Activity Limitations Experienced by People with Rheumatoid Arthritis On Biologic Medications and Their Use of Ergonomic Methods

Hammond, Alison; Tyson, Sarah

Abstract

Background/Purpose:
People with rheumatoid arthritis (RA) commonly have daily activity difficulties. Whilst biologics significantly improve ability, ergonomic methods (e.g. altered working methods, ergonomic equipment, activity and environment modification) may still improve ability further. The aim of this study was to investigate activity limitations of people with RA on biologics and their use of ergonomic methods.
Methods:
Participants on biologics completed the Evaluation of Daily Activity Questionnaire (EDAQ): measuring ability performing 138 activities (grouped in 14 domains: Table 1). Activities are scored as 0 (no difficulty) to 3 (unable to do). Each is scored twice: Section A = ability without ergonomic methods or help; Section B (completed if difficulty) =ability with ergonomic methods (if used). Percentages of participants experiencing difficulties per activity (Section A) were calculated. Score differences between sections A and B were analysed using paired t-tests.
Results:
Participants were recruited from 14 Rheumatology units (n=198: 156 women; 42 men). Mean age = 59.16 (SD 10.46) years; RA duration 13.83 (SD 9.24) years). Biologics prescribed were: etanercept (n=75); adalimumab (57); rituximab (44), infliximab (16), golimumab (3), certolizumab (1) and abatacept (1). Average pain was 4.69 (SD2.57) and fatigue 5.47 (SD2.47). Average HAQ score was 1.21 (SD 0.83).Participants rated their health as: very good (9%); good (29%); fair (42%); poor (16%) and very poor (4%). Average EDAQ scores without ergonomic methods were at or below the lower tertile in all domains (Table 1). Common difficulties included: opening jars (88%); carrying pans (82%); preparing vegetables (76%); using a kettle (68%); vacuuming (67%); turning taps (56%); preparing meals (49%). Average ability using ergonomic methods (section B) was significantly better for all domains, except Caring (as many had few childcare responsibilities due to their age). Ergonomic methods were used more by those rating health as fair, poor or very poor.
Table 1. EDAQ domain scores for people with RA on biologic drugs (n=198)
EDAQ Domain score Domain score range n Section A Mean (SD) Section B Mean (SD) p
1. Eating/Drinking 0–30 187 10.47 (6.70) 8.21 (6.12) <0.001
2. Bathroom 0–36 184 5.83 (5.80) 5.24 (5.49) <0.001
3. Dressing 0–33 190 8.65 (7.30) 8.25 (7.10) <0.001
4. Bathing 0–33 192 9.85 (8.36) 8.95 (7.86) <0.001
5. Cooking 0–42 182 12.26 (9.69) 11.26 (9.63) <0.001
6. Moving Indoors 0–36 180 10.38 (7.78) 9.81 (7.62) <0.001
7. Cleaning 0–27 194 9.66 (7.15) 9.43 (7.19) <0.001
8. Laundry 0–27 191 8.41 (7.31) 7.92 (7.17) <0.001
9. Transfers 0–18 196 4.68 (3.71) 4.44 (3.64) <0.001
10. Communication 0–18 192 3.15 (3.13) 2.83 (2.98) <0.001
11. Moving Outdoors 0–39 182 11.86 (9.32) 11.12 (9.14) <0.001
12. House/Garden maintenance 0–21 194 10.30 (7.08) 10.21 (7.08) <0.001
13. Caring 0–27 189 3.99 (7.16) 3.97 (7.12) 0.1
14. Leisure 0–27 184 6.43 (6.26) 6.24 (6.29) <0.001
Conclusion:
People with RA on biologics continued using ergonomic methods, reporting significantly better ability as a result. Section B scores indicated scope for greater use of ergonomic methods to further reduce limitations. Many on biologics might benefit from occupational therapy assessment and ergonomic advice to help further reduce limitations.

Citation

Hammond, A., & Tyson, S. (2012, November). Activity Limitations Experienced by People with Rheumatoid Arthritis On Biologic Medications and Their Use of Ergonomic Methods. Presented at 2012 ACR/ARHP Annual Meeting, Washington, DC

• Presentation Conference Type: Other
• Conference Name: 2012 ACR/ARHP Annual Meeting
• Conference Location: Washington, DC
• Start Date: Nov 9, 2012
• End Date: Nov 14, 2012
• Deposit Date: Oct 23, 2023
• Publisher: Wiley
• Publisher URL: https://acrabstracts.org/abstract/activity-limitations-experienced-by-people-with-rheumatoid-arthritis-on-biologic-medications-and-their-use-of-ergonomic-methods/