Abstract
Purpose
We evaluated whether two disease-specific quality of life instruments (Disabilities of the Arm, Shoulder and Hand, DASH and Western Ontario & McMaster Universities Osteoarthritis Index, WOMAC) reflect a patient’s perception of general disability using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and determined whether disability components are explained by upper and lower extremity HRQOL.
Methods
We recruited 421 participants, 50 years or older without stroke, cancer, or history of surgery for musculoskeletal disease, who participated in the NAMGARAM Cohort. Upper extremity HRQOL was determined with the DASH score and lower extremity HRQOL with the WOMAC; as a measure of disability, we obtained WHODAS 2.0 component. Multiple regression modeling was used to assess the relative contributions made by upper and lower extremity HRQOL to disability.
Results
When adjusted for covariates, the DASH total score was correlated with getting around (β = 0.217, p < 0.001) and social participation (β = 0.226, p < 0.001), and the WOMAC total score was correlated with getting around (β = 0.363, p < 0.001), life activation (β = 0.363, p < 0.001), and social participation (β = 0.301, p < 0.001). QOL significantly correlated with upper extremity disorders (β = 0.081, p = 0.018) or lower extremity disorders (β = 0.095 p = 0.004).
Conclusion
We found that in a community-based population, perceived activity limitation and social participation were associated with upper and lower extremity HRQOL. Since the WHODAS 2.0 does not target a specific disease (as opposed to DASH and WOMAC), it can be used to compare disabilities caused by different diseases.
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References
Bingefors, K., & Isacson, D. (2004). Epidemiology, co-morbidity, and impact on health-related quality of life of self-reported headache and musculoskeletal pain: A gender perspective. European Journal of Pain, 8(5), 435–450.
Lawrence, R. C., Helmick, C. G., Arnett, F. C., Deyo, R. A., Felson, D. T., Giannini, E. H., et al. (1998). Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis & Rheumatism, 41(5), 778–799.
The Burden of Musculoskeletal Diseases in the United States (BMUS) 3rd Edition (Dated 12.31.16).pdf. (n.d.). Retrieved from http://www.boneandjointburden.org/docs/The%20Burden%20of%20Musculoskeletal%20Diseases%20in%20the%20United%20States%20%28BMUS%29%203rd%20Edition%20%28Dated%2012.31.16%29.pdf.
Dieppe, P. A. (2005). Relationship between symptoms and structural change in osteoarthritis: What are the important targets for therapy? The Journal of Rheumatology, 32(6), 1147–1149.
Furner, S. E., Hootman, J. M., Helmick, C. G., Bolen, J., & Zack, M. M. (2011). 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 & Research, 63(6), 788–799. https://doi.org/10.1002/acr.20430.
Gruber, G., Zacherl, M., Giessauf, C., Glehr, M., Fuerst, F., Liebmann, W., et al. (2010). Quality of life after volar plate fixation of articular fractures of the distal part of the radius. The Journal of Bone and Joint Surgery, 92(5), 1170–1178. https://doi.org/10.2106/JBJS.I.00737.
Menz, H. B., Roddy, E., Thomas, E., & Croft, P. R. (2011). Impact of hallux valgus severity on general and foot-specific health-related quality of life. Arthritis Care & Research, 63(3), 396–404.
Ostendorf, M., van Stel, H. F., Buskens, E., Schrijvers, A. J. P., Marting, L. N., Verbout, A. J., et al. (2004). Patient-reported outcome in total hip replacement. A comparison of five instruments of health status. The Journal of Bone and Joint Surgery, 86(6), 801–808.
SooHoo, N. F., McDonald, A. P., Seiler, J. G., & McGillivary, G. R. (2002). Evaluation of the construct validity of the DASH questionnaire by correlation to the SF-36. The Journal of Hand Surgery, 27(3), 537–541.
Bae, S. C., Lee, H. S., Yun, H. R., Kim, T.-H., Yoo, D.-H., & Kim, S. Y. (2001). Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne Osteoarthritis Indices for Clinical Research. Osteoarthritis and Cartilage, 9(8), 746–750. https://doi.org/10.1053/joca.2001.0471.
Lim, J. Y., Lee, H. Y., Song, J. H., Kang, J. W., & Lee, J. Y. (2005). Evaluation of the reliability, construct validity, and responsiveness of the Korean version of the DASH. The Journal of the Korean Society for Surgery of the Hand, 10(4), 192–198.
Kutlay, Ş, Küçükdeveci, A. A., Elhan, A. H., Öztuna, D., Koç, N., & Tennant, A. (2011). Validation of the World Health Organization disability assessment schedule II (WHODAS-II) in patients with osteoarthritis. Rheumatology International, 31(3), 339–346. https://doi.org/10.1007/s00296-009-1306-8.
Kim, J. M., Stewart, R., Glozier, N., Prince, M., Kim, S. W., Yang, S. J., et al. (2005). Physical health, depression and cognitive function as correlates of disability in an older Korean population. International Journal of Geriatric Psychiatry, 20, 160–167.
Silva, C., Coleta, I., Silva, A. G., Amaro, A., Alvarelhao, J., Queiros, A., et al. (2013). Adaptacao e validacao do WHODAS 2.0 em utentes com dor musculoesqueletica. Revista de Saúde Pública, 47(4), 752–758. https://doi.org/10.1590/S0034-8910.2013047004374.
Zheng, Q. L., Tian, Q., Hao, C., Gu, J., Lucas-Carrasco, R., Tao, J. T., et al. (2014). The role of quality of care and attitude towards disability in the relationship between severity of disability and quality of life: Findings from a cross-sectional survey among people with physical disability in China. Health and Quality of Life Outcomes, 12, 25. https://doi.org/10.1186/1477-7525-12-25.
Roux, C. H., Guillemin, F., Boini, S., Longuetaud, F., Arnault, N., Hercberg, S., et al. (2005). Impact of musculoskeletal disorders on quality of life: An inception cohort study. Annals of the Rheumatic Diseases, 64(4), 606–611. https://doi.org/10.1136/ard.2004.020784.
Cuperus, N., Vlieland, T. P., Mahler, E. A., Kersten, C. C., Hoogeboom, T. J., & van den Ende, C. H. (2015). The clinical burden of generalized osteoarthritis represented by self-reported health-related quality of life and activity limitations: A cross-sectional study. Rheumatology International, 35(5), 871–877. https://doi.org/10.1007/s00296-014-3149-1.
Kwok, W. Y., Vlieland, V., Rosendaal, F. R., Huizinga, T. W., & Kloppenburg, M. (2011). Limitations in daily activities are the major determinant of reduced health-related quality of life in patients with hand osteoarthritis. Annals of the Rheumatic Diseases, 70(2), 334–336. https://doi.org/10.1136/ard.2010.133603.
Funding
This study was supported by a grant of the Center for Farmer’s Safety and Health, Ministry of Agriculture, Food and Rural Affairs, Republic of Korea.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Yoo, JI., Park, JS., Kim, RB. et al. WHO disability assessment schedule 2.0 is related to upper and lower extremity disease-specific quality of life. Qual Life Res 27, 2243–2250 (2018). https://doi.org/10.1007/s11136-018-1869-5
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DOI: https://doi.org/10.1007/s11136-018-1869-5