ORIJINAL ARAŞTIRMA
Osteoartritli Hastalarda Ağrı ve Radyolojik Evrenin Yaşam Kalitesi ve Uyku Üzerine Etkisi Var mı?
Is There an Effect of Pain and Radiological Stage on Quality of Life and Sleep in Patients with Osteoarthritis?
Received Date : 16 Jun 2020
Accepted Date : 11 Jan 2021
Available Online : 05 May 2021
Tubanur YILMAZa, Melike Mercan BAŞPINARa, Neşe Güneş ARSLANb, Ebru YILMAZ YALÇINKAYAb, Okcan BASATa
aDepartment of Family Medicine, University of Health Sciences Gaziosmanpaşa Training and Research Hospital, İstanbul, TURKEY bDepartment of Physical Medicine and Rehabilitation, University of Health Sciences Gaziosmanpaşa Training and Research Hospital, İstanbul, TURKEY
Doi: 10.31609/jpmrs.2020-77436 - Makale Dili: EN
J PMR Sci. 2021;24(2):97-106
ÖZET
Amaç: Bu kesitsel çalışmanın amacı, diz osteoartritli (OA)
hastalarda ağrı ve radyolojik evrenin yaşam kalitesi ve uyku üzerindeki
etkisini değerlendirmektir.Gereç ve Yöntemler: Araştırmaya
Ağustos 2018 ile Kasım 2018 tarihleri arasında Gaziosmanpaşa Eğitim
ve Araştırma Hastanesi’nin Fiziksel Tıp-Rehabilitasyon ve Aile
Hekimliği polikliniklerine başvuran OA hastaları dâhil edildi. Katılımcılara,
demografik değişkenler ile Kısa Ağrı Envanteri [Brief Pain
Inventory Short Form scale (BPI)], Western Ontario and McMaster
Universiteleri Osteoartrit İndeksi (WOMAC), Pittsburgh Uyku Kalite
İndeksi (PSQI), Diz OA Yaşam Kalitesi Ölçeği [OsteoArthritis
Knee and Quality of Life Scale in the Lower Legs (OAKHQOL)]
formlarını içeren bir sağlık görüşmesi uygulandı. Bulgular: Yüz elli
bir OA hastasında (127 kadın, 24 erkek; ortalama yaş±SS: 60,14±8,95
yıl) radyolojik evre ile ilişkili diz ağrısı vardı. PSQI puanına göre tüm
katılımcıların uyku kalitesi kötü düzeyde saptandı. Radyolojik evre,
WOMAC'daki ağrı (p<0.001 r=-0.322) ve OAKHQOL’deki fiziksel
aktivite (p=0.014 r=-0.200) ile ilişkili olmasına rağmen uyku kalitesi
ile ilişkili değildi (p=0.077 r=0.144). WOMAC ölçeğinin; ağrı, sertlik,
özürlülük puanları radyolojik olarak Evre 4 olan olgularda diğerlerine
göre anlamlı olarak yüksekti (p꞊0.004, p꞊0.023, p꞊0.001).
BPI'nın ağrı alt ölçekleri için radyolojik derece açısından fark yoktu
(ağrı şiddeti ve ağrı interferansı alt ölçeği; sırasıyla p꞊0.538 p꞊0.627).
Sonuç: Hem WOMAC hem de BPI ölçekleri, ağrının yaşam kalitesini
ve uykuyu bozduğunu göstermiştir. Yine de BPI ağrı alt ölçeği,
WOMAC ve OAKHQOL'de artan radyolojik evre ilişkili ağrının aksine
radyolojik derece ile ilişkili bulunmadı. Bu sonuç, BPI ölçeğinin
OA ağrısını değerlendirmek için sınırlı olabileceğini
göstermektedir.
Anahtar Kelimeler: Osteoartrit; ağrı; uyku; yaşam kalitesi
ABSTRACT
Objective: The aim of this cross-sectional study is to
evaluate the effect of pain and radiological grade on quality of life
and sleep in patients with knee osteoarthritis (OA). Material and
Methods: Patients with OA who admitted to the outpatient clinics of
Physical Medicine-Rehabilitation and Family Medicine at
Gaziosmanpaşa Training and Research Hospital between August
2018 and November 2018 were included in this search. A health interview
sharing demographic variables, Brief Pain Inventory Short
Form scale (BPI), Western Ontario and McMaster Universities Osteoarthritis
Index (WOMAC), Pittsburgh Sleep Quality Index
(PSQI), OsteoArthritis Knee and Quality of Life Scale in the Lower
Legs (OAKHQOL) scales were used to collect data. Results: One
hundred and fifty-one OA patients (127 women, 24 men; mean
age±SD: 60.14±8.95 years) had knee pain correlated with radiological
grade (p=0.004; r=0.234). Poor sleep quality was detected in all
participants based on PSQI score. Despite the radiological grade
were related to pain of WOMAC (p<0.001 r=-0.322) and physical
activity (p=0.014 r=-0.200) of OAKHQOL, sleep quality was not
(p=0.077 r=0.144). The pain, stiffness, and disability scores of the
WOMAC scale were significantly higher in radiologically Grade 4
cases than in others (p꞊0.004, p꞊0.023, p꞊0.001). There was no difference
in the radiological grade for BPI's pain subscales (pain severity
and pain interference subscale; p꞊0.538 p꞊0.627, respectively).
Conclusion: Both WOMAC and BPI scales have shown that pain
impaired life quality and sleep. Nevertheless, the BPI pain subscale
was not associated with radiological grade, in contrast to the increased
radiological grade-related pain in WOMAC and OAKHQOL.
This result shows that the BPI scale might be limited to evaluate OA
pain.
Keywords: Osteoarthritis; pain; sleep; quality of life
REFERENCES
- Lawrence RC, Felson DT, Helmick CG, et al. National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58:26-35. [Crossref] [PubMed] [PMC]
- Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998;41:778-99. [Crossref] [PubMed]
- Harris ED. Etiology and pathogenesis of rheumatoid arthritis. In: Kelly WN, Rubby S, Harris ED, Sledge CB, eds. Textbook of Rheumatology. 4th ed. Philadelphia: WB Saunders Co.; 1993. p.833-73.
- Breedveld FC. Osteoarthritis--the impact of a serious disease. Rheumatology (Oxford). 2004;43:i4-8. [Crossref] [PubMed]
- Kaçar C, Gilgil E, Urhan S, et al. The prevalence of symptomatic knee and distal interphalangeal joint osteoarthritis in the urban population of Antalya, Turkey. Rheumatol Int. 2005;25:201-4. [Crossref] [PubMed]
- Sarıdoğan M. Tanıdan Tedaviye Osteoartrit. Ankara: Nobel Tıp Kitabevi; 2007.
- Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29:1039-49. [Crossref] [PubMed]
- Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494-502. [Crossref] [PubMed] [PMC]
- Celik EC, Yalcinkaya EY, Atamaz F, et al. Validity and reliability of a Turkish Brief Pain Inventory Short Form when used to evaluate musculoskeletal pain. J Back Musculoskelet Rehabil. 2017;30:229-33. [Crossref] [PubMed]
- Tüzün EH, Eker L, Aytar A, et al. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage. 2005;13:28-33. [Crossref] [PubMed]
- Agargun M. Pittsburgh uyku kalitesi indeksinin gecerligi ve guvenirligi [The validity and reliability of the Pittsburgh Sleep Quality Index]. Turk Psikiyatri Dergisi. 1996;7:107-15. [Link]
- Duruöz M, Duruöz E, Uçar Ü, et al. SAT0338 Adaptation and Validation of the Osteoarthritis Knee and Hip Quality of Life (Oakhqol) Questionnaire in Turkish Population. Annals of the Rheumatic Diseases. 2013;72:A697-A. [Crossref]
- Kerrigan DC, Todd MK, Riley PO. Knee osteoarthritis and high-heeled shoes. Lancet. 1998;351:1399-401. [Crossref] [PubMed]
- Woo J, Lau E, Lau CS, et al. Socioeconomic impact of osteoarthritis in Hong Kong: utilization of health and social services, and direct and indirect costs. Arthritis Rheum. 2003;49:526-34. [Crossref] [PubMed]
- Tang X, Wang S, Zhan S, et al. The Prevalence of Symptomatic Knee Osteoarthritis in China: Results From the China Health and Retirement Longitudinal Study. Arthritis Rheumatol. 2016;68:648-53. [Crossref] [PubMed]
- Atamaz F, Hepgüler S, Öncü J. Diz osteoartritinde ağrı ve özürlülükle ilişkili faktörler [Factors Associated with Pain and Disability in Knee Osteoarthritis]. Türk Fiz Tıp Rehab Derg. 2006;52:119-22. [Link]
- Özvurmaz S, Asgarpour H, Güneş Z. Yaşlılarda Uyku Kalitesi Ve Yaşam Kalitesi Arasındaki İlişki: Kesitsel Bir Çalışma [Relationship of quality of sleep and quality of life in elderly: cross sectional study]. Medical Sciences. 2018;13:72-9. [Crossref]
- Kiadaliri AA, Lamm CJ, de Verdier MG, et al. Association of knee pain and different definitions of knee osteoarthritis with health-related quality of life: a population-based cohort study in southern Sweden. Health Qual Life Outcomes. 2016;14:121. [Crossref] [PubMed] [PMC]
- Mahmoud GA, Moghazy A, Fathy S, et al. Osteoarthritis knee hip quality of life questionnaire assessment in Egyptian primary knee osteoarthritis patients: Relation to clinical and radiographic parameters. The Egyptian Rheumatologist. 2019;41:65-9. [Crossref]
- Erdoğanoğlu Y, Solak BN, Şimşek M, et al. Erken ve geç evre osteoartritli hastalarda ağrı şiddeti ile beden algısı, benlik saygısı, depresyon ve fonksiyonel düzey arasındaki ilişkinin incelenmesi: pilot çalışma [Investigation of relationship between pain severity and body image, self-esteem, depression, and functional level in patients with early and late stage osteoarthritis: a pilot study]. Journal of Exercise Therapy and Rehabilitation. 2019;6:188-94. [Link]
- Cooper C, Snow S, McAlindon TE, et al. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000;43:995-1000. [Crossref] [PubMed]
- Dai Z, Neogi T, Brown C, et al. Sleep Quality Is Related to Worsening Knee Pain in Those with Widespread Pain: The Multicenter Osteoarthritis Study. J Rheumatol. 2020;47:1019-1025. [Crossref] [PubMed] [PMC]
- Pickering ME, Chapurlat R, Kocher L, et al. Sleep Disturbances and Osteoarthritis. Pain Pract. 2016;16:237-44. [Crossref] [PubMed]
- Heffner K, France C, Quinones M, et al. Insomnia Treatment In Adults Over Age 50 With Osteoarthritis Pain: Effects On Physical Function And Quality Of Life. Innovation in Aging. 2018;2:48. [Crossref] [PMC]
- Onen SH, Onen F, Courpron P, et al. How pain and analgesics disturb sleep. Clin J Pain. 2005;21:422-31. [Crossref] [PubMed]
- Tang NK, Goodchild CE, Sanborn AN, et al. Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study. Sleep. 2012;35:675-87A. [Crossref] [PubMed] [PMC]
- Mahmoudi SF, Toulgui E, Jeddou KB, et al. Quality of life for patient with knee osteoarthritis. Annals of physical and rehabilitation medicine. 2016;59:e158-e9. [Crossref]
- Salas-Vargas S-C, Rodríguez-Grande E-I. Confiabilidad de un cuestionario específico para evaluar calidad de vida en personas con osteoartritis. Reumatología Clínica. 2019. [Link]