scholarly journals Tender and swollen joint counts are poorly associated with disability in chikungunya arthritis compared to rheumatoid arthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hugh Watson ◽  
Ramão Luciano Nogueira-Hayd ◽  
Maony Rodrigues-Moreno ◽  
Felipe Naveca ◽  
Giulia Calusi ◽  
...  

AbstractChronic rheumatological manifestations similar to those of rheumatoid arthritis (RA) are described after chikungunya virus infection. We aimed to compare the relevance of joint counts and symptoms to clinical outcomes in RA and chronic chikungunya disease. Forty patients with chronic chikungunya arthralgia and 40 patients with RA were enrolled in a cross-sectional study. The association of tenderness and swelling, clinically assessed in 28 joints, and patient evaluations of pain and musculoskeletal stiffness with modified Health Assessment Questionnaire (HAQ) and quality of life (QoL) assessments were investigated. Tender and swollen joint counts, pain and stiffness scores were all associated with the HAQ disability index in RA (all r > 0.55, p ≤ 0.0002), but only stiffness was significantly associated with disability in chikungunya (r = 0.38, p = 0.02). Joint counts, pain and stiffness were also associated with most QoL domains in RA patients. In contrast, in chikungunya disease, tender joint counts were associated only with one QoL domain and swollen joints for none, while pain and stiffness were associated with several domains. Our results confirm the relevance of joint counts in RA, but suggest that in chronic chikungunya disease, joint counts have more limited value. Stiffness and pain score may be more important to quantify chikungunya arthritis impact.

Author(s):  
Ayça Uran Şan ◽  
Ahmet Onur Çakiryilmaz ◽  
Sinem Uyar Köylü ◽  
Tuğba Atan ◽  
Serdar Kesikburun ◽  
...  

Abstract Objective Taking care of a patient can significantly impact both physical and psychological statuses of caregivers. This study aimed to examine musculoskeletal problems, health status, and quality of life of caregivers. This study is novel in determining musculoskeletal disorders, pain characteristics, activity levels, sleep condition, general and psychological health statuses, and quality of life of caregivers. Design A cross-sectional study Patients and Methods A total of 240 participants were enrolled in this prospective and cross-sectional study conducted at a tertiary rehabilitation center (patients, n = 120; caregivers, n = 120). The demographic and clinical characteristics of the participants were recorded during the evaluation process. The Functional Ambulation Classification Scale (FAS) and Barthel Scale scores of the patients were determined. The pain level of the caregivers was evaluated according to the Visual Analog Scale (VAS). The International Physical Activity Questionnaire (IPAQ)–short form was used to evaluate caregivers’ activity levels. The quality of life of caregivers was evaluated with the World Health Organization Quality of Life Assessment Scales score (WHOQOL-BREF). The anxiety and depression status of the caregivers were interpreted using the Hospital Anxiety and Depression Scale, The health level of the caregivers was evaluated using the Health Assessment Questionnaire. Results A statistically significant positive correlation was found between the duration of caregiving (hours per week) and the pain duration of the caregiver (month) (P = 0.000, r = 0.766). the caregivers who provided longer-term care for their patients (hours per week) had higher VAS scores (P = 0.000, r = 0.944). A significant reverse correlation was found between the duration of caregiving (hours per week) and IPAQ-Walking MET (metabolic equivalent) scores (minutes/week) (P = 0.000, r = –0.811). On the contrary, a positive significant association was detected between the duration of caregiving (hours per week) and IPAQ-Vigorous MET scores (minutes/week) due to the caregiving activities of the patients such as lifting, positioning, and so forth. Also, a significant positive correlation was observed between the duration of caregiving (hours per week) and Hospital Depression Scale scores (P = 0.000, r = 0.394), Hospital Anxiety Scale scores (P = 0.000, r = 0.548), and Health Assessment Questionnaire scores (P = 0.000, r = 0.415). Conclusion Providing protective exercise programs, including walking activity, to caregivers and organizing education programs that include caregiving techniques can positively affect the quality of life of caregivers.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 791.1-792
Author(s):  
D. Almeida ◽  
E. Costa ◽  
F. Guimarães ◽  
S. Azevedo ◽  
J. Rodrigues ◽  
...  

Background:Osteoarthritis (OA) is frequently regarded by patients and health care providers as a normal consequence of ageing (1). On the other hand, it is well established that rheumatoid arthritis (RA) is a pathological condition requiring prompt and efficacious treatment and in which remarkable progresses have been achieved in the last decades. Pain and physical limitations are hallmarks of both conditions. Some previous studies suggest that OA and RA may have a similar burden (2,3).Objectives:To compare levels of pain, physical disability and health-related quality of life in patients with primary hand osteoarthritis (hOA) and with RA: active disease (aRA) or in remission (rRA).Methods:Observational cross-sectional study including patients of two clinical centres with hOA and RA, either in remission or with active disease (at least two swollen and/or tender hand joints). Matching for sex and age was performed. Patients were asked to complete a survey consisting of visual analogic scale (VAS) for pain, Health Assessment Questionnaire (HAQ) and Short Form 36 (SF36). Mean values for each domain were compared between the three groups using one-way ANOVA test with significance accepted for p<.05.Results:Thirty patients with hOA and 93 with RA (33 with aRA and 60 with rRA) were included. All patients were caucasian females with no significant differences in age between groups. Patients with hOA reported higher levels of pain in comparison with aRA patients (mean VAS 57.3vs49.3mm, respectively, p=.265) and with rRA patients (57.3vs28.6mm, respectively, p<.001) [F(2.120)=25.907, p<.001]. Regarding physical function, patients with hOA reported levels of disability similar to rRA patients, but significantly lower disability than patients with aRA [F(2.120)=6.962, p=.001]. Patients with hOA evaluated their quality of life significantly better than patients with aRA and in similar levels to patients with rRA, as measured by mental health and general health status domains of SF36.Conclusion:Our results show that hOA may have similar or even higher burden of pain than RA; this is in line with previous studies, although most of them did not consider the level of inflammatory activity of RA. On the other hand, patients with hOA seem to preserve function and have better health-related quality of life despite the higher levels of pain. These results highlight OA as a cause of severe pain, which should lead us to try an optimal symptom control for these patients. These findings should also encourage rheumatologists to endeavor efforts to perform more studies in the field of OA, to better understand its pathogenesis and to eventually find disease modifying drugs.References:[1]Gignac MAM, Davis AM, Hawker G, Wright JG, Mahomed N, Fortin PR, et al. “What do you expect? You’re just getting older”: A comparison of perceived osteoarthritis-related and aging-related health experiences in middle- and older-age adults. Arthritis Rheum. 2006 Dec 15;55(6):905–12.[2]El-Haddad C, Castrejon I, Gibson KA, Yazici Y, Bergman MJ, Pincus T. MDHAQ/RAPID3 scores in patients with osteoarthritis are similar to or higher than in patients with rheumatoid arthritis: a cross-sectional study from current routine rheumatology care at four sites. RMD Open. 2017 Jul;3(1):e000391.[3]Slatkowsky-Christensen B, Mowinckel P, Kvien T. Health status and perception of pain: a comparative study between female patients with hand osteoarthritis and rheumatoid arthritis. Scand J Rheumatol. 2009 Jan;38(5):342–8.Disclosure of Interests:None declared


2009 ◽  
Vol 36 (11) ◽  
pp. 2443-2448 ◽  
Author(s):  
VARUN DHIR ◽  
ABLE LAWRENCE ◽  
AMITA AGGARWAL ◽  
RAMNATH MISRA

Objectives.Fibromyalgia (FM) has been shown to be common in patients with rheumatoid arthritis (RA), but studies on Asian patients are lacking. It remains unclear whether FM has an adverse influence on pain, fatigue, quality of life, and mood in these patients, and what its relationship is with disease activity. We studied prevalence and effects of FM in North Indian patients with RA and associations of RA with disease activity.Methods.This cross-sectional study included 200 RA patients and an equal number of controls. Presence of FM was defined using the American College of Rheumatology 1990 criteria. Pain and fatigue scores were assessed using a 10 cm visual analog scale. Quality of life and presence of depression/anxiety were determined using validated questionnaires. Disease activity and functional disability in RA patients was assessed using the Disease Activity Score 28-3 and Health Assessment Questionnaire, respectively.Results.FM was present in 15% of patients with RA compared to 2.5% of controls in the North Indian population. RA patients with FM did not differ from those without FM in terms of age, gender, current disease-modifying agents, or steroid use. RA patients with FM had higher disease activity and worse functional disability. The number of tender and swollen joints was higher in patients with FM, but correlated poorly with each other. RA patients with FM had higher pain and fatigue scores but were not different in the quality of life or mood.Conclusion.FM is more common in North Indian patients with RA compared to controls. It adversely affects the pain and fatigue felt by RA patients. Disease activity and FM influence each other.


2019 ◽  
Vol 15 (5) ◽  
pp. 296-300
Author(s):  
Yessenia Cruz-Castillo ◽  
Nadia Montero ◽  
Rosa Salazar-Ponce ◽  
Rómulo Villacís-Tamayo

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