidity (31.6% vs 42.6%, P = .012 and 27.2% vs 39.7%, P = .001, respectively).In real life, physicians may postpone to prescribe biological DMARDs and less frequently choose TNFi biological drugs in patients with multimorbidity. Furthermore, comorbidity may have a negative effect on the treatment response.
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Affiliation(s)
| | | | | | | | | | - Saadettin Kilickap
- Division of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Ji J, Zhang L, Zhang Q, Yin R, Fu T, Li L, Gu Z. Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis. Health Qual Life Outcomes 2017; 15:89. [PMID: 28464888 PMCID: PMC5414118 DOI: 10.1186/s12955-017-0659-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 04/19/2017] [Indexed: 01/29/2023] Open
Abstract
Background As an important outcome measure among rheumatoid arthritis (RA) patients, functional disability may contribute to unemployment, loss of work productivity, and impaired quality of life. However, little is known about the risk factors of functional disability in Chinese RA patients. This study aimed (1) to examine the prevalence of functional disability in Chinese RA patients; (2) to explore factors associated with the health assessment questionnaire-disability index (HAQ-DI). Methods A total of 101 RA patients in this cross-sectional study underwent standardized laboratory examinations and responded to the questionnaire for demographic data, the HAQ-DI for functional disability, the Compliance Questionnaire on Rheumatology (CQR) for medication adherence, the Hospital Anxiety and Depression Scale (HADS) for psychological status, and the Short Form 36 health survey (SF-36) for quality of life. Pain, grip/pinch strength, disease activity, and large joint mobility were recorded. Independent samples t-tests, chi-square analyses, and logistic regression modeling were used to analyze the data. Results The mean ± SD age of RA patients was 54.9 ± 11.9 years. Approximately 15.8% RA patients in mainland China experience functional disability (defined as a HAQ-DI score ≥ 1). Long disease duration, pain, high disease activity, a larger number of tender and swollen joints, high C-reactive protein (CRP) level, decreased grip strength, and limitation of shoulder, elbow, wrist, knee, and ankle motion were associated with the HAQ-DI. Participants with functional disability tended to have more severe depressive symptoms and a lower quality of life compared with individuals without functional disability. Stepwise logistic regression analyses found that limitation of wrist extension (P = 0.001) and lower body pain (BP) score (P = 0.001) explained higher HAQ-DI score. Conclusions The present study reported that functional disability was common in Chinese RA patients. A low quality of life and limitation of joint mobility had great impacts on functional disability in Chinese RA patients. Targeted and culturally sensitive interventions should be strengthened to delay the onset of disabilities of this population.
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Affiliation(s)
- Juan Ji
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China
| | - Lijuan Zhang
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China.,School of Nursing, Nantong University, 19th Qixiu Road, 226001, Nantong, People's Republic of China
| | - Qiuxiang Zhang
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China.,School of Nursing, Nantong University, 19th Qixiu Road, 226001, Nantong, People's Republic of China
| | - Rulan Yin
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China.,School of Nursing, Nantong University, 19th Qixiu Road, 226001, Nantong, People's Republic of China
| | - Ting Fu
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China.,School of Nursing, Nantong University, 19th Qixiu Road, 226001, Nantong, People's Republic of China
| | - Liren Li
- School of Nursing, Nantong University, 19th Qixiu Road, 226001, Nantong, People's Republic of China.
| | - Zhifeng Gu
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China.
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Williams EM, Walker RJ, Faith T, Egede LE. The impact of arthritis and joint pain on individual healthcare expenditures: findings from the Medical Expenditure Panel Survey (MEPS), 2011. Arthritis Res Ther 2017; 19:38. [PMID: 28245879 PMCID: PMC5331686 DOI: 10.1186/s13075-017-1230-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Joint pain, including back pain, and arthritis are common conditions in the United States, affecting more than 100 million individuals and costing upwards of $200 billion each year. Although activity limitations associated with these disorders impose a substantial economic burden, this relationship has not been explored in a large U.S. cohort. METHODS In this study, we used the Medical Expenditures Panel Survey to investigate whether functional limitations explain the difference in medical expenditures between patients with arthritis and joint pain and those without. We used sequential explanatory linear models to investigate this relationship and accounted for various covariates. RESULTS Unadjusted mean expenditures were $10,587 for those with joint pain or arthritis, compared with $3813 for those without. In a fully adjusted model accounting also for functional limitations, those with joint pain or arthritis paid $1638 more than those without, a statistically significant difference. CONCLUSIONS The growing economic and public health burden of arthritis and joint pain, as well as the corresponding complications of functional, activity, and sensory limitations, calls for an interdisciplinary approach and heightened awareness among providers to identify strategies that meet the needs of high-risk patients in order to prevent and delay disease progression.
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Affiliation(s)
- Edith M Williams
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite CS303, Charleston, SC, 29425, USA.,Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280H, Charleston, SC, 29425, USA
| | - Rebekah J Walker
- Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280H, Charleston, SC, 29425, USA.,Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 803, Charleston, SC, 29425, USA.,Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Medical Center, 109 Bee Street, Charleston, SC, 29401, USA
| | - Trevor Faith
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite CS303, Charleston, SC, 29425, USA
| | - Leonard E Egede
- Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280H, Charleston, SC, 29425, USA. .,Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 803, Charleston, SC, 29425, USA. .,Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Medical Center, 109 Bee Street, Charleston, SC, 29401, USA.
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