bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elastic wrist orthoses: Reduction of pain and increase in grip force for women with rheumatoid arthritis
Authors: Nordenskiöld Ulla 
Published: February 2007

AbstractThe aim of this study was to investigate effects of elastic wrist orthoses on pain, grip strength, and function. Twenty‐two women with seropositive rheumatoid arthritis (mean age, 53 years) registered their pain on a visual analogue scale both with and without orthosis on the wrist of the dominant hand in three standardized activities of daily living (ADL) situations. Grip force at onset of pain was measured on an electronic instrument (Grippit) with three different grips. Pain was decreased by 39%, 42%, and 52% when using an orthosis in the three ADL situations. Anecdotally, the women noted that the splints provided support and decreased pain both in home, at work, and during leisure activities. Orthoses improved grip force at onset of pain by 26%, 22%, and 29%. All subjects showed reduced strength (20%–25%) when compared to grip strength in a group of women without rheumatoid arthritis.
HLA‐B27: What is its role in the development of ankylosing spondylitis?
Authors: Cromwell Karen G. , Baron S. Lynn 
Published: February 2007

AbstractAlthough the association between HLA‐B27 and ankylosing spondylitis (AS) is well established, the mechanism governing this association remains unknown. Although ∼90% of affected individuals possess the HLA‐B27 antigen, HLA‐B27 is also present in ∼8% of the normal population. This article examines the association by reviewing recent literature. Theories proposed have ranged from HLA‐B27's possible role as a marker for an AS susceptibility gene to the possibility of HLA‐B27 being a direct contributor to disease. Theories suggest the presence of pathogenic and benign forms of the antigen, as well as interaction with genetic and environmental factors in disease development. Recent investigations have focused on a link with Klebsiella and its role in a “cross‐reactive” mechanism with HLA‐B27 in AS development. Studies to date have not provided conclusive evidence on the exact mechanism by which HLA‐B27 predisposes individuals to the development of disease. The importance of isolating a specific causative agent for AS is discussed.
Rheumatoid arthritis and the use of medical services
Authors: Berkanovic Emil , Hurwicz Margo‐Lea , Batchlor Elaine 
Published: February 2007

AbstractAlthough there have been several studies examining the direct and indirect costs of rheumatoid arthritis (RA), no studies have analyzed the group and individual factors that are associated with the use of services among RA patients. The present study applies the behavioral model of health services utilization developed by Andersen to data derived from interviews with 288 RA patients. The behavioral model proposes that the use of services is related to predisposing, enabling, and need variables. All visits within 6 months of the interview that were initiated by the patient, requested by the physician, in response to RA flare‐ups and/or for physical therapy were analyzed. Ever having had surgery for RA also was analyzed. The results indicate that predisposing and enabling variables are related to use among these RA patients and, therefore, use is not a simple function of need.
The use of the health assessment questionnaire (HAQ) to determine physical disability in systemic sclerosis
Authors: Poole Janet L. , Steen Virginia D. 
Published: February 2007

AbstractThe health assessment questionnaire (HAQ), a self administered instrument to determine physical disability, was completed by 211 patients with systemic sclerosis who subsequently received scleroderma examinations. The mean HAQ disability index for the entire group was 0.92. Patients with high skin scores had significantly higher disability indices as compared to patients with low skin scores (p < 0.001). Higher disability indices were found for patients with joint pain, tendon rubs, and contractures. However, the presence of ulcers on the digital tip did not interfere with patients' abilities to function as measured by this scale. Intensive hand evaluations were performed on a subset of these 211 patients with systemic sclerosis (n = 80). Grip strength, thumb abduction, wrist extension, and motion of the index and middle fingers significantly correlated with the HAQ scores (p < 0.01). The findings from this study suggest that patients with systemic sclerosis have significant physical disability. Furthermore, the HAQ appears to be useful in assisting health professionals in quantitating this disability.
The effects of chronic illness on the spouse. Social resources as stress buffers
Authors: Revenson Tracey A. , Deborah Majerovitz S. 
Published: February 2007

AbstractThis study examined the effects of rheumatoid arthritis (RA) on spouses' psychological well‐being and the role of social resources in enhancing adaptation in the face of illness‐related stress. Spouses of 42 patients with RA completed a mailed questionnaire assessing marital adjustment, social support received from the person with RA and from the close social network, and depressive symptoms. Illness‐related stress was assessed using rheumatologists' assessments of patients' disease severity and patients' self‐reports of depressive symptoms. Social resources within and outside the marriage were related to spouses' well‐being through different pathways. Marital adjustment had a direct effect on well‐being, such that greater marital adjustment was related to lower depression. In contrast, support from the social network operated in a stress‐buffering fashion: When the patient's illness was more severe, spouses with greater network support experienced fewer depressive symptoms. Implications of these findings for psychosocial interventions are discussed.
Biopsychosocial parameters of disease activity in rheumatoid arthritis
Authors: Parker Jerry C. , Smarr Karen L. , Walker Sara E. , Hagglund Kristofer J. , Anderson Sharon K. , Hewett John E. , Bridges Alan J. , William Caldwell C. 
Published: February 2007

AbstractThe purpose of this study was to examine the applicability of a biopsychosocial model for estimating disease activity in rheumatoid arthritis (RA). Sixty‐three patients with RA were evaluated at baseline, 3 months, and 6 months. Joint counts were collected as the measure of disease activity. Peripheral blood immunophenotypic subsets, demographic characteristics, and psychological measures were obtained and entered into hierarchical regression analyses, with the joint count as the dependent variable. Immunophenotypic subsets (that is, CD57+ /CD16−, HLA‐DR+) were predictive of disease activity at all three time intervals. At baseline and 3 months, psychological variables (that is, helplessness and depression) were significantly related to joint counts, and the full model was highly significant. The conclusion was that the biopsychosocial perspective is useful for estimating RA disease activity.
The impact of hurricane hugo and the san francisco earthquake on a sample of people with rheumatoid arthritis
Authors: Grady Kathleen E. , Reisine Susan T. , Fifield Judith , Lee Norma R. , McVay Janine , Kelsey Margaret E. 
Published: February 2007

AbstractThe health effects of two natural disasters on 32 people with rheumatoid arthritis (RA) were assessed during the second‐year wave of interviews in an ongoing 3‐year study. Although the severity of Hurricane Hugo exceeded that of the San Francisco earthquake, no significant differences in health impacts were found. Both groups reported significantly increased ratings of RA activity, pain, and depression compared with ratings during the first year. However, comparison with the rest of the sample (n = 767) showed that increases in disease activity and pain were a general phenomenon but that the increase in depression was unique to the disaster subsample. Physician health status assessments also indicated that those who experienced the disaster were more likely to be classified in later stages of the disease subsequent to the disaster and were more likely to experience flares. These results suggest that people with RA may constitute a special high‐risk population for adverse health effects after natural disasters.
The validity and reliability of parental ratings of disease activity in juvenile rheumatoid arthritis
Authors: Rapoff Michael A. , Lindsley Carol B. , Purviance Mark R. 
Published: February 2007

AbstractThis study assessed the validity and reliability of parental ratings of morning stiffness, activity limitations, and pain complaints on a sample of 31 patients with juvenile rheumatoid arthritis (JRA). Parental ratings were found to be significant predictors of active joint counts, accounting for 40% of the variance in joint counts. Internal consistency reliability was moderately high (0.819), but test‐retest reliability was moderate to low; this is not unexpected given the fluctuations in symptoms of JRA over time. The results suggest that parental ratings are valid and moderately reliable measures of disease activity in JRA. Regular monitoring of symptoms by parents could be a useful source of information for health care providers in making treatment decisions and can increase parental and patient involvement in the treatment process.
Development of a Shoulder Pain and Disability Index
Authors: Roach Kathryn E. , Budiman‐Mak Elly , Songsiridej Norwarat , Lertratanakul Yongsuk 
Published: February 2007

AbstractA shoulder pain and disability index (SPADI) was developed to measure the pain and disability associated with shoulder pathology. The SPADI is a self‐administered index consisting of 13 items divided into two subscales: pain and disability. Thirty‐seven male patients with shoulder pain were used in a study to examine the measurement characteristics of the SPADI. Test‐retest reliability of the SPADI total and subscale scores ranged from 0.6377 to 0.6552. Internal consistency ranged from 0.8604 to 0.9507. SPADI total and subscale scores were highly negatively correlated with shoulder range of motion (ROM) supporting the criterion validity of the index. Principal components factor analysis with and without varimax rotation supported the construct validity of the total SPADI and its subscales. High negative correlations between changes in SPADI scores and changes in shoulder ROM indicated the SPADI delected changes in clinical status over short time intervals. The SPADI should prove useful for both clinical and research purposes.
A comparison of the full and short versions of the arthritis impact measurement scales
Authors: Lorish Christopher D. , Abraham Noval , Austin Janet S. , Bradley Laurence A. , Alarcón Graciela S. 
Published: February 2007

AbstractThis study examined the validity and reliability of full and short versions of the Arthritis Impact Measurement Scales (AIMS). One hundred fifty‐five patients with Rheumatoid Arthritis followed at a University Hospital Rheumatology Clinic completed the full AIMS at baseline, 6 months, 12 months, and 18 months. After reducing the 45‐item AIMS to 22, alpha reliabilities and test‐retest correlations showed that, with the exception of test‐retest correlations for mobility at 6 months and for pain at 12 and 18 months, the full and short scales were comparably reliable. Convergent validity correlations with theoretically related scales were also comparable. However, some of the short scales did not detect the same differences over time that the full scales did. Specifically, the short mobility, pain, anxiety, and depression scales were not as sensitive to change as the full scales. Except for these four scales, the short version appears to be a viable alternative for use by health professionals and researchers.
Determining suitability for home versus community‐based ambulatory therapy services for adults with arthritis
Authors: Rothman Linda M. , Badley Elizabeth M. 
Published: February 2007

AbstractObjective. A survey of clients seen by a communitybased arthritis therapy service was conducted to investigate how characteristics of clients might provide information to assist in the development of guidelines for services delivered in the home versus in a community‐based ambulatory setting.Methods. Clients completed a self‐administered questionnaire, which included the Health Assessment Questionnaire, and a mobility handicap measure. Two indicator variables selected as criteria for suitability for ambulatory therapy were the therapists' rating of client suitability and the clients'report of going out more than once weekly.Results. Based on these indicator variables, 60–76% of clients currently receiving home therapy by this service could potentially receive services in a communitybased ambulatory setting.Conclusion. The results demonstrate the usefulness of considering client characteristics when deciding whether clients need to be seen at home. This study emphasizes the need to determine the most efficient and effective methods of providing services to people in the community with chronic conditions.
A comparison of patients with late‐stage rheumatoid arthritis and osteoarthritis of the shoulder using self‐assessed shoulder function and health status
Authors: Iii Frederick A. Matsen , Smith Kevin L. , Debartolo Susan E. , von Oesen Gretchen 
Published: February 2007

AbstractObjective. To compare the function and health status of individuals with advanced rheumatoid arthritis (RA) and osteoarthritis (OA) of the shoulder using standardized patient self‐assessment tools.Methods. A group of patients with late‐stage arthritic involvement of the shoulder was evaluated at the time of initial presentation using 2 questionnaires, one focusing on shoulder function and the other on overall health status.Results. There was substantial variability in the shoulder function and health status within each diagnostic group; however, both groups demonstrated significant deficits in their Simple Shoulder Test responses and in many of their Health Status Questionnaire‐Short Form 36 scores. While the patients with RA tended to have somewhat greater impairment of shoulder function, many of the differences were not statistically significant. By contrast, most health status parameters were significantly more impaired in the patients with RA.Conclusions. Among patients with late‐stage shoulder arthritis, the overall health status of those with RA is significantly worse than those with OA. Differences in health status may be important in selecting the optimal management for individual patients with latestage shoulder arthritis. Self‐assessment questionnaires are effective in characterizing these differences.
Inter‐rater reliability for function and strength measurements in the acute care hospital after elective hip and knee arthroplasty
Authors: Kwoh C. Kent , Petrick Monica A. , Munin Michael C. 
Published: February 2007

AbstractObjective. To determine the inter‐rater reliability of function and strength measurements in patients undergoing elective hip and knee arthroplasty in an acute care setting.Method. Forty‐four patients underwent either total hip or knee arthroplasty. Patients were rated by 4 occupational therapists and 7 physical therapists on their performance of 5 functional tasks: lower extremity dressing, toilet transfer, supine‐to‐sit transfer, sit‐to‐stand transfer, and ambulation to 100 feet. Strength measurements of the quadriceps femoris muscle were measured quantitatively with a Microfet hand‐held dynamometer. Data were analyzed to determine the inter‐rater reliability using the Kappa statistic (K) for the functional tasks and the intra‐class correlation coefficient (ICC) for the strength measurements.Results. A high level of inter‐rater reliability was achieved for lower extremity dressing, toilet transfer, supine‐to‐sit transfer, sit‐to‐stand transfer, and ambulation to 100 feet, as evidenced by K values between 0.75 and 0.99. Reliability was also excellent for quantitative strength measurements using the dynamometer, with an ICC of 0.94.Conclusion. This study demonstrated excellent interrater reliability with measurements of function and strength post‐operatively after elective hip and knee arthroplasty. The practical implication is that by using a standardized measurement tool in the acute care setting, the treatment team can more reliably assess patients'progress, which may aid clinical decision making.
Patient education and disease activity: A study among rheumatoid arthritis patients
Authors: Brus Herman L. M. , Taal Erik , van de Laar Martin A. F. J. , Rasker Johannes J. , Wiegman Oene 
Published: February 2007

AbstractObjective. To determine whether patients experiencing high disease activity derive more benefit from patient education than those experiencing low disease activity.Methods. Data from a randomized study on the effects of a program of patient education were analyzed retrospectively. Four subgroups were studied: the high disease activity subgroup of patients who had participated in the educational program, the complementary low disease activity subgroup, the high disease activity subgroup of controls, and its low disease activity complement. Patients with erythrocyte sedimentation rate >28 mm/first hour were classified as having high disease activity. Effects on frequency of physical exercises, endurance exercises, and relaxation exercises and effects on health status (Modified Health Assessment Questionnaire, Dutch Arthritis Impact Measurement Scales [AIMS]) were measured.Results. There were no significant differences between the adherence parameters of the various pairs of groups. Four months after the educational program began, anxiety and depression scores on the Dutch‐AIMS had increased among participating patients who were experiencing high disease activity and decreased among those who were experiencing low disease activity.Conclusions. Patients experiencing high disease activity did not derive more benefit from patient education than those experiencing low disease activity. On the contrary, an increase of anxiety and depression is found in these patients. Further study is needed to confirm our findings.
Assessing cost‐effectiveness analyses in rheumatoid arthritis and osteoarthritis
Authors: Ruchlin Hirsch S. , Elkin Elena B. , Paget Stephen A. 
Published: February 2007

AbstractEconomic considerations are now a source of great concern to clinicians and policy analysts. Many cost‐effectiveness analyses have been published in the area of arthritis, most with substantial methodologic deficiencies. The goal of this article is to outline a method for evaluating cost‐effectiveness assessments within the field of rheumatology. We do so by critically evaluating 6 cost‐effectiveness analyses–2 in rheumatoid arthritis and 4 in osteoarthritis–as a basis for appraising the literature and developing future studies.
Sexual and physical abuse in women with fibromyalgia: Association with outpatient health care utilization and pain medication usage
Authors: Alexander Ronald W. , Aaron Leslie A. , Alberts Kristin R. , Martin Michelle Y. , Stewart Katharine E. , Bradley Laurence A. , Alarcón Graciela S. , Triana‐Alexander Mireya 
Published: February 2007

AbstractObjective. To evaluate the relationship between sexual and/or physical abuse and health care usage in patients with fibromyalgia (FM) and identify variables that may influence this relationship.Methods. We assessed history of sexuall physical abuse, health care utilization, and medication usage, as well as related variables in 75 women with FM using standardized questionnaires, structured interviews, and laboratory pain perception tasks.Results. Fifty‐seven percent of FM patients reported a history of sexuall physical abuse. Compared to non‐abused patients, abused patients reported significantly greater utilization of outpatient health care services for problems other than FM and greater use of medications for pain (P ≤ 0.025). Consistent with our expectations, abused patients also were characterized by significantly greater pain, fatigue, functional disability, and stress, as well as by a tendency to label dolorimeter stimuli as painful regardless of their intensities (P ≤ 0.05). Additional analyses suggested that the high frequency of sexuall physical abuse in our patients was associated primarily with seeking health care for chronic pain rather than the FM syndrome itself or genetic factors.Conclusion. There is an association in FM patients between sexuall physical abuse and increased use of outpatient health care services and medications for pain. This association may be influenced by clinical symptoms, functional disability, psychiatric disorders, stress, and abnormal pain perception. The relationships among these variables should be further tested in prospective, population‐based studies.
Validation of questionnaire‐based response criteria of treatment efficacy in the fibromyalgia syndrome
Authors: Finckh Axel , Morabia Alfredo , Deluze Christopher , Vischer Thomas 
Published: February 2007

AbstractObjective To compare the validity of self‐reported questionnaires as response criteria of treatment efficacy in patients with fibromyalgia syndrome.Method At the beginning of the treatment period, 70 fibromyalgia patients, ranndomly allocated to electro‐acupuncture or placebo, underwent a clinical evaluation by rheumatologists and answered 1) a generic quality of life questionnaire—the Psychological General Well‐Being Index (PGWB), 2) a specific function and symptom questionnaire, and 3) a pain questionnaire—the Regional Pain Score (RPS). The same evaluation was repeated at the end of the treatment period. Severity of the condition was assessed by a composite outcome score, a combination of different clinical outcome measures forming a clinical severity index.The variations between these questionnaire scores before and after treatment and the variations between the clinical severity indices estimated by clinicians were used as measures of the treatment impact. The first rationale for the validation was a positive correlation between clinical and questionnaire score changes. Another rationale for validation of the new instruments was the ability to identify the different treatment interventions.Results The correlation between the clinical severity index and the RPS was good (r = 0.62). Moreover, the RPS demonstrated a good discriminant power in detecting patients with effective treatment: it showed a specificity of 74% and a sensitivity of 75%. The PGWB correlated less well with the clinical score and was less discriminant. The specific function and symptom questionnaire showed little additional validity.Conclusions. Outcomes of syndrome severity such as pain and subjective well‐being, as measured by self reported questionnaires, can be valid instruments to evaluate treatment efficacy in short‐term clinical trials. In the current study, the RPS proved to be particularly useful to assess the widespread tenderness of fibromyalgia and demonstmted high discriminative power.