scholarly journals Gait variables: appropriate objective outcome measures in rheumatoid arthritis

Rheumatology ◽  
1999 ◽  
Vol 38 (7) ◽  
pp. 663-667 ◽  
Author(s):  
M Fransen
2002 ◽  
Vol 65 (4) ◽  
pp. 165-171 ◽  
Author(s):  
Sarah Elizabeth Henderson ◽  
Ian R McMillan

The use of orthotics in the management of rheumatoid arthritis appears to be relatively commonplace within occupational therapy departments. The aim of this study was to identify the frequency of orthotic use by occupational therapists, their beliefs about the efficacy of orthotic use, what they aimed to achieve by orthotic provision and any outcome measures used. The total membership of the British Association of Hand Therapists who were both occupational therapists and self-identified as working and/or having an interest in rheumatology (n = 132) were surveyed through a postal questionnaire. Of the responses received (n = 89, 67%), all the respondents (100%) were regular users of orthotics in the management of rheumatoid arthritis. The results showed that the most highly rated reasons for orthotic provision were to decrease hand and wrist pain and to improve hand function. Subjective comments from the respondents provided evidence of positive beliefs about the efficacy of orthotic use, despite a lack of objective outcome measures to support such comment. Given the complexity of the intervening variables that occur with orthotic use, perhaps there is no easy answer; however, with the expectation of evidence-based practice and intervention, it is suggested that an increased use of standardised outcome measures may provide additional strength in presenting, often subjective, evidence.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038829
Author(s):  
Ross McQueenie ◽  
Barbara I Nicholl ◽  
Bhautesh D Jani ◽  
Jordan Canning ◽  
Sara Macdonald ◽  
...  

ObjectiveTo investigate how the type and number of long-term conditions (LTCs) impact on all-cause mortality and major adverse cardiovascular events (MACE) in people with rheumatoid arthritis (RA).DesignPopulation-based longitudinal cohort study.SettingUK Biobank.ParticipantsUK Biobank participants (n=502 533) aged between 37 and 73 years old.Primary outcome measuresPrimary outcome measures were risk of all-cause mortality and MACE.MethodsWe examined the relationship between LTC count and individual comorbid LTCs (n=42) on adverse clinical outcomes in participants with self-reported RA (n=5658). Risk of all-cause mortality and MACE were compared using Cox’s proportional hazard models adjusted for lifestyle factors (smoking, alcohol intake, physical activity), demographic factors (sex, age, socioeconomic status) and rheumatoid factor.Results75.7% of participants with RA had multimorbidity and these individuals were at increased risk of all-cause mortality and MACE. RA and >4 LTCs showed a threefold increased risk of all-cause mortality (HR 3.30, 95% CI 2.61 to 4.16), and MACE (HR 3.45, 95% CI 2.66 to 4.49) compared with those without LTCs. Of the comorbid LTCs studied, osteoporosis was most strongly associated with adverse outcomes in participants with RA compared with those without RA or LTCs: twofold increased risk of all-cause mortality (HR 2.20, 95% CI 1.55 to 3.12) and threefold increased risk of MACE (HR 3.17, 95% CI 2.27 to 4.64). These findings remained in a subset (n=3683) with RA diagnosis validated from clinical records or medication reports.ConclusionThose with RA and other LTCs, particularly comorbid osteoporosis, are at increased risk of adverse outcomes, although the role of corticosteroids could not be evaluated in this study. These results are clinically relevant for the monitoring and management of RA across the healthcare system, and future clinical guidelines for RA should acknowledge the importance of multimorbidity.


2021 ◽  
Vol 57 (2) ◽  
pp. 81-90
Author(s):  
Sebastian Mejia ◽  
Felix Michael Duerr ◽  
Gregg Griffenhagen ◽  
Stephanie McGrath

ABSTRACT The objective of this study was to provide preliminary data describing the safety and effect of cannabidiol (CBD) for symptom relief of canine osteoarthritis-associated pain in a clinical setting using objective outcome measures. Twenty-three client-owned dogs with naturally occurring osteoarthritis of appendicular joints completed this prospective, double-blinded, crossover, placebo-controlled study. Baseline data were acquired for 4 wk, followed by random allocation to either placebo or CBD treatment for 6 wk, followed by 6 wk with the opposite treatment. Outcome measures included objective gait analysis, activity counts (via accelerometry) and clinical metrology instruments. There were no differences noted between groups at any time point for any of the recorded outcome measures. Adverse events associated with CBD administration included elevation in liver enzymes (n = 14) and vomiting (n = 2).


2020 ◽  
Vol 8 (6) ◽  
pp. 3674-3679
Author(s):  
Sanjeev Kumar Singh ◽  
◽  
Afsha Mulla ◽  
Farheen Farooque Khan ◽  
Ronika Agrawal ◽  
...  

Background: Rheumatoid arthritis (RA) is an autoimmune, systemic, inflammatory condition causing pain, disability, and psychological distress. It is the most common chronic inflammatory joint disease, affecting 0.1-1% of the population. Women are affected 3 times more than men. Because of its chronic, painful, and disabling character, RA tends to have a profound impact on health-related quality of life (HRQOL). Materials and methods: In the present study a convenience sample of 30 individuals between 30 to 60 years of age group according to the inclusion and exclusion criteria. The exercise intervention was participation in aerobic exercise session 3 times weekly for 6 weeks. The session consisted of 3 phases –1)Warm-up phase 2).Aerobic period 3) Cool down phase.Subjects were given their target heart rate for 40% and 60% of their HRmax. They were instructed to start exercising at 40% and progress to 60% as tolerated given their subjective exertion using the Talk Test (being able to talk while exercising without being short of breath). Global Fatigue Index Of The Multidimensional Assessment Of Fatigue Questionnaire (GFI) and The Center for Epidemiologic Studies- Depression Scale (CES-D)were used as outcome measures for evaluating fatigue and severity of depression respectively in the subjects and the data was statistically analysed. Results: Paired t-test was done for pre and post mean values for MAF-GFI scale. The results showed statistically significant values for both the outcome measures (p value < 0.05). Conclusion: The present study concludes that 6 weeks of aerobic exercise showed significant effect in decreasing fatigue and depression in individuals with rheumatoid arthritis. KEY WORDS: Rheumatoid Arthritis, Fatigue, Depression, Aerobic Exercise.


2016 ◽  
Author(s):  
Tessa Sanderson ◽  
John Kirwan ◽  
Celia Almeida ◽  
Marianne Morris ◽  
Robert Noddings ◽  
...  

2019 ◽  
Vol 33 (11) ◽  
pp. 1788-1799 ◽  
Author(s):  
Ana Belen Ortega-Avila ◽  
Laura Ramos-Petersen ◽  
Pablo Cervera-Garvi ◽  
Christopher J Nester ◽  
José Miguel Morales-Asencio ◽  
...  

Objective: To identify self-reported outcome measures specific to the foot and ankle in patients with rheumatoid arthritis and to investigate the methodological quality and psychometric properties of these measures. Method: A systematic review focusing on patients with rheumatoid arthritis. Setting: The search was conducted in the PubMed, SCOPUS, CINAHL, PEDro and Google Scholar databases, based on the following inclusion criteria: population (with rheumatoid arthritis) > 18 years; psychometric or clinimetric validation studies of patient-reported outcomes specific to the foot and ankle, in different languages, with no time limit. Two of the present authors independently assessed the quality of the studies located and extracted the relevant data. Terwee’s criteria and the COSMIN checklist were employed to ensure adequate methodological quality. Results: Of the initial 431 studies considered, 14 met the inclusion criteria, representing 7,793 patients (56.8 years). These instruments were grouped into three dimensions (pain, perceived health status and quality of life and disability). The time to complete any of the PROMs varies around 15 minutes. PROMs criterias with the worst scores by COSMIN, 92.85% and 85.71% were criterion validity, measurement error, internal consistency and responsiveness. 28.57% of PROMs were compared with the measurement properties. Conclusion: the Self-Reported Foot and Ankle Score achieved the highest number of positive criteria (according to Terwee and COSMIN), and is currently the most appropriate for patients with Rheumatoid arthritis.


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