RESEARCH - Impact of functional impairment in AS: impairment, activity limitation, and participation restrictions.

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J Rheumatol. 2005 Mar;32(3):516-23.

Impact of functional impairment in ankylosing spondylitis: impairment,

activity limitation, and participation restrictions.

Dagfinrud H, Kjeken I, Mowinckel P, Hagen KB, Kvien TK.

Section for Health Science, University of Oslo, PO Box 1153, Blindern, 0316

Oslo, Norway. h.s.dagfinrud@...

OBJECTIVE: To describe difficulties in everyday activities related to

impaired function in patients with ankylosing spondylitis (AS), and to

examine possible sex differences in the impact of the disease. In addition,

to examine the relationships between measures of personal characteristics,

impairment, and activity/participation levels within the framework of the

International Classification of Functioning (ICF). METHODS: A total of 152

patients with AS took part in a clinical examination including

anthropometric measures, blood samples, and self-reported disease related

measures. The Canadian Occupational Performance Measure (COPM) interviews

were performed to describe and measure activity limitations and

participation restrictions perceived by the patient during the last year.

The study variables were categorized and analyzed according to the levels of

the ICF model using bivariate and multivariate statistical approaches.

RESULTS: The mean age of patients was 47 (SD 13) years, 58% were men, and

the mean disease duration was 15 (SD 12) years. The problems most frequently

reported in COPM interviews were " interrupted sleeping, " " turn head when

driving, " " carry groceries, " and " " having energy for social activities. "

Women reported higher level of disease activity and more physical

limitations than men. Disease activity and reduced mobility (impairment

variables) seemed to result in more activity/participation restrictions in

female than in male patients. The impairment variables explained only

one-third of the activity and participation restrictions perceived by

patients.

CONCLUSION: Activity limitations and participation restrictions reported by

patients were only partly explained by the impairment variables. Further

research should identify social, structural, and attitudinal barriers

influencing activity and participation in patients with AS.

PMID: 15742446

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