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Hand Function and Activity Limitation According to Health Assessment Questionnaire in Patients with Rheumatoid Arthritis and Healthy Referents:
5-Year Followup of Predictors of Activity Limitation (The Swedish TIRA Project)
MATHILDA A. BJÖRK, INGRID S.M. THYBERG, THOMAS SKOGH, and BJÖRN U.C. GERDLE ABSTRACT. Objective. This study identifies baseline predictors of future activity limitation in rheumatoid arthritis (RA). To reinforce the utility of instruments assessing functional ability/activity limitation, we used reference data from healthy referents. Methods. This study includes 189 patients (69% women) with recent-onset RA (onset of joint swelling not more than 12 months at diagnosis) in a prospective cohort ("the Swedish TIRA project") during 27 months from 1996 through 1998. Regular followups were done for a period of 5 years, and 123 healthy persons (50% women) were recruited as referents. Hand function was assessed by the "grip ability test (GAT)" and "signals of functional impairment" (SOFI). Grip force was measured with the electronic device GrippitTM. Activity limitation was assessed with the Swedish version of the Health Assessment Questionnaire (HAQ). Results. Throughout the study and for both sexes, GAT, grip force, SOFI-hand, and HAQ were significantly different for the patients compared to healthy referents. In the healthy referents, HAQ was mainly related to age and GAT, whereas in RA HAQ was most obviously linked to grip force. Five years after diagnosis only 8% of HAQ outcome was explained by the baseline measures: HAQ, grip force, SOFI-lower limb, sex, walking speed, and GAT. Conclusion. Our study provides valuable reference data for several functional ability and activity limitation measures. The HAQ score was explained by different variables in healthy referents compared to patients with RA. Five years after diagnosis only 8% of HAQ outcome was explained by the variables assessed at inclusion. (First Release Jan 15 2007; J Rheumatol 2007;34:296–302) Key Indexing Terms:
RHEUMATOID ARTHRITIS From the Division of Occupational Therapy, Department of Neuroscience and Locomotion, Faculty of Health Sciences, Linköping, Sweden. Supported by grants from The Vårdal Foundation, the Swedish Research Council (project number K2006-74X-14594-04-03), the Research Council of Southeast Sweden (FORSS), the Swedish Rheumatism Association, and Karin Svensson's and Siv Olsson's research foundations at the County Council of Östergötland. M.A. Björk, BSc, OT, Division of Occupational Therapy, Department of Neuroscience and Locomotion, Faculty of Health Sciences, Linköping University and The Vårdal Foundation, The Swedish Institute for Health Sciences; I.S.M. Thyberg, PhD; Thomas Skogh, MD, PhD, Division of Rheumatology/AIR, Department of Molecular and Clinical Medicine; B.U.C. Gerdle, MD, PhD, Division of Rehabilitation Medicine, Department of Neuroscience and Locomotion, Faculty of Health Sciences, Linköping University, and Pain and Rehabilitation Centre, University Hospital, Linköping, Sweden. Address reprint requests to M. Björk, Faculty of Health Sciences, Division of Occupational Therapy, Department of Neuroscience and Locomotion, SE-581 85 Linköping, Sweden. E-mail: matbj@inr.liu.se Accepted for publication October 16, 2006.
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