scholarly journals AB0716 FIBROMYALGIA SYNDROME SEVERITY ACCORDING TO AGE CATEGORIES: RESULTS FROM A NATIONAL REGISTER

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1389.2-1390
Author(s):  
M. Di Carlo ◽  
S. Farah ◽  
L. Bazzichi ◽  
F. Atzeni ◽  
M. Govoni ◽  
...  
Keyword(s):  
Health Status ◽  
Standard Deviation ◽  
Physical Function ◽  
Disease Severity ◽  
Analysis Of Variance ◽  
Symptom Severity ◽  
Fibromyalgia Syndrome ◽  
Fibromyalgia Impact Questionnaire ◽  
Revised Fibromyalgia Impact Questionnaire ◽  
Patient Reported

Background:Fibromyalgia syndrome (FM) is characterised by a complex symptom spectrum, dominated by the presence of chronic widespread pain, fatigue and unrefreshing sleep. FM affects between 2 and 3% of the general population. It is a condition that mainly involves middle-aged women, although it is increasingly being diagnosed in younger people. The severity of symptoms can vary greatly between individual patients, and is influenced by many factors (e.g. sex, body mass index) [1]. To date, there is little information about changes in severity in accordance with patient age.Objectives:The aim of this study was to investigate variations in symptom severity in FM patients according to age categories.Methods:A cross-sectional study of adult FM patients diagnosed according to the American College of Rheumatology 2010/2011 criteria was performed. The case series was included from an Italian national registry [2]. Patients were grouped according to five age categories: 18-40 years, 41-50 years, 51-60 years, 61-70 years, over 71 years. Symptom severity was assessed through the revised Fibromyalgia Impact Questionnaire (FIQR) and domains, including FIQR physical function (items 1-9), FIQR health status (items 10-11), and FIQR symptoms (items 12-21). Between-group characteristics were analysed using one-way analysis of variance (ANOVA).Results:This study included a total of 2889 patients, 403 aged 18-40 years, 756 aged 40-50 years, 1035 aged 50-60 years, 528 aged 60-70 years, and 167 over 70 years, respectively. The mean (standard deviation [SD]) score of the total FIQR was 52.68 (11.82). Total FIQR and individual domains all showed a normal distribution. Analysing the data by age category, there were statistically significant differences between the categories for the total FIQR (p = 0.030). The age categories with the highest disease severity were those above 71 years (FIQR 62.14, SD 22.45), and between 51-60 years (FIQR 60.31, SD 22.89) (Table 1). Significant differences between age categories were also found for the domains physical function (p = 0.006) and health status (p = 0.012), but not for the domain symptoms (p = 0.164).Table 1.Mean values of FIQR total score and domains according to age categories.FIQR and domains18-40 years41-50 years51-60 years61-70 years≥71 yearsp*FIQR total, mean (SD)57.90 (21.76)59.25 (23.30)60.31 (22.89)57.13 (23.59)62.14 (22.45)0.030FIQR physical function, mean (SD)15.51 (7.56)16.44 (7.77)16.77 (7.51)15.96 (7.82)17.68 (7.26)0.006FIQR health status, mean (SD)11.19 (5.85)11.24 (5.99)11.49 (5.93)10.57 (6.11)12.21 (5.97)0.012FIQR symptoms, mean (SD)31.32 (10.48)31.56 (11.32)32.10 (11.01)30.68 (11.47)32.24 (11.34)0.164Abbreviations and legend. FIQR = revised Fibromyalgia Impact Questionnaire; SD = standard deviation; * = one-way analysis of variance (ANOVA).Conclusion:Distinguishing the disease severity in FM patients according to age categories, a bimodal distribution emerges, with the disease severity being greatest in patients over 71 years and in the 51-60 years decade. The main differences in severity, according to what can be detected through the FIQR, are attributable to the domains physical function and health status, which show higher scores in the two classes with higher severity.References:[1]Sarzi-Puttini P et al., Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol 2020; 16: 645–660.[2]Salaffi F et al., The Italian Fibromyalgia Registry: a new way of using routine real-world data concerning patient-reported disease status in healthcare research and clinical practice. Clin Exp Rheumatol 2020; Suppl 123: 65-71.Acknowledgements:Società Italiana di Reumatologia (SIR) and Italian Ministry of HealthDisclosure of Interests:None declared

scholarly journals PATIENT REPORTED KNEE FUNCTION AND STABILITY IN PATIENTS WITH FIBULAR DEFICIENCY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0015
Author(s):  
Matthew J. Brown ◽  
Lauren Agatstein ◽  
Brian Haus ◽  
Joel Lerman
Keyword(s):  
Standard Deviation ◽  
Physical Function ◽  
Normal Population ◽  
Lysholm Score ◽  
Knee Function ◽  
Average Score ◽  
T Score ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

BACKGROUND Fibular deficiency is a common long-bone deficiency with an estimated incidence of 7.4-20 cases per million live births. Absence or hypoplasia of the cruciate ligaments is present in most patients with fibular deficiency. In one series, the anterior cruciate ligament (ACL) was deficient in 95% while the posterior cruciate ligament (PCL) was deficient in 60% of patients with fibular deficiency. Symptomatic instability of the knee is variably present in patients with congenital absence of the ACL including fibular deficiency, with a reported incidence of between 3% and 50%. Despite this reported incidence, limited literature assessing the perceived knee stability in patients with fibular deficiency exists. METHODS Patients diagnosed with fibular hemimelia with congenital absence of the ACL were identified retrospectively at a pediatric hospital. Of the identified patients over the age of 16, 28 agreed to be part of the study and were sent an online survey. They completed Lysholm and Patient-Reported Outcomes Measurement Information System (PROMIS) surveys on knee problems, physical function, pain intensity, and overall health. The PROMIS raw score responses were converted to a T-score, scaled to a mean of 50 points (representative of the mean of the reference population), with a standard deviation of 10 points. Any response more than one standard deviation away from 50 was considered worthy of further review. 18 patients returned surveys, and these individuals comprise the final study group. RESULTS Of the study patients, the average age was 19.8 years (16-24 years), with 7 females and 11 males. 9 patients are amputees and 9 are non-amputees. On the Lysholm Knee Scoring Scale, the highest possible score is 100 points, which relates to normal knee function. Our average Lysholm score was 79.94, with a wide range in scores from 25-100 points, in comparison to the average adult knee score of 94 (Briggs et al). The amputee average Lysholm score was 77.8 and the non-amputee average Lysholm score was 74.1, with no statistically significant difference. For our cohort, the mean Physical Function T-score was 52 (range 27.5-60.1), with a higher score relating to better physical function. The amputee average score was 53.1 and the non-amputee average score was 45.8, with no statistically significant difference. 12 respondents reported normal physical function compared to the general population, with 8 more than 1 standard deviation (SD) above a T-score of 50. Of the 6 respondents with a physical function score lower than 50, 4 reported mild functional impairment (.5 – 1.0 SD), 1 moderate impairment (1.6 SD), and 1 severe impairment (2.25 SD). The severe impairment was reported by an amputee and the moderate physical impairment reported by a non-amputee. For the PROMIS Global Physical Health domain, the mean T-score was 52.6 (range 29 -63.3). There was no significant difference between the average scores of the amputee (54.8) and non-amputee (50.3) groups. 13 respondents had no difference or had better health than the normal population mean, with 8 being amputees and 5 being non-amputees. 5 respondents had the highest possible score of 63.3, which is 1.33 standard deviations better than the normal average (2 non-amputees and 3 amputees). Of the 5 patients (4 non-amputees and 1 amputee) reporting worse health, only 1 respondent reported severe health impairments (2.1 SD). All PROMIS subject areas measure whether more of the domain occurs. For Physical Function and Global Health, a higher score indicates improved function. In the Pain Intensity realm, a higher score relates to more pain. In this study population, the mean pain T-score was 40.15 (range 30.7 – 60.5). The amputee average score was 38.98 and the non-amputee average score was 41.3, with no significant difference between them. 16 patients had less pain or normal pain levels compared to the population mean. Of the two patients reporting worse pain than the normal population, the amputee patient had mild pain (within 1 SD of 50) and the non-amputee had moderate pain (1.05 SD). CONCLUSIONS The only previously published report on knee function in adults with fibular deficiency contained 11 patients; our 18 patients substantially expands data available on knee function in these patients. Previously, Crawford, et al, obtained Lysholm and Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) scores on nine patients treated since 1928. Their data demonstrated an average Lysholm score of 90.2, compared to ours of 79.94. The majority of our patients demonstrated excellent PROMIS responses, with 12-15 demonstrating average or above pain, physical function, and global health scores. Amputees tended to self-report better health than the non-amputees. Overall, in the young adult cohort, we demonstrate that the majority of patients with fibular deficiency function well and have a stable knee, although a small subset of patients do have challenges with knee function.

scholarly journals Enthesitis-related Arthritis Is Associated with Higher Pain Intensity and Poorer Health Status in Comparison with Other Categories of Juvenile Idiopathic Arthritis: The Childhood Arthritis and Rheumatology Research Alliance Registry

2012 ◽  
Vol 39 (12) ◽  
pp. 2341-2351 ◽  
Author(s):  
PAMELA F. WEISS ◽  
TIMOTHY BEUKELMAN ◽  
LAURA E. SCHANBERG ◽  
YUKIKO KIMURA ◽  
ROBERT A. COLBERT
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Health Status ◽  
Pain Intensity ◽  
Physical Function ◽  
Physician Global Assessment ◽  
Enthesitis Related Arthritis ◽  
Rheumatology Research ◽  
Childhood Arthritis ◽  
Patient Reported ◽  
Research Alliance

Objective.To assess the relative effect of clinical factors and medications on pain intensity, physical function, and health status in juvenile idiopathic arthritis (JIA).Methods.We conducted a retrospective cross-sectional study of data from children with JIA enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. We tested whether clinical characteristics of JIA were associated with pain intensity, physical function, and health status using multivariable linear and ordinal logistic regression.Results.During the study period, 2571 subjects with JIA enrolled in the CARRA Registry. Ratings of pain intensity, physical function, and health status differed significantly between JIA categories. In comparison to other categories of JIA, subjects with enthesitis-related arthritis (ERA) reported worse pain and function. In multivariable analyses, higher active joint count and current use of nonsteroidal antiinflammatory drugs (NSAID), biologics, or corticosteroids were associated with worse scores on all patient-reported measures. ERA and older age were significantly associated with higher pain intensity and poorer health status. Systemic JIA and uveitis were significantly associated with worse health status. Enthesitis, sacroiliac tenderness, and NSAID use were independently associated with increased pain intensity in ERA. The correlation was low between physician global assessment of disease activity and patient-reported pain intensity, physical function, and health status.Conclusion.Significant differences in pain intensity, physical function, and health status exist among JIA categories. These results suggest that current treatments may not be equally effective for particular disease characteristics more common in specific JIA categories, such as enthesitis or sacroiliac tenderness in ERA.

scholarly journals Patient-reported Outcomes in Young Adults with Osteonecrosis Secondary to Developmental Dysplasia of the Hip

2020 ◽  
Author(s):  
Avi Marks ◽  
Mario Cortina-Borja ◽  
Dror Maor ◽  
Aresh Hashemi-Nejad ◽  
Andreas Roposch
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Physical Function ◽  
Young Adulthood ◽  
Developmental Dysplasia ◽  
Maximum Score ◽  
Patient Reported ◽  
Hip Function ◽  
Dysplasia Of The Hip

Abstract Background: Osteonecrosis of the femoral head is a common complication in the treatment of developmental dysplasia of the hip (DDH). While functional outcomes of affected patients are good in childhood, it is not clear how they change during the transition to young adulthood. This study determined the relationship between osteonecrosis and hip function, physical function and health status in adolescents and young adults.Methods: We studied 181 patients with a mean age of 19.7 ± 3.8 years with and without osteonecrosis following an open or closed reduction (1995-2005). Patients completed patient-reported outcome measures in 2015/2016 to quantify hip function (maximum score 100); physical function (maximum score 100); and general health status (maximum score 1). We graded all radiographs for subtype of osteonecrosis (Bucholz-Ogden); acetabular dysplasia (centre-edge angle); subluxation (Shenton’s line); and osteoarthritis (Kellgren-Lawrence). Analyses were adjusted for the number of previous surgical procedures on the hip and for the severity of residual hip dysplasia.Results: In 149 patients (186 hips) with and without osteonecrosis, the mean differences (95% confidence interval) in hip function, physical function and quality of life were -4.7 (-10.26, 0.81), -1.03 (-9.29, 7.23) and 0.10 (-1.15, 1.18), respectively. Adjusted analyses stratified across types of osteonecrosis showed that only patients with Bucholz-Odgen grade III had reduced hip function (p<0.01) and physical function (p<0.05) but no difference in health-related quality of life when compared to no osteonecrosis. Conclusion: Osteonecrosis secondary to DDH is a relatively benign disorder in adolescents and young adulthood. Affected patients demonstrated minimal physical disability, a normal quality of life but reduced hip function.

scholarly journals Does Physical Therapy Produce Value for Post-Operative and/or Non-Operative Foot and Ankle Patients?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Jeff Houck ◽  
Christopher Neville ◽  
Kostantinos Vasalos ◽  
Chad Condidorio ◽  
Kathleen Fear ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Physical Function ◽  
Symptom Severity ◽  
Median Number ◽  
Foot And Ankle ◽  
Linear Regression Models ◽  
Operative Care ◽  
Patient Reported ◽  
R Value ◽  
Using Data

Category: Outcomes Introduction/Purpose: Healthcare is at a unique time in history where patient reported outcomes have become important in assessing value and subsequent reimbursement with pay-4-performance initiatives. It is unclear whether physical function, pain and depressive symptoms can assist providers determine if additional physical therapy may improve care for foot and ankle patients considering post-op and/or non-operative care. The purpose of this research was to examine symptom severity (PROMIS PF, PI, and Dep) after surgery or with non-operative care at the start of formal physical therapy to determine if this symptom severity presentation and/or change in symptoms over time are predictors of improvement in physical function as assessed by PROMIS PF. Methods: PROMIS scales were available at the start and end of physical therapy treatment for 377 patients with foot and ankle ICD10 codes. The mean age (40.2±18.1 years), body mass index (BMI) (28.9±7.9 kg/m2), and proportion of females (62.1%) were recorded. The median number of physical therapy visits was 5 (interquartile range=5). Clinical categories of greater than 20 were identified for 7 groups including: Achilles rupture (n=24), Fracture (n=34), Ankle Pain (n=105), Foot Pain (n= 50), Ankle Sprain (n=51), Achilles Non-Rupture (n=45) and Other (n=68). Two multivariate linear regression models; 1) solely using data available at the start of therapy (age, gender, BMI, diagnosis category, PROMIS scores at the start of physical therapy); And, 2) a second model adding change in PROMIS PI, DP and completed visits to model 1 were examined for their ability to predict change in PF (Start to end of physical therapy). Results: The average change in PROMIS PF was 6.5±8.8 with a range of -20 to 49.1. Correlations of PROMIS scales at the start of therapy with change in PROMIS PF were r-values <0.48. Correlations among change in PROMIS PI and Dep with PF scales were r- values <0.38. The first model predicting change in PF based on available data at the start of physical therapy included PROMIS PF(p<0.01), PI(p<0.01) and Dep(p=0.03) at the start of physical therapy (r-value = 0.58 an r-value increase of 0.1 over univariate correlations). No other variables were significant. The second model included PROMIS PF(p<0.01), PI(p<0.01) and Dep (p=0.05) and change in PI(p<0.01), Dep(p=0.01) and visits completed (p<0.01) achieving an r-value = 0.75 (an r-value increase of 0.27 over univariate values) (Figure 1). Conclusion: Providers should consider patients who present with more severe symptoms as good candidates for formal physical therapy. Positive trends during therapy suggest that patient may continue to improve. Severity of PI and Dep at the start of PT were independent predictors of improvements in PF. Using PROMIS assessments, appropriate referrals can be made to physical therapy to improve physical function and add value to the health of our patients.

scholarly journals QOLP-20. IMPACT OF GLIOBLASTOMA ON PATIENT-REPORTED SYMPTOM BURDEN AND PHYSICAL ACTIVITY ASSESSED BY CONVENTIONAL INSTRUMENTS AND A NOVEL DEVICE–BASED TECHNOLOGY

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi201-vi202
Author(s):  
Terri Armstrong ◽  
Vinay Puduvalli ◽  
Tobias Walbert ◽  
Katherine Peters ◽  
Ashlee Loughan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Function ◽  
Stable Disease ◽  
Symptom Severity ◽  
Recurrent Disease ◽  
Symptom Burden ◽  
Motor Dysfunction ◽  
Newly Diagnosed ◽  
Patient Reported ◽  
Group 1

Abstract Glioblastoma (GBM) is a rapidly progressing disease associated with significant deterioration in quality of life. This study evaluated clinical patient-reported outcomes (PROs) and the physical activity of patients with GBM. Adults with GBM (n=180) were stratified across 4 groups representing specific stages in the disease course: Group 1=newly diagnosed; 2=postradiation; 3=stable disease; 4=recurrence. Self-reported physical function (EORTC-QLQC30), motor dysfunction (BN20), symptom burden and interference (MDASI-BT), and objective physical activity level (via Fitbit®) were compared across groups by ANOVA. Associations between outcomes were assessed with a Pearson correlation (r) test. Patients were highly symptomatic, with overall mean (MDASI-BT) symptom severity (1.7–2.4; P=0.23) and interference (2.3–3.2; P=0.68) scores similar across groups. Patients with recurrent disease experienced the numerically greatest symptom severity and interference. Self-reported activity-related interference scores (2.7–3.6, P=0.48) were highest in patients with newly diagnosed or recurrent disease. Motor dysfunction (BN20) mean scores were highest in postradiation (22) and recurrent (22) disease groups (P=0.95). Mean physical function (EORTC-QLQC30) scores were worse in patients with recurrent disease (67) than in those with stable disease (79; P=0.38). Newly diagnosed patients and those with stable disease were the most active (≈4000 and ≈4500 mean steps/day, respectively), whereas those with recurrent disease were least active (≈2300 mean steps/day; P=0.032). Greater physical activity (via Fitbit®) correlated with better self-reported physical function (EORTC-QLQC30) for all groups (Group 1, r=0.0292; Group 2, r=0.0211; Group 3, r=0.0008; Group 4, r=0.0002). Greater motor dysfunction was correlated with lower physical activity in patients with stable (r=0.0003) and recurrent (r=0.0441) disease. Patients in this study were highly symptomatic throughout the disease stages with disease recurrence associated with worse motor and physical function. Future studies exploring these findings in a longitudinal cohort are needed to assess this relationship.

scholarly journals Longitudinal Evaluation of PROMIS-29 and FACIT-Dyspnea Short Forms in Systemic Sclerosis

2014 ◽  
Vol 42 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Monique E. Hinchcliff ◽  
Jennifer L. Beaumont ◽  
Mary A. Carns ◽  
Sofia Podlusky ◽  
Krishna Thavarajah ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Health Status ◽  
Physical Function ◽  
Short Form ◽  
Functional Limitations ◽  
Measurement Information ◽  
Change Scores ◽  
Short Forms ◽  
Sf 36 ◽  
Patient Reported

Objective.To assess the sensitivity of the Patient-Reported Outcomes Measurement Information System 29-item Health Profile (PROMIS-29) and the Functional Assessment of Chronic Illness Therapy-Dyspnea 10-item short form (FACIT-Dyspnea) for measuring change in health status and dyspnea in systemic sclerosis (SSc).Methods.One hundred patients with SSc completed the PROMIS-29, FACIT-Dyspnea, and traditional instruments [Medical Research Council Dyspnea Score, St. George’s Respiratory Questionnaire (SGRQ), Health Assessment Questionnaire-Disability Index (HAQ-DI), and Medical Outcomes Study Short Form-36 (SF-36)] at baseline and 1-year visits. PROMIS-29, FACIT-Dyspnea, and traditional instrument change scores were compared across composite modified Medsger Disease Severity and modified Rodnan Skin score (mRSS) change groups.Results.Moderately high Spearman correlation coefficients were observed between FACIT-Dyspnea and SGRQ (r = 0.57), FACIT-Dyspnea functional limitations and SF-36 physical component summary (PCS; r = 0.51), PROMIS-29 physical functioning and HAQ-DI (r = 0.50), and SF-36 PCS (r = 0.52) change scores. In most validity comparisons, PROMIS-29, FACIT-Dyspnea, HAQ-DI, and SF-36 scores performed similarly. While PROMIS-29 covers more content areas than SF-36 (e.g., sleep), it may do so at the expense of responsiveness of its 4-item physical function scale as compared to the multiitem-derived SF-36 PCS. Statistically significant increases in SF-36 role physical (p = 0.01) and physical component scale (p = 0.016), but not PROMIS-29, were observed in patients with mRSS improvement.Conclusion.PROMIS-29 and FACIT-Dyspnea are valid instruments to measure health status and dyspnea in patients with SSc. In physical function assessment, longer PROMIS short forms or computer adaptive testing should be considered to improve responsiveness to the effect of skin disease changes on physical function in patients with SSc.

scholarly journals Patient-reported Outcomes in Young Adults with Osteonecrosis Secondary to Developmental Dysplasia of the Hip

2020 ◽  
Author(s):  
Avi Marks ◽  
Mario Cortina-Borja ◽  
Dror Maor ◽  
Aresh Hashemi-Nejad ◽  
Andreas Roposch
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Physical Function ◽  
Young Adulthood ◽  
Developmental Dysplasia ◽  
Maximum Score ◽  
Patient Reported ◽  
Hip Function ◽  
Dysplasia Of The Hip

Abstract Background: Osteonecrosis of the femoral head is a common complication in the treatment of developmental dysplasia of the hip (DDH). While functional outcomes of affected patients are good in childhood, it is not clear how they change during the transition to young adulthood. This study determined the relationship between osteonecrosis and hip function, physical function and health status in adolescents and young adults.Methods: We performed a cross-sectional study of 169 patients with a mean age of 19.7 ± 3.8 years with and without osteonecrosis following an open or closed reduction (1995-2005). We also performed a separate longitudinal evaluation of an historical cohort of 54 patients with osteonecrosis, embedded in this sample. All completed patient-reported outcome measures in 2015/2016 to quantify hip function (maximum score 100); physical function (maximum score 100); and general health status (maximum score 1). We graded all radiographs for subtype of osteonecrosis (Bucholz-Ogden); acetabular dysplasia (centre-edge angle); subluxation (Shenton’s line); and osteoarthritis (Kellgren-Lawrence). Analyses were adjusted for the number of previous surgical procedures on the hip and for the severity of residual hip dysplasia.Results: In 149 patients (186 hips) with and without osteonecrosis, the mean differences (95% confidence interval) in hip function, physical function and quality of life were -4.7 (-10.26, 0.81), -1.03 (-9.29, 7.23) and 0.10 (-1.15, 1.18), respectively. Adjusted analyses stratified across types of osteonecrosis showed that only patients with Bucholz-Odgen grade III had reduced hip function (p<0.01) and physical function (p<0.05) but no difference in health-related quality of life when compared to no osteonecrosis. Conclusion: Osteonecrosis secondary to DDH is a relatively benign disorder in adolescents and young adulthood. Affected patients demonstrated minimal physical disability, a normal quality of life but reduced hip function.

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