Introduction
Methods
Study design
Participants
Assessments
Sociodemographic and disease characteristics
Physical functioning measures
Patient specific complaints instrument (PSC)
ICF linking method
Analyses
Results
Demographics and disease characteristics
RA (N = 206) | axSpA (N = 155) | |
---|---|---|
Age, mean (SD) | 58.7 (12.9) | 53.2 (11.8) |
Sex, female, N (%) | 187 (90.8) | 73 (47.1) |
BMI, mean (SD) | 27.6 (6.1) | 28.8 (6.6) |
Current medication use, N (%) | ||
Any DMARD | 139 (67.5) | 101 (65.2) |
csDMARD | 83 (59.7) | 20 (19.8) |
bDMARD | 102 (73.4) | 93 (92.1) |
tsDMARDs | 12 (8.6) | 0 (0) |
NSAIDs | 90 (43.7) | 79 (51.0) |
No anti-rheumatic or anti-inflammatory medication | 9 (4.4) | |
Self-reported symptom duration (years), mean (SD) | 21.6 (13.5) | 24.7 (14.4) |
Number of comorbidities, N (%) | N = 204 | N = 153 |
0 | 7 (3.4) | 7 (4.5) |
1–2 | 51 (24.8) | 33 (19.3) |
3–4 | 67 (32.5) | 46 (29.7) |
≥ 5 | 79 (38.3) | 67 (45.2) |
Joint replacement surgeries ≥ 1, N (%) | 80 (38.8) | 25 (16.1) N = 154 |
DAS-28, mean (sd) | 3.1 (1.3) N = 151 | – |
BASDAI, mean (sd) | – | 5.0 (2.0) N = 94 |
Education level, N (%) | ||
Low | 89 (43.2) | 39 (25.2) |
Medium | 58 (28.2) | 58 (37.4) |
High | 59 (28.6) | 58 (37.4) |
Work status, N (%) | ||
≤ 66 years old | 147 (71.4) | 135 (87.1) |
Paid job | 42 (28.6) | 43 (31.9) |
No job, health problems | 59 (40.1) | 62 (45.9) |
No job, other reasons | 46 (31.3) | 30 (22.2) |
PROMIS PF-10 (13.5–61.9), mean (SD) | 33.9 (5.2) | 35.8 (4.5) |
HAQ-DI (0–3), mean (SD) | 1.7 (0.5) | – |
BASFI (0–10), mean (SD) | – | 6.1 (1.9) N = 153 |
Number of identified meaningful concepts derived from PSC, and total and unique ICF categories
RA (N = 206) | axSpA (N = 155) | |
---|---|---|
Total PSC activities, N | 618 | 465 |
PSC scores (0–10), mean (SD) | ||
PSC activity 1 | 7.5 (1.4) | 7.8 (1.0) |
PSC activity 2 | 7.5 (1.3) | 7.6 (1.1) |
PSC activity 3 | 7.6 (1.3) | 7.4 (1.1) |
Total meaningful concepts | 911 | 769 |
Total meaningful concepts “nd-ap” | 2 | 10 |
Total number of ICF categories | 909 | 759 |
Total unique ICF categories, second level | 5 | 4 |
Total unique ICF categories, third level | 67 | 53 |
ICF categories per participant, mean (SD) | 4.4 (0.6) | 4.9 (0.8) |
ICF categories per participant: 3 | 42 | 16 |
ICF categories per participant: 4 | 80 | 44 |
ICF categories per participant: 5 | 51 | 49 |
ICF categories per participant: 6 | 24 | 34 |
ICF categories per participant: 7 | 8 | 9 |
ICF categories per participant: 8 | 1 | 2 |
ICF categories per participant: 9 | – | 1 |
Type and frequency of ICF categories
Code and description of ICF category | RA (N = 206) | axSpA (N = 155) |
---|---|---|
d1 Learning and applying knowledge, N (%) | 0 (0%) | 0 (0%) |
➢ d170 Writing | 0 | 0 |
d2 General tasks and demands, N (%) | 0 (0%) | 0 (0%) |
➢ d230 Carrying out daily routine | 0 | 0 |
➢ d240 Handling stress and other psychological demands | 0 | 0 |
d3 Communication, N (%) | 6 (0.7%) | 4 (0.5%) |
➢ d345 Writing messages | 3 | 1 |
➢ d360 Using communication devices and techniques | 3 | 3 |
• d3601 Using writing machines | 3 | 3 |
d4 Mobility, N (%) | 696 (76.6%) | 532 (70.1%) |
➢ d410 Changing basic body position | 102 | 91 |
• d4100 Lying down | 2 | 6 |
• d4101 Squatting | 3 | 6 |
• d4102 Kneeling | 0 | 2 |
• d4103 Sitting | 60 | 30 |
• d4104 Standing | 3 | 2 |
• d4105 Bending | 22 | 44 |
• d4107 Rolling over | 4 | 0 |
• d4108 Other specified | 8 | 1 |
➢ d415 Maintaining a body position | 35 | 89 |
• d4150 Maintaining a lying position | 1 | 2 |
• d4151 Maintaining a squatting position | 1 | 0 |
• d4152 Maintaining a kneeling position | 0 | 1 |
• d4153 Maintaining a sitting position | 10 | 26 |
• d4154 Maintaining a standing position | 23 | 60 |
➢ d430 Lifting and carrying objects | 47 | 51 |
• d4300 Lifting | 34 | 42 |
• d4301 Carrying in the hands | 7 | 9 |
• d4302 Carrying in the arms | 6 | 0 |
➢ d435 Moving objects with lower extremities | 1 | 0 |
• d4351 Kicking | 1 | 0 |
➢ d440 Fine hand use | 98 | 62 |
• d440 Fine hand use | 0 | 0 |
• d4400 Picking up | 2 | 4 |
• d4401 Grasping | 51 | 39 |
• d4402 Manipulating | 44 | 11 |
• d4408 Other specified | 1 | 8 |
➢ d445 Hand and arm use | 23 | 10 |
• d4452 Reaching | 2 | 6 |
• d4453 Turning or twisting the hands or arms | 11 | 4 |
• d4454 Throwing | 2 | 0 |
• d4455 Catching | 1 | 0 |
• d4458 Other specified | 1 | 0 |
• d4459 Unspecified | 6 | 0 |
➢ d449 Carrying, moving, and handling objects, other specified and unspecifieda | 0 | 0 |
➢ d450 Walking | 268 | 158 |
• d450 Walking | 0 | 0 |
• d4500 Walking short distances | 48 | 12 |
• d4501 Walking long distances | 121 | 92 |
• d4502 Walking on different surfaces | 79 | 43 |
• d4508 Other specified | 20 | 11 |
➢ d451 Stair climbing | 62 | 32 |
➢ d455 Moving around | 3 | 2 |
• d4451 Climbing | 0 | 1 |
• d4552 Running | 1 | 0 |
• d4554 Swimming | 2 | 1 |
➢ d460 Moving around in different locations | 7 | 2 |
• d4600 Within the home | 2 | 2 |
• d4602 Outside the home and other buildings | 1 | 0 |
• d4608 Other specified | 4 | 0 |
➢ d465 Moving around using equipment | 0 | 0 |
➢ d470 Using transportation | 0 | 0 |
➢ d475 Driving | 50 | 35 |
• d4750 Driving human-powered transportation | 37 | 25 |
• d4751 Driving motorized vehicles | 3 | 4 |
• d4752 Driving animal-powered vehicles | 1 | 0 |
• d4758 Other specified | 9 | 6 |
d5 Self-care, N (%) | 69 (7.6%) | 60 (7.9%) |
➢ d510 Washing oneself | 22 | 9 |
• d5100 Washing body parts | 5 | 3 |
• d5101 Washing whole body | 9 | 4 |
• d5102 Drying oneself | 8 | 2 |
➢ d520 Caring for body parts | 2 | 2 |
• d5202 Caring for hair | 1 | 2 |
• d5204 Caring for toenails | 1 | 0 |
➢ d530 Toiletinga | 7 | 7 |
• d5301 Regulating defecation | 4 | 4 |
➢ d540 Dressing | 35 | 42 |
• d5400 Putting on clothes | 22 | 21 |
• d5401 Taking off clothes | 7 | 2 |
• d5402 Putting on footwear | 6 | 19 |
➢ d550 Eating | 3 | 0 |
➢ d560 Drinking | 0 | 0 |
➢ d570 Looking after one’s health | 0 | 0 |
d6 Domestic life, N (%) | 100 (11.0%) | 136 (17.9%) |
➢ d620 Acquisition of goods and services | 19 | 35 |
• d6200 Shopping | 19 | 35 |
➢ d630 Preparing meals | 23 | 32 |
• d6300 Preparing simple meals | 4 | 2 |
• d6309 Preparing meals, unspecified | 19 | 30 |
• d6403 Using household appliances | 29 | 28 |
➢ d640 Doing housework | 38 | 44 |
• d6400 Washing and drying clothes and garments | 1 | 2 |
• d6401 Cleaning cooking area and utensils | 0 | 3 |
• d6402 Cleaning living area | 6 | 7 |
• d6403 Using household appliances | 29 | 28 |
• d6408 Other specified | 1 | 4 |
• d6409 Unspecified | 1 | 0 |
➢ d650 Caring for household objects | 19 | 23 |
• d6501 Maintaining dwelling and furnishings | 0 | 1 |
• d6503 Maintaining vehicles | 2 | 0 |
• d6505 Taking care of plants, indoors and outdoors | 11 | 17 |
• d6506 Taking care of animals | 6 | 5 |
➢ d660 Assisting others | 1 | 2 |
• d6609 Assisting others, unspecified | 1 | 2 |
d7 Interpersonal interactions and relationships, N (%) | 0 (0%) | 0 (0%) |
➢ d760 Family relationships | 0 | 0 |
➢ d770 Intimate relationships | 0 | 0 |
d8 Major life areas, N (%) | 3 (0.3%) | 4 (0.5%) |
➢ d845 Acquiring, keeping, and terminating a job | 0 | 0 |
➢ d850 Remunerative employment | 0 | 0 |
➢ d859 Work and employment, other specified and unspecified | 3 | 4 |
➢ d859 Work and employment, other specified and unspecified | 3 | 4 |
➢ d870 Economic self-sufficiency | 0 | 0 |
d9 Community, social and civic life, N (%) | 36 (4.0%) | 23 (3.0%) |
➢ d910 Community life | 0 | 0 |
➢ d920 Recreation and leisure | 36 | 23 |
• d9200 Play | 1 | 0 |
• d9201 Sports | 8 | 3 |
• d9202 Arts and culture | 8 | 0 |
• d9203 Crafts | 1 | 0 |
• d9205 Socializing | 5 | 5 |
• d9208 Other specified | 3 | 0 |
• d9209 Unspecified | 10 | 15 |
RA (N = 206) | |||
---|---|---|---|
Ranking | ICF code | Total three PSC activities (N = 909 ICF categories) | Number of ICF categories (%) |
1 | d4501 | Walking long distances | 121 (13.3) |
2 | d4502 | Walking on different surfaces | 79 (8.7) |
3 | d451 | Stair climbing | 62 (6.8) |
4 | d4103 | Changing basic body position: sitting | 60 (6.6) |
5 | d4401 | Grasping | 51 (5.6) |
Ranking | ICF code | PSC activity 1 (N = 316 ICF categories) | Number of ICF categories (%) |
---|---|---|---|
1 | d4501 | Walking long distances | 75 (23.7) |
2 | d4502 | Walking on different surfaces | 47 (14.9) |
3 | d4500 | Walking short distances | 33 (10.4) |
4 | d4401 | Grasping | 14 (4.4) |
5 | d4103 | Changing basic body position: sitting | 12 (3.8) |
Ranking | ICF code | PSC activity 2 (N = 294 ICF categories) | Number of ICF categories (%) |
---|---|---|---|
1 | d4501 | Walking long distances | 28 (9.5) |
2 | d451 | Stair climbing | 25 (8.5) |
3 | d4103 | Changing basic body position: sitting | 20 (6.8) |
4 | d4750 | Driving human-powered transportation | 19 (6.4) |
5 | d4401 | Grasping | 18 (6.1) |
Ranking | ICF code | PSC activity 3 (N = 299 ICF categories) | Number of ICF categories (%) |
---|---|---|---|
1 | d4103 | Changing basic body position: sitting | 28 (9.4) |
2 | d451 | Stair climbing | 27 (9.0) |
3 | d4402 | Manipulating | 20 (6.7) |
4 | d4401 | Grasping | 19 (6.4) |
5 | d4501 | Walking long distances | 18 (6.0) |
AxSpA (N = 155) | |||
---|---|---|---|
Ranking | ICF code | Total three PSC activities (N = 759 ICF categories) | Number of ICF categories (%) |
1 | d4501 | Walking long distances | 92 (12.1) |
2 | d4154 | Maintaining a standing position | 60 (7.9) |
3 | d4105 | Changing basic body position: bending | 44 (5.8) |
4 | d4502 | Walking on different surfaces | 43 (5.7) |
5 | d4300 | Lifting | 42 (5.5) |
Ranking | ICF code | PSC activities 1 (N = 247 ICF categories) | Number of ICF categories (%) |
---|---|---|---|
1 | d4501 | Walking long distances | 50 (20.2) |
2 | d4502 | Walking on different surfaces | 22 (8.9) |
3a | d4154 / | Maintaining a standing position / | 17 (6.9) |
d451 | Stair climbing | 17 (6.9) | |
5a | d4300 / | Lifting / | 10 (4.0) |
d4153 | Maintaining a sitting position | 10 (4.0) |
Ranking | ICF code | PSC activities 2 (N = 253 ICF categories) | Number of ICF categories (%) |
---|---|---|---|
1 | d4154 | Maintaining a standing position | 30 (11.9) |
2a | d4105 / | Changing basic body position: bending | 19 (7.5) |
d4501 | Walking long distances | 19 (7.5) | |
4 | d4401 | Grasping | 16 (6.3) |
5 | d4750 | Driving human-powered transportation | 14 (5.5) |
Ranking | ICF code | PSC activities 3 (N = 259 ICF categories) | Number of ICF categories (%) |
---|---|---|---|
1 | d4501 | Walking long distances | 23 (8.9) |
2 | d4300 | Lifting | 20 (7.7) |
3a | d6200 / | Shopping | 16 (6.2) |
d4105 | Changing basic body position: bending | 16 (6.2) | |
5 | d4103 | Changing basic body position: sitting | 15 (5.8) |
Overlap and differences between identified ICF categories and the Brief and Comprehensive ICF Core Sets
ICF category | RA (N = 206) | ICF Core Sets RA | axSpA (N = 155) | ICF Core Sets AS |
---|---|---|---|---|
d170 Writing | – | * | – | |
d230 Carrying out daily routine | – | ** | – | ** |
d240 Handling stress and other psychological demands | – | – | * | |
d345 Writing messages | + | + | ||
d360 Using communication devices and techniques | + | * | + | |
d410 Changing basic body position | + | ** | + | ** |
d415 Maintaining a body position | + | * | + | * |
d430 Lifting and carrying objects | + | * | + | * |
d435 Moving objects with lower extremities | + | – | ||
d440 Fine hand use | + | ** | + | |
d445 Hand and arm use | + | ** | + | |
d449 Carrying, moving, and handling objects, other specified and unspecified | – | * | – | |
d450 Walking | + | ** | + | ** |
d451 Stair climbing | + | + | ||
d455 Moving around | + | * | + | * |
d460 Moving around in different locations | + | * | + | |
d465 Moving around using equipment | – | * | – | |
d470 Using transportation | – | * | – | * |
d475 Driving | + | * | + | ** |
d510 Washing oneself | + | * | + | * |
d520 Caring for body parts | + | * | + | * |
d530 Toileting | + | * | + | * |
d540 Dressing | + | * | + | * |
d550 Eating | + | * | – | |
d560 Drinking | – | * | – | |
d570 Looking after one’s health | – | * | – | * |
d620 Acquisition of goods and services | + | * | + | * |
d630 Preparing meals | + | * | + | |
d640 Doing housework | + | * | + | * |
d650 Caring for household objects | + | + | ||
d660 Assisting others | + | * | + | * |
d760 Family relationships | – | * | – | ** |
d770 Intimate relationships | – | * | – | * |
d845 Acquiring, keeping, and terminating a job | – | – | ** | |
d850 Remunerative employment | – | ** | – | ** |
d859 Work and employment, other specified and unspecified | + | * | + | |
d870 Economic self-sufficiency | – | – | * | |
d910 Community life | – | * | – | * |
d920 Recreation and leisure | + | * | + | ** |
ICF Categories in Comprehensive ICF Core Set | 32 | 24 | ||
Total number of second-level ICF categories | 25 | 23 | ||
Overlapping ICF categories with Comprehensive Core Set | 21 | 14 | ||
ICF categories in Brief ICF Core Set | 6 | 8 | ||
Overlapping ICF categories with Brief Core Set | 4 | 4 |