Background/Purpose:

Mobility is necessary for participation in all areas of daily life including self-care, work and leisure.  In rheumatic conditions such as rheumatoid arthritis (RA) and systemic sclerosis (SSc), mobility can be compromised due to decreased joint motion, muscle weakness and pain in the lower extremities.  While the lower extremity impairments in RA have been studied, less attention has been paid to lower extremity involvement in persons with SSc. Therefore the purpose of the study is to compare lower extremity impairments in persons with RA, SSc and healthy controls.

Methods:

Fifty eight persons with RA, 64 persons with SSc and 30 healthy controls were evaluated with the Keital Functional Test (KFT), a performance based test of functional joint motion and strength that has been shown to be an important predictor of disability and mortality in people with RA.  Only the 15 items from the KFT that related to lower extremity function in an upright position were used.  There are specific ordinal scoring criteria for each item.  Scores for 11 items range from 0 (no limitation) to 2 (impossible).  Two items (rise from a chair and walk 30 minutes) range from 0 (no problem) to 6 (impossible) while two other items (going up and down stairs) are scored from 0 (7 seconds, no rail) to 5 (impossible).  Demographic information on age, disease duration, gender, employment status and health status was also collected. Analysis of variance compared the three groups on item scores and total scores on the KFT.

Results:

There were no significant differences between the 3 groups for any of the demographic variables except for perceived health status `(p = .001) and employment status (p = .001). Perceive health was significantly better in the HC group and significantly more HC were working full time compared to the RA and SSc groups. On the KFT, there were significant differences between the HC group and RA and SSc groups for 5 items and the total score: rising from a chair (p = .007), squatting (p = .001), walking 30 meters (p = 001), walking downstairs (p = 001), walking upstairs (p = 001), and the total score (p = 001).  There were no significant differences for 7 items:  standing on heels, standing on the right leg, standing on the left leg, placing right foot on chair for hip and knee flexion, placing left foot on chair, placing right heel on chair for hip flexion and knee extension, and placing left heel on chair. All 3 groups scored significantly different from each other for external rotation of the right hip (p = 001) in that the HC group has the highest external rotation and the SSc group had the least. For external rotation of the left hip, there was only a significant difference between the RA and HC group.

Conclusion:

The results show that persons with RA and SSc have greater lower extremity involvement than HC and suggest areas that could be targeted for intervention. The results also show that persons with SSc do have lower extremity impairments which have not been examined, other than walking speed and time, in other studies.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-comparison-of-performance-on-the-keital-functional-test-by-persons-with-rheumatoid-arthritis-and-systemic-sclerosis/