Toshihisa Kojima1, Hajime Ishikawa2, Sakae Tanaka3, Nobuhiko Haga4, Keiichiro Nishida5, Masao Yukioka6, Jun Hashimoto7, Hisaaki Miyahara8, Yasuo Niki9, Tomoatsu Kimura10, Hiromi Oda11, Shuji Asai1, Koji Funahashi12, Masayo Kojima13, Naoki Ishiguro1. 1. Department of Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan. 2. Department of Rheumatology, Niigata Rheumatic Center, Niigata, Japan. 3. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan. 4. Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan. 5. Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 6. Department of Orthopedic Surgery, Yukioka Hospital, Osaka, Japan. 7. Department of Rheumatology, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Japan. 8. Department of Orthopedic Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. 9. Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan. 10. Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan. 11. Department of Orthopedic Surgery, Saitama Medical University, Morohongo, Moroyama, Japan. 12. Department of Orthopedic Surgery, Kariya-Toyota General Hospital, Kariya, Japan. 13. Department of Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Abstract
AIM: This study aimed to validate the Timed Up and Go test (TUG) for measuring objective functional impairment in patients with established rheumatoid arthritis (RA) based on a prospective observational cohort of RA patients undergoing joint surgery. METHODS: We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and associations between TUG and HAQ-DI and other patient-reported outcomes, including European Quality of life scale (EQ-5D) were determined. Cut-off values of TUG for HAQ remission (HAQ-DI ≤0.5), normal HAQ (HAQ-DI ≤0.25), and the absence of disability in each HAQ-DI category were also determined by age. RESULTS: A total of 435 patients were enrolled and analyzed. Mean age was 64.2 years, mean disease duration was 17.1 years, mean HAQ-DI was 1.14, and mean TUG was 11.1 sec. TUG was significantly correlated with aging, EQ-5D, and HAQ-DI categories related to lower limb function (arising, walking, reach and activity). After adjusting for age and sex, mean TUG values were 9.0 sec (95% CI, 7.7-10.3) in patients with HAQ remission and 8.7 sec (7.4-10.4) in those with normal HAQ. By age, mean TUG values for HAQ remission were 7.2 sec (5.9-8.5) in young patients (≤61 years), 9.1 sec (7.6-10.5) in middle-aged patients (62-70 years) and 10.0 sec (5.7-14.2) in old patients (≥71 years). CONCLUSION: TUG was significantly associated with functional impairment and aging in patients with long-standing RA. Thus, TUG could be useful in setting treatment goals for joint surgery and rehabilitation in established RA patients.
AIM: This study aimed to validate the Timed Up and Go test (TUG) for measuring objective functional impairment in patients with established rheumatoid arthritis (RA) based on a prospective observational cohort of RApatients undergoing joint surgery. METHODS: We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and associations between TUG and HAQ-DI and other patient-reported outcomes, including European Quality of life scale (EQ-5D) were determined. Cut-off values of TUG for HAQ remission (HAQ-DI ≤0.5), normal HAQ (HAQ-DI ≤0.25), and the absence of disability in each HAQ-DI category were also determined by age. RESULTS: A total of 435 patients were enrolled and analyzed. Mean age was 64.2 years, mean disease duration was 17.1 years, mean HAQ-DI was 1.14, and mean TUG was 11.1 sec. TUG was significantly correlated with aging, EQ-5D, and HAQ-DI categories related to lower limb function (arising, walking, reach and activity). After adjusting for age and sex, mean TUG values were 9.0 sec (95% CI, 7.7-10.3) in patients with HAQ remission and 8.7 sec (7.4-10.4) in those with normal HAQ. By age, mean TUG values for HAQ remission were 7.2 sec (5.9-8.5) in young patients (≤61 years), 9.1 sec (7.6-10.5) in middle-aged patients (62-70 years) and 10.0 sec (5.7-14.2) in old patients (≥71 years). CONCLUSION: TUG was significantly associated with functional impairment and aging in patients with long-standing RA. Thus, TUG could be useful in setting treatment goals for joint surgery and rehabilitation in established RApatients.