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Clinical Orthopaedics and Related Research®

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01-11-2012 | Clinical Research

How Much Are Upper or Lower Extremity Disabilities Associated with General Health Status in the Elderly?

Authors: Young Hak Roh, MD, Ki Woong Kim, MD, Nam-Jong Paik, MD, Tae Kyun Kim, MD, Hyun Sik Gong, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 11/2012

Abstract

Background

Musculoskeletal complaints influence general health status, but the relative contribution of concurrent upper and lower extremity disabilities on patient perceptions of general health is unclear.

Questions/Purposes

We evaluated whether two regional instruments (DASH and WOMAC) reflect a patient’s perception of general health measured using the SF-36 and determined whether general health components are explained by upper and lower extremity disabilities.

Methods

We recruited 272 randomly chosen participants 65 years or older without a history of surgery for musculoskeletal disease or trauma who participated in the Korean Longitudinal Study on Health and Aging. Upper extremity disability was determined with the DASH score and lower extremity disability with the WOMAC; as a measure of general health, we obtained SF-36 scores. Multivariate regression modeling was used to assess the relative contributions made by upper and lower extremity disabilities to general health.

Results

The DASH and WOMAC each was correlated with the physical component summary (PCS) scale and with the mental component summary (MCS) scale to differing extents. Multivariate regression analyses revealed that WOMAC alone, DASH alone, and WOMAC and DASH accounted for 24%, 19%, and 26% of the variance in the PCS scale. However, only the DASH was associated with the MCS scale but accounted for only 2% of the variance.

Conclusions

We found that in a community-based elderly population, perceived general physical health is associated with upper and lower extremity disabilities, whereas perceived general mental health is associated with only upper extremity disabilities, but to a small extent.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Aktekin LA, Eser F, Baskan BM, Sivas F, Malhan S, Oksuz E, Bodur H. Disability of Arm Shoulder and Hand Questionnaire in rheumatoid arthritis patients: relationship with disease activity, HAQ, SF-36. Rheumatol Int. 2011;31:823–826.PubMedCrossRef

Angst F, Aeschlimann A, Steiner W, Stucki G. Responsiveness of the WOMAC osteoarthritis index as compared with the SF-36 in patients with osteoarthritis of the legs undergoing a comprehensive rehabilitation intervention. Ann Rheum Dis. 2001;60:834–840.PubMed

Angst F, John M, Pap G, Mannion AF, Herren DB, Flury M, Aeschlimann A, Schwyzer HK, Simmen BR. Comprehensive assessment of clinical outcome and quality of life after total elbow arthroplasty. Arthritis Rheum. 2005;53:73–82.PubMedCrossRef

Bae SC, Lee HS, Yun HR, Kim TH, Yoo DH, Kim SY. Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis Cartilage. 2001;9:746–750.PubMedCrossRef

Basaran S, Guzel R, Seydaoglu G, Guler-Uysal F. Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis. Clinl Rheumatol. 2010;29:749–756.CrossRef

Beaton DE, Bombardier C, Hogg-Johnson SA. Measuring health in injured workers: a cross-sectional comparison of five generic health status instruments in workers with musculoskeletal injuries. Am J Ind Med. 1996;29:618–631.PubMedCrossRef

Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed

Bingefors K, Isacson D. Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain: a gender perspective. Eur J Pain. 2004;8:435–450.PubMedCrossRef

Dieppe PA. Relationship between symptoms and structural change in osteoarthritis: what are the important targets for osteoarthritis therapy? J Rheumatol Suppl. 2004;70:50–53.PubMed

10.

Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004;86:963–974.PubMed

11.

Furner SE, Hootman JM, Helmick CG, Bolen J, Zack MM. Health-related quality of life of US adults with arthritis: analysis of data from the behavioral risk factor surveillance system, 2003, 2005, and 2007. Arthritis Care Res (Hoboken). 2011;63:788–799.CrossRef

12.

Gruber G, Zacherl M, Giessauf C, Glehr M, Fuerst F, Liebmann W, Gruber K, Bernhardt GA. Quality of life after volar plate fixation of articular fractures of the distal part of the radius. J Bone Joint Surg Am. 2010;92:1170–1178.PubMedCrossRef

13.

Gummesson C, Atroshi I, Ekdahl C. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord. 2003;4:11.PubMedCrossRef

14.

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29:602–608.PubMedCrossRef

15.

Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F; National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis Rheum. 2008;58:26–35.PubMedCrossRef

16.

Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder GG, Liang MH, Pillemer SR, Steen VD, Wolfe F. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998;41:778–799.PubMedCrossRef

17.

Lee JY, Lim JY, Oh JH, Ko YM. Cross-cultural adaptation and clinical evaluation of a Korean version of the disabilities of arm, shoulder, and hand outcome questionnaire (K-DASH). J Shoulder Elbow Surg. 2008;17:570–574.PubMedCrossRef

18.

Leveille SG, Zhang Y, McMullen W, Kelly-Hayes M, Felson DT. Sex differences in musculoskeletal pain in older adults. Pain. 2005;116:332–338.PubMedCrossRef

19.

Masi AT. Potential uses and limitations of hospital data in epidemiologic research. Am J Public Health Nations Health. 1965;55:658–667.PubMedCrossRef

20.

Menz HB, Roddy E, Thomas E, Croft PR. Impact of hallux valgus severity on general and foot-specific health-related quality of life. Arthritis Care Res (Hoboken). 2011;63:396–404.

21.

Ostendorf M, van Stel HF, Buskens E, Schrijvers AJ, Marting LN, Verbout AJ, Dhert WJ. Patient-reported outcome in total hip replacement: a comparison of five instruments of health status. J Bone Joint Surg Br. 2004;86:801–808.PubMedCrossRef

22.

Park JH, Lim S, Lim J-Y, Kim K-I, Han M-K, Yoon IY, Kim J-M, Chang Y-S, Chang CB, Chin HJ, Choi EA, Lee SB, Park YJ, Paik N-J, Kim TK, Jang HC, Kim KW. An overview of the Korean longitudinal study on health and aging. Psychiatry Investig. 2007;4:84–95.

23.

Picavet HS, Hazes JM. Prevalence of self reported musculoskeletal diseases is high. Ann Rheum Dis. 2003;62:644–650.PubMedCrossRef

24.

Raven EE, Haverkamp D, Sierevelt IN, van Montfoort DO, Poll RG, Blankevoort L, Tak PP. Construct validity and reliability of the disability of arm, shoulder and hand questionnaire for upper extremity complaints in rheumatoid arthritis. J Rheumatol. 2008;35:2334–2338.PubMedCrossRef

25.

Scudds RJ, Robertson JM. Pain factors associated with physical disability in a sample of community-dwelling senior citizens. J Gerontol A Biol Sci Med Sci. 2000;55:M393–399.PubMedCrossRef

26.

SooHoo NF, McDonald AP, Seiler JG 3rd, McGillivary GR. Evaluation of the construct validity of the DASH questionnaire by correlation to the SF-36. J Hand Surg Am. 2002;27:537–541.PubMedCrossRef

27.

Szabo RM. Outcomes assessment in hand surgery: when are they meaningful? J Hand Surg Am. 2001;26:993–1002.PubMedCrossRef

28.

Ware JE Jr. SF-36 health survey update. Spine (Phila Pa 1976). 2000;25:3130–3139.

29.

Ware JE Jr, Sherbourne CD. The MOS 36-item Short-Form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRef

30.

Wijnhoven HA, de Vet HC, Picavet HS. Prevalence of musculoskeletal disorders is systematically higher in women than in men. Clin J Pain. 2006;22:717–724.PubMedCrossRef

31.

Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol. 1995;22:151–156.PubMed

Title: How Much Are Upper or Lower Extremity Disabilities Associated with General Health Status in the Elderly?
Authors: Young Hak Roh, MD
Ki Woong Kim, MD
Nam-Jong Paik, MD
Tae Kyun Kim, MD
Hyun Sik Gong, MD
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 11/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2417-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

How Much Are Upper or Lower Extremity Disabilities Associated with General Health Status in the Elderly?

Abstract

Background

Questions/Purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Questions/Purposes

Methods

Results

Conclusions

Level of Evidence

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