Characteristics of Functional Impairment in Patients with Long-Standing Rheumatoid Arthritis Based on Range of Motion of Joints: Multicenter Prospective Cohort Study for Evaluation of Joint Surgery on Physical Function

Toshihisa Kojima¹, Hajime Ishikawa², Sakae Tanaka³, Nobuhiko Haga⁴, Keiichiro Nishida⁵, Masao Yukioka⁶, Jun Hashimoto⁷, Hisaaki Miyahara⁸, Yasuo Niki⁹, Hiromi Oda¹⁰, Shuji Asai¹¹, Koji Funahashi¹, Masayo Kojima¹² and Naoki Ishiguro¹³, ¹Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan, ²Orthopedic Surgery, Niigata Rheumatic Center, Shibata, Japan, ³Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, ⁴Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan, ⁵Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama city, Japan, ⁶Orthopedic Surgery, Yukioka Hospital, Osaka, Japan, ⁷Dept of Rheumatology, Osaka-Minami Medical Center, Kawachinagano City, Japan, ⁸Department of Rheumatology and Orthopaedic Surgery, Kyushu Medical Center, Fukuoka, Japan, ⁹Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan, ¹⁰Orthopedic Surgery, Faculty of Medicine, Saitama Medical Univeristy, Morohongo Moroyama, Japan, ¹¹Nagoya University Hospital, Nagoya, Japan, ¹²Medical education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, ¹³Department of Orthopedic Surgery, Nagoya University, Graduate School & Faculty of Medicine, Nagoya, Japan

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Outcome measures, physical impairment and rheumatoid arthritis, treatment

Session Information

Date: Sunday, November 13, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster I: Clinical Characteristics/Presentation/Prognosis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Even now, in clinical practice, most of RA patients have long-standing disease and structural damage in their joints. Reconstructive joint surgery should be needed for further improvements of physical function for long-standing RA patients. It is very important to understand how much range of motion (ROM) should be needed to gain better physical function in each case.

The purpose of this study is to explore the characteristics of functional impairment in RA patients who were needed joint surgery based on ROM of joints using multicenter prospective cohort.

Methods:

We conducted this prospective study from 2012 to2015 (Study registration: UMIN000012649) supported by grant from the Japanese Ministry of Health, Labour and Welfare.

We collected data on age, sex, disease duration, drug therapies, disease activity, and physical functional including HAQ-DI. Joint range of motion including shoulder, elbow, wrist, hip knee ankle was also measured. ROM in each joint by disability in HAQ-DI categories was compared by ANOVA with adjustment of age and sex. Association between ROM of each joint and no disability of daily activity in each 8 HAQ-DI categories and cut-off values for no disability were determined using ROC curve. Independent impact of ROM each joint was also determined multivariate analysis.

Results:

460 patients who have data of ROM of any joints in registry were analyzed. Mean values for age, disease duration, DAS28-CRP and sex were 64.5 years, 16.7 years, 3.14, and 86.8% female, respectively. Median values for CRP was 0.2 mg/dl. We could find significant association between ROM and disability in HAQ-DI category based on area under the ROC curve (AUC>0.7) as follows; shoulder in dressing, wrist in eating, hip, knee ankle in walking, shoulder in hygiene, shoulder in activity. The cut-off values of ROM of each joints for daily activity in each HAQ-DI category was shown in Table 1 using ROC curves (Table 1). Multivariate analysis adjusting disease activity, age, and sex, showed which joint had significant impact on disability of each category (Table 2).

Conclusion: ROMs of the joints were significantly associated with functional impairment. The information should be important for assessment of disability in patients with long-standing RA. The cut-off of ROM as shown in this study could be target of surgical procedure. It will be validated by further analysis of longitudinal data of this study.

Disclosure: T. Kojima, None; H. Ishikawa, None; S. Tanaka, None; N. Haga, None; K. Nishida, None; M. Yukioka, None; J. Hashimoto, None; H. Miyahara, None; Y. Niki, None; H. Oda, None; S. Asai, None; K. Funahashi, None; M. Kojima, None; N. Ishiguro, None.

To cite this abstract in AMA style:

Kojima T, Ishikawa H, Tanaka S, Haga N, Nishida K, Yukioka M, Hashimoto J, Miyahara H, Niki Y, Oda H, Asai S, Funahashi K, Kojima M, Ishiguro N. Characteristics of Functional Impairment in Patients with Long-Standing Rheumatoid Arthritis Based on Range of Motion of Joints: Multicenter Prospective Cohort Study for Evaluation of Joint Surgery on Physical Function [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/characteristics-of-functional-impairment-in-patients-with-long-standing-rheumatoid-arthritis-based-on-range-of-motion-of-joints-multicenter-prospective-cohort-study-for-evaluation-of-joint-surgery-on/. Accessed .

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