Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Total management including reconstructive joint surgery and rehabilitation should be needed for further improvements of physical function for long-standing RA patients. It is very important to set treatment goal for those management using index of activity speed [Timed Up and Go test (TUG)] and range of motion (ROM). The purpose of this study is to explore the characteristics of functional impairment and relationship TUG and physical function in RA patients who were needed joint surgery using multicenter prospective cohort.
We started the prospective study in September, 2012 (Study registration: UMIN000012649). In this study, we used baseline (preoperation) data as follows; age, sex, disease duration, drug therapies, and disease activity, functional evaluations [TUG, HAQ-DI, DASH (upper limb function), joint ROM (hip, knee, ankle, shoulder, elbow, wrist)], and patient-reported outcome [EQ-5D (QOL) and BDI-II (depression)]. Correlation between TUG and other variables were determined. Association between TUG and no disability of daily activity in each 8 HAQ-DI categories and cut-off values for no disability were determined using ROC curve. TUG by disability in 8 HAQ-DI categories was compared by ANOVA with adjustment of age and sex. This study is supported by grant from the Japanese Ministry of Health, Labour and Welfare.
435 surgical patients were registered. Mean values for age, disease duration, and sex were 64.2 years, 17.1 years, and 89% female, respectively. Actually, even long-standing RA patients who were needed joint surgery had remission or low disease activity in this baseline data (median values for DAS28 (3.0) and CRP (0.2 mg/dl). 23.0% of the patients were treated with biologics. We confirmed the significant correlation (r>0.3) between TUG and Age, HAQ-DI, DASH, patient-reported outcome (EQ-5D) and range of motion (hip, knee, shoulder). We also found significant relationship between TUG and 5 of 8 categories in HAQ-DI.
The relevant association between TUG and category Walking, Arising, and Activity (AUC>0.7) was found based on ROC analyses. Cut-off value of TUG for HAQ remission (<0.5) was 8.6 seconds (sensitivity 64%, specificity 65%). Cut-off for no disability in category Arising, Walking, and Activity were 8.6s (sensitivity 74%, specificity 63%), 8.4s (sensitivity 76%, specificity 71%) and 8.2s (sensitivity 69%, specificity 66%), respectively. Age, sex-adjusted TUG for no disability in Arising, 9.2s (95%CI: 8.2-10.1), Waling, 8.6s (95%CI: 7.6-9.6), Activity, 8.6s (95%CI: 7.2-10.0).
Conclusion: TUG was significantly associated with other physical function measurements and patient-reported outcome. The cut-off values of TUG (~9 seconds) should be important for assessment of disability in patients with long-standing RA and could provide target of surgical procedure and rehabilitation program.
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, Kimura T, Oda H, Asai S, Funahashi K, Kojima M, Ishiguro N. Validation of Index of Activity Speed (Timed Up and Go test) for Outcome Measure of Patients with Long-Standing Rheumatoid Arthritis: Multicenter Prospective Cohort Study for Evaluation of Joint Surgery on Physical Function [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/validation-of-index-of-activity-speed-timed-up-and-go-test-for-outcome-measure-of-patients-with-long-standing-rheumatoid-arthritis-multicenter-prospective-cohort-study-for-evaluation-of-joint-surge/. Accessed July 23, 2019.
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