Investigating Dimensions of Stiffness in Rheumatoid and Psoriatic Arthritis: The Australian Rheumatology Association Database Registry and OMERACT Collaboration
Investigating Dimensions of Stiffness in Rheumatoid and Psoriatic Arthritis: The Australian Rheumatology Association Database Registry and OMERACT Collaboration
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DOI：
10.3899/jrheum.181251
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发表时间：
2019-11-01
影响因子：
3.9
通讯作者：
March, Lyn
中科院分区：
文献类型：
--
作者：
Sinnathurai, Premarani;Bartlett, Susan J.;March, Lyn
目标。目前还不知道僵硬的经验在不同的诊断之间是如何变化的，也不知道如何最好地测量僵硬。我们研究的目的是(1)使用患者报告的结果来比较银屑病关节炎(PSA)和类风湿关节炎(RA)的僵硬程度，(2)调查僵硬程度如何相互关联并反映患者的经验，(3)分析僵硬程度的不同维度如何与身体功能相关。一份在线调查发送给澳大利亚风湿病协会数据库参与者(158名PSA和158名年龄和性别匹配的RA)，评估僵硬的严重性、持续时间、影响、重要性、应对和身体功能[修改后的健康评估问卷(MHAQ)]。比较诊断之间的分数和计算出的僵硬维度之间的相关性。根据年龄、性别、病程、肥胖和疼痛对mHAQ的僵硬程度、影响和持续时间进行了多变量回归。认知情况汇报通过半结构化电话访谈进行。总体而言，240/316(75.9%)的诊断有效[124/158RA(78.5%)和116/158PSA(73.4%)]，在不同诊断之间僵硬评级没有显著差异。所有僵硬维度的得分都有很强的相关性(r=0.52-0.89)，在两种诊断中，严重程度和影响都与mHAQ相关。在RA中，僵硬持续时间与mHAQ无关。在认知汇报中，参与者描述了僵硬的严重程度和对日常活动的影响(分别为10/16和14/16参与者)。PSA和RA之间的僵硬程度相似。僵硬的不同维度之间有很强的相关性。僵硬严重程度和冲击均可独立预测mHAQ。僵硬对参与者来说很重要；然而，测量多个维度的僵硬可能具有最小的附加价值。
Objective. It is not known how the experience of stiffness varies between diagnoses or how best to measure stiffness. The aims of our study were to (1) compare stiffness in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) using patient-reported outcomes, (2) investigate how dimensions of stiffness are associated with each other and reflect the patient experience, and (3) analyze how different dimensions of stiffness are associated with physical function.Methods. An online survey was sent to Australian Rheumatology Association Database participants (158 PsA, and 158 age- and sex-matched RA), assessing stiffness severity, duration, impact, importance, coping, and physical function [modified Health Assessment Questionnaire (mHAQ)]. Scores were compared between diagnoses and correlations among stiffness dimensions calculated. Multivariate regression was performed for stiffness severity, impact, and duration on mHAQ, adjusting for age, sex, disease duration, obesity, and pain. Cognitive debriefing was conducted through semistructured telephone interviews.Results. Overall, 240/316 (75.9%) responded [124/158 RA (78.5%) and 116/158 PsA (73.4%)], with no significant difference in stiffness ratings between diagnoses. Scores for all stiffness dimensions were strongly correlated (r = 0.52-0.89), and severity and impact were associated with mHAQ in both diagnoses. Stiffness duration was not associated with mHAQ in RA. In cognitive debriefing, participants described stiffness severity and impact by their effect on daily activities (10/16 and 14/16 participants, respectively).Conclusion. Stiffness ratings were similar between PsA and RA. Different dimensions of stiffness were strongly correlated. Stiffness severity and impact both independently predicted mHAQ. Stiffness was important to participants; however, measuring multiple dimensions of stiffness may have minimal additive value.