Article

PURPOSE: To determine associations between multiple joint symptoms and
radiographic osteoarthritis (rOA) and functional outcomes. METHOD: Complete
cross-sectional data for multi-joint symptoms and radiographs, Health Assessment
Questionnaire (HAQ) scores, and gait speed were available for 1307 Johnston
County Osteoarthritis Project participants (34% men, 32% African American, mean
age 66 years). Factor analysis of symptom scores and radiographic grades for the
lumbosacral spine, bilateral hands, knees, and hips provided composite scores.
Regression models were used to determine associations between composite scores,
HAQ, and gait speed, adjusting for age, body mass index, gender, and race.
RESULTS: Five rOA factors were identified: (1) IP/CMC factor (carpometacarpal
[CMC] and all interphalangeal [IP] joints); (2) MCP factor (metacarpophalangeal
joints 2-5); (3) Knee factor (tibiofemoral and patellofemoral joints); (4) Spine
factor (L1/2 to L5/S1); and (5) Symptom factor. After adjustment, only the
Symptom composite was significantly associated with HAQ and gait speed; a
1-standard deviation increase in Symptom score was associated with 9 times higher
odds of having poorer function on the HAQ (odds ratio 9.32, 95% confidence
interval [CI] 6.80, 12.77), and a clinically significant decline in gait speed
(0.06 m/s, 95% CI -0.07, -0.05). CONCLUSIONS: A novel Symptom composite score was
associated with poorer functional outcomes. IMPLICATIONS FOR REHABILITATION:
Osteoarthritis (OA) commonly affects multiple joints and is the most common form
of arthritis. Symptomatic assessments, which can be easily executed by
rehabilitation practitioners, are more closely related to self-reported and
performance-based functional status than are less accessible and more costly
radiographs. Symptomatic assessments are likely to be more informative for
understanding, treating, and potentially preventing functional limitations than
radiographic assessments.

Langue : ANGLAIS