Association between characteristics of pain and stiffness and the functional status of patients with incident polymyalgia rheumatica from primary care
Autor: | A. Cawley, Toby Helliwell, Kevin Barraclough, Sara Muller, Christian D Mallen, Bhaskar Dasgupta, James A. Prior, Samantha L. Hider |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Activities of daily living Pain Severity of Illness Index Cohort Studies Polymyalgia rheumatica 03 medical and health sciences 0302 clinical medicine Rheumatology Rating scale Internal medicine Activities of Daily Living medicine Humans 030212 general & internal medicine Modified health assessment questionnaire Function Depression (differential diagnoses) Aged Aged 80 and over 030203 arthritis & rheumatology Primary Health Care business.industry Cohort General Medicine medicine.disease Primary care R1 Confidence interval mHAQ Polymyalgia Rheumatica Physical therapy Anxiety Female Original Article medicine.symptom business RA |
Zdroj: | Clinical Rheumatology |
ISSN: | 1434-9949 |
Popis: | This paper aims to examine the relationship between different characteristics of pain and stiffness and the functional status of patients with newly diagnosed polymyalgia rheumatica (PMR). Baseline analysis of an inception cohort study was conducted. Patients aged ≥18 years, with a new diagnosis of PMR were recruited from 382 English general practices. Participants were mailed a baseline questionnaire, including separate pain and stiffness manikins and numerical rating scales (NRS), a question on their ability to raise their arms above their head and the modified Health Assessment Questionnaire (mHAQ) to examine participants’ functional status. Linear regression analysis, reported as regression co-efficients (95% confidence intervals (95% CI)), was used to assess the association of pain and stiffness with function, initially unadjusted and then adjusted for age, gender, deprivation status, smoking status, BMI, anxiety and depression. Six hundred fifty two patients responded to the baseline survey (88.5%). The majority (88.2%) reported no, or mild impairment in their functional status. Adjusted linear regression analysis demonstrated that high (NRS ≥8) pain (0.20 (95% CI 0.10–0.28)) or stiffness (0.18 (0.09–0.26)) ratings, an increasing number of sites of pain (0.18 (0.06–0.29)) or stiffness (0.19 (0.08–0.31)) and shoulder pain (0.18 (0.05–0.31)), stiffness (0.10 (0.01–0.20)) and difficulty raising arms above one’s head (0.19 (0.10–0.28)) were all associated with increased functional impairment. The majority of newly diagnosed PMR patients reported no or minimal functional difficulty. However, those who experience severe or widespread pain or stiffness often have significant functional limitation in performing their daily activities and may be a subset worthy of additional focus in primary care. |
Databáze: | OpenAIRE |
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