Activity limitations and participation restrictions in women with hand osteoarthritis: patients' descriptions and associations between dimensions of functioning
Activity limitations and participation restrictions in women with hand osteoarthritis: patients' descriptions and associations between dimensions of functioning
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DOI：
10.1136/ard.2004.034900
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发表时间：
2005-11-01
影响因子：
27.4
通讯作者：
Finset, A
中科院分区：
文献类型：
--
作者：
Kjeken, I;Dagfinrud, H;Finset, A
目的：描述手部骨关节炎的功能后果，并在国际功能分类 (ICF) 框架内分析个人因素、手部损伤、活动限制和参与限制之间的关联。方法：87 名患有手部骨关节炎的女性完成了临床检查，包括记录社会人口统计数据、手部损伤测量以及完成自我报告的健康状况测量。 AUSCAN 骨关节炎手指数的功能子量表被用作手部相关活动限制的衡量标准，而加拿大职业绩效衡量标准 (COPM) 被用来描述和衡量个人感知的活动限制和参与限制。使用 ICF 框架中的维度对研究变量进行分类，并使用双变量和多变量统计方法进行分析。结果：患者描述了活动和参与的许多领域的问题。最常描述的与手相关的问题是需要相当大的握力并结合双手扭转的活动。在损伤水平上，患者手中的握力和关节活动度降低，并且抵抗运动是痛苦的。回归分析表明，手部相关的活动限制与手部损伤的测量相关，而活动和参与（通过 COPM 测量）与个人因素的相关性比与手部损伤的相关性更强。结论：手部骨关节炎在疼痛、手部活动能力和握力降低、活动限制和参与限制方面具有重要的功能后果。因此，康复计划应该是多学科和多维度的，重点关注手部功能、职业表现和应对策略。
Objective: To describe the functional consequences of hand osteoarthritis, and analyse associations between personal factors, hand impairment, activity limitations, and participation restrictions within the framework of the International Classification of Functioning (ICF).Methods: 87 women with hand osteoarthritis completed a clinical examination including recording of sociodemographic data, measures of hand impairment, and completion of self reported health status measures. The function subscale of the AUSCAN Osteoarthritis Hand Index was used as a measure of hand related activity limitations, while the Canadian Occupational Performance Measure (COPM) was used to describe and measure activity limitations and participation restrictions as perceived by the individual. The study variables were categorised using the dimensions in the ICF framework and analysed using bivariate and multivariate statistical approaches.Results: The patients described problems in many domains of activity and participation. The most frequently described hand related problems were activities requiring considerable grip strength combined with twisting of the hands. On the impairment level, the patients had reduced grip force and joint mobility in the hands, and resisted motion was painful. Regression analyses showed that hand related activity limitations were associated with measures of hand impairment, while activity and participation ( as measured by the COPM) were more strongly associated with personal factors than with hand impairment.Conclusions: Hand osteoarthritis has important functional consequences in terms of pain, reduced hand mobility and grip force, activity limitations, and participation restrictions. Rehabilitation programmes should therefore be multidisciplinary and multidimensional, focusing on hand function, occupational performance, and coping strategies.