Background: The overall goal in the treatment of RA is to minimize the loss of function and preserve the quality of life. In addition to drug therapy orthopaedic surgery may offer an opportunity to improve functioning in varies parts of the skeletal system.
Objective: To examine the overall magnitude of change in quality of life over a ten years period, with special focus on the changes in physical functioning in different joint areas.
Methods: Data from the Oslo RA register with 1600 living patients were used as basis for the study. Self-reported questionnaires were sent to the patients in 1994, 1996, 2001 and 2004, including the SF36, the AIMS2, the MHAQ, and three 100 mm visual analogue scales (pain, fatigue and patient global). 310 patients (mean (SD) age 56.4 (13.0) years, and disease duration 12.0 (9.9) years, 85.5% women) who completed questionnaires at baseline and after 10 years were eligible for the current analyses. Changes in health status were adjusted for age, sex and duration of disease. Magnitude of change was analysed by standardized response mean (SRM), i.e. the change divided by the standard deviation. AIMS2 comprises physical scales for different parts of the body and was used to examine changes in physical functioning in different areas of the musculoskeletal system.
Results: The overall physical functioning was deteriorated with MHAQ SRM 0.25 and AIMS2 physical SRM 0.11. Larger average deterioration in physical functioning was seen in mobility and walking and bending, than for upper extremity function (arm and hand finger scales). These results were supported by adjusted SRMs for the individual items of MHAQ: Dressing 0.26, Get out of car 0.24, Walk outdoor 0.22, Bending 0.22, Get in and out of bed 0.16, Lift to mouth 0.13, Turning faucets −0.02.
Conclusion: Physical functioning and quality of life deteriorated over 10 years in patients with RA. The largest loss of functioning was seen in the lower limb physical activity (mobility, walking and bending). This finding may give a clue to priorities of resources to surgical procedures in patients with RA.
