Skip to main content

Advertisement

SpringerLink
Log in

Physical impairment in patients with idiopathic inflammatory myopathies is associated with the American College of Rheumatology functional status measure

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The goals of this study were to assess the predictive value of chart-abstracted American College of Rheumatology functional status (ACR-FS) with patient-reported ACR-FS and to relate it with measures of muscle function in a single-institution cohort of patients with idiopathic inflammatory myopathies (IIMs). Demographic and clinical data of 102 patients with IIMs regularly followed in the Rheumatology and Neurology Clinics at the University of Kentucky Medical Center between 2006 and 2012 were obtained through retrospective chart review. Clinical and functional status evaluation, muscle performance testing, and body composition measures were performed on a subset of 21 patients. ACR-FS was obtained by both chart abstraction and direct patient report. Spearman’s correlations were used to examine the relationship of ACR-FS derived from chart abstraction with direct patient report, as well as the relationship of measures of physical function and body composition with ACR-FS. ACR-FS derived from chart abstraction was significantly correlated with ACR-FS derived from direct patient report (ρ = 0.78, p < 0.001). ACR-FS derived from chart abstraction was also significantly correlated with patient-reported physical function (ρ = −0.71, p < 0.001) and physical activity (ρ = −0.58, p < 0.05), manual muscle testing (ρ = −0.66, p < 0.01), and skeletal muscle endurance as measured by the functional index-2 test (shoulder flexion ρ = −0.62, p < 0.01; hip flexion ρ = −0.65, p < 0.0; heel lift ρ = −0.67, p < 0.01; and toe lift ρ = −0.68, p < 0.01). The ACR-FS is a simple measure of disability that can be used in chart abstraction studies involving IIM patients. We have demonstrated that ACR-FS correlates well with muscle performance tests of strength and endurance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bronner IM, van der Meulen MF, de Visser M, Kalmijn S, van Venrooij WJ, Voskuyl AE, Dinant HJ, Linssen WH, Wokke JH, Hoogendijk JE (2006) Long-term outcome in polymyositis and dermatomyositis. Ann Rheum Dis 65(11):1456–1461. doi:10.1136/ard.2005.045690

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Clarke AE, Bloch DA, Medsger TA Jr, Oddis CV (1995) A longitudinal study of functional disability in a national cohort of patients with polymyositis/dermatomyositis. Arthritis Rheum 38(9):1218–1224

    Article  CAS  PubMed  Google Scholar 

  3. Lillioja S, Young AA, Culter CL, Ivy JL, Abbott WG, Zawadzki JK, Yki-Jarvinen H, Christin L, Secomb TW, Bogardus C (1987) Skeletal muscle capillary density and fiber type are possible determinants of in vivo insulin resistance in man. J Clin Invest 80(2):415–424. doi:10.1172/JCI113088

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Cox FM, Titulaer MJ, Sont JK, Wintzen AR, Verschuuren JJ, Badrising UA (2011) A 12-year follow-up in sporadic inclusion body myositis: an end stage with major disabilities. Brain: J Neurol 134(Pt 11):3167–3175. doi:10.1093/brain/awr217

    Article  Google Scholar 

  5. Stucki G, Stoll T, Bruhlmann P, Michel BA (1995) Construct validation of the ACR 1991 revised criteria for global functional status in rheumatoid arthritis. Clin Exp Rheumatol 13(3):349–352

    CAS  PubMed  Google Scholar 

  6. Cheng S, Tylavsky F, Kroger H (2003) Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Am J Clin Nutr 78(3):485-492. Erratum in: Am J Clin Nutr. 2006 83(1):174

  7. Stamm TA, Machold KP, Smolen JS (2002) Functional and health status assessment in patients with rheumatoid arthritis. Acta Med Austriaca 29(1):30–32

    Article  PubMed  Google Scholar 

  8. Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292(8):403–407. doi:10.1056/NEJM197502202920807

    Article  CAS  PubMed  Google Scholar 

  9. Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292(7):344–347. doi:10.1056/NEJM197502132920706

    Article  CAS  PubMed  Google Scholar 

  10. Tawil R, Griggs RC (2002) Inclusion body myositis. Curr Opin Rheumatol 14(6):653–657

    Article  CAS  PubMed  Google Scholar 

  11. Chinoy H, Salway F, John S, Fertig N, Tait BD, Oddis CV, Ollier WE, Cooper RG (2007) Interferon-gamma and interleukin-4 gene polymorphisms in Caucasian idiopathic inflammatory myopathy patients in UK. Ann Rheum Dis 66(7):970–973. doi:10.1136/ard.2006.068858

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Vancsa A, Ponyi A, Constantin T, Zeher M, Danko K (2007) Pregnancy outcome in idiopathic inflammatory myopathy. Rheumatol Int 27(5):435–439. doi:10.1007/s00296-006-0239-8

    Article  CAS  PubMed  Google Scholar 

  13. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381. doi:10.1016/j.jbi.2008.08.010

    Article  PubMed Central  PubMed  Google Scholar 

  14. Alexanderson H, Broman L, Tollback A, Josefson A, Lundberg IE, Stenstrom CH (2006) Functional index-2: validity and reliability of a disease-specific measure of impairment in patients with polymyositis and dermatomyositis. Arthritis Rheum 55(1):114–122. doi:10.1002/art.21715

    Article  PubMed  Google Scholar 

  15. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395. doi:10.1249/01.MSS.0000078924.61453.FB

    Article  PubMed  Google Scholar 

  16. Rider LG, Werth VP, Huber AM, Alexanderson H, Rao AP, Ruperto N, Herbelin L, Barohn R, Isenberg D, Miller FW (2011) Measures of adult and juvenile dermatomyositis, polymyositis, and inclusion body myositis: physician and patient/parent global activity, Manual Muscle Testing (MMT), Health Assessment Questionnaire (HAQ)/Childhood Health Assessment Questionnaire (C-HAQ), Childhood Myositis Assessment Scale (CMAS), Myositis Disease Activity Assessment Tool (MDAAT), Disease Activity Score (DAS), Short Form 36 (SF-36), Child Health Questionnaire (CHQ), physician global damage, Myositis Damage Index (MDI), Quantitative Muscle Testing (QMT), Myositis Functional Index-2 (FI-2), Myositis Activities Profile (MAP), Inclusion Body Myositis Functional Rating Scale (IBMFRS), Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), Cutaneous Assessment Tool (CAT), Dermatomyositis Skin Severity Index (DSSI), Skindex, and Dermatology Life Quality Index (DLQI). Arthritis Care Res 63(Suppl 11):S118–S157. doi:10.1002/acr.20532

    Article  Google Scholar 

  17. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB (2000) Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A: Biol Med Sci 55(4):M221–M231

    Article  CAS  Google Scholar 

  18. Bogardus ST Jr, Towle V, Williams CS, Desai MM, Inouye SK (2001) What does the medical record reveal about functional status? A comparison of medical record and interview data. J Gen Intern Med 16(11):728–736

    Article  PubMed Central  PubMed  Google Scholar 

  19. Loell I, Lundberg IE (2011) Can muscle regeneration fail in chronic inflammation: a weakness in inflammatory myopathies? J Intern Med 269(3):243–257. doi:10.1111/j.1365-2796.2010.02334.x

    Article  CAS  PubMed  Google Scholar 

  20. Campbell R, Gordon P, Ward K, Reilly C, Scott DL, Rafferty G (2013) Non volitional assessment of muscle endurance in idiopathic inflammatory myopathies (IIM): there is no relationship between patient reported fatigue and muscle fatigability. Muscle Nerve. doi:10.1002/mus.24148

    Google Scholar 

  21. Peterson MJ, Giuliani C, Morey MC, Pieper CF, Evenson KR, Mercer V, Cohen HJ, Visser M, Brach JS, Kritchevsky SB, Goodpaster BH, Rubin S, Satterfield S, Newman AB, Simonsick EM (2009) Physical activity as a preventative factor for frailty: the health, aging, and body composition study. J Gerontol A: Biol Med Sci 64(1):61–68. doi:10.1093/gerona/gln001

    Article  Google Scholar 

  22. Ng TP, Feng L, Nyunt MS, Larbi A, Yap KB (2014) Frailty in older persons: multisystem risk factors and the frailty risk index (FRI). J Am Med Dir Assoc. doi:10.1016/j.jamda.2014.03.008

    Google Scholar 

  23. Alemo Munters L, Alexanderson H, Crofford LJ, Lundberg IE (2014) New insights into the benefits of exercise for muscle health in patients with idiopathic inflammatory myositis. Curr Rheumatol Rep 16(7):429. doi:10.1007/s11926-014-0429-4

    Article  PubMed  Google Scholar 

  24. Munters LA, Dastmalchi M, Andgren V, Emilson C, Bergegard J, Regardt M, Johansson A, Tholander IO, Hanna B, Liden M, Esbjornsson M, Alexanderson H (2013) Improvement in health and possible reduction in disease activity using endurance exercise in patients with established polymyositis and dermatomyositis: a multicenter randomized controlled trial with a 1-year open extension follow up. Arthritis care Res 65(12):1959–1968. doi:10.1002/Acr.22068

    Article  Google Scholar 

  25. Johnson LG (2007) The effectiveness of an individualized, home-based functional exercise program for patients with sporadic inclusion body myositis. J Clin Neuromuscul Dis 8(4):187–194

    Article  Google Scholar 

  26. Ponyi A, Borgulya G, Constantin T, Vancsa A, Gergely L, Danko K (2005) Functional outcome and quality of life in adult patients with idiopathic inflammatory myositis. Rheumatology (Oxford) 44(1):83–88. doi:10.1093/rheumatology/keh404

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by the Clinical to Research Transition Award from the Arthritis Foundation to Dr. Hanaoka. This work was also supported by the University Of Kentucky College Of Medicine Clinician Scholar Award, the Center for Clinical and Translational Science (CCTS) Pilot Award to Dr. Hanaoka, and the CCTS Clinical Services Core (UL1 TR000117). Dr. Bush’s work was supported by the University of Kentucky Biostatistics, Epidemiology, and Research Design Consultation service.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Division of Rheumatology, College of Medicine, University of Kentucky, 138 Leader Avenue, Lexington, KY, 40506-9983, USA

    Beatriz Y. Hanaoka, Laura C. Cleary, Douglas E. Long, Archana Srinivas, Kirk A. Jenkins & Natasha Fraser

  2. College of Public Health, University of Kentucky, 111 Washington Ave., Lexington, KY, 40536-0003, USA

    Heather M. Bush, Catherine P. Starnes, Mathew Rutledge, Jidan Duan & Qian Fan

  3. Department of Medicine, Division of Rheumatology & Immunology, School of Medicine, Vanderbilt University, 1161 21st Ave S, MCN T-3113, Nashville, TN, 37232, USA

    Leslie J. Crofford

Authors
  1. Beatriz Y. Hanaoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laura C. Cleary
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Douglas E. Long
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Archana Srinivas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kirk A. Jenkins
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Heather M. Bush
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Catherine P. Starnes
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mathew Rutledge
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jidan Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Qian Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Natasha Fraser
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Leslie J. Crofford
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leslie J. Crofford.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hanaoka, B.Y., Cleary, L.C., Long, D.E. et al. Physical impairment in patients with idiopathic inflammatory myopathies is associated with the American College of Rheumatology functional status measure. Clin Rheumatol 34, 1929–1937 (2015). https://doi.org/10.1007/s10067-014-2821-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-014-2821-x

Keywords

Search

Navigation