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Kuhlow, Heide (2007): Factors explaining limitations in activities and restrictions in participation in rheumatoid arthritis. Dissertation, LMU München: Medizinische Fakultät



Introduction Rheumatoid Arthritis is a chronic, systemic, inflammatory disease causing disability. Identifying factors that influence the impact of the disease is important for planning adequate therapy. Knowing the effect on activities and on participation according to the International Classification of Functioning, Disability and Health (ICF) in daily living determines the rehabilitation therapy management. Objectives Objectives were to evaluate, which factors contribute how much to the explanation of activity limitations measured by the Health Assessment Questionnaire HAQ (model I) and which factors contribute how much to the explanation of participation restrictions measured by the Social Function Scale of SF-36 (model II) in RA according to the ICF. Design and Patients Cross-sectional data collection of variables concerning the health status of 239 consecutively included patients with RA at the outpatient departments of Physical Medicine and Rehabilitation of the University Hospital of Zurich, Switzerland, and of the University Hospital of Munich, Germany was conducted. Measures: Disease Activity Score (DAS-28), Rheumatoid Arthritis Disease Activity Index (RADAI), Health Assessment Questionnaire (HAQ), Short-form-36 (SF-36), Sociodemography Questionnaire, Comorbidity Questionnaire (SCQ), Muscle Strength Index (MSI), range of motion (EPM-ROM), grip strength, Sequentional Occupational and Dexterity Assessment (SODA), radiologic score (Ratingen Score). Analyses Multivariate regression analyses were conducted building models of explanation. Results In Model I Vitality, RADAI, DAS, SODA PAIN Score, MSI and EPM-ROM were found to be explaining variables with a globally explained variance of 53%. In Model II these were Vitality, Mental Health, the HAQ and Living alone with a globally explained variance of 42.4%. Conclusion Activity limitations in RA were mainly explained by Vitality and disease activity factors. Restrictions in participation in RA were mainly explained by Vitality and Mental Health.