Rheumatoid Arthritis: Dixon J

Rome K, Dixon J, Gray M, Woodley R. · School of Rehabilitation and Occupation Studies, Health and Rehabilitation Research Centre, Discipline of Podiatry, AUT University, Private Bag 92006, Auckland 1142, New Zealand. · Clin Biomech (Bristol, Avon). · Pubmed #19361898 No free full text.

Abstract: BACKGROUND: It has been proposed that people with rheumatoid arthritis experience difficulties in postural control and activities of daily living such as walking. The aim of the study is to evaluate postural stability in rheumatoid arthritis patients. METHOD: A convenience sample of 19 rheumatoid arthritis patients (mean duration 13.1+/-9.2 years) were aged matched with a non-rheumatoid group (n=21). Postural stability was measured using a force plate for anterior-posterior and mediolateral centre of pressure excursion for 30s with eyes closed and open. Patients also performed three walks at a self-selected speed and mean temporal-spatial parameters were recorded. FINDINGS: Significant differences were observed between the groups in anterior-posterior centre of pressure excursion during the eyes open task and the eyes closed task (P<0.05). No significant differences were found in the mediolateral centre of pressure excursion during either condition (P>0.05). The rheumatoid group displayed a significantly slower mean walking velocity, double support, cadence and cycle time than the non-rheumatoid group (P<0.05). INTERPRETATION: The results from this study showed that rheumatoid arthritis patients displayed a significantly larger centre of pressure excursion in the anterior-posterior direction during quiet standing, when compared to a non-rheumatoid arthritis control group suggesting that postural control mechanisms such as ankle strategies are impeded by the rheumatoid process.

Oliver S, Bosworth A, Airoldi M, Bunyan H, Callum A, Dixon J, Home D, Lax I, O'Brien A, Redmond A, Ryan S, Scott DG, Steuer A, Tanner L. · Litchdon Medical Centre, Devon, UK. · Musculoskeletal Care. · Pubmed #18785194 No free full text.

Abstract: OBJECTIVE: Consumers of healthcare can reveal important insights into the personal challenges they experience when negotiating their health needs. The National Rheumatoid Arthritis Society (NRAS) wanted to explore the experiences of those with rheumatoid arthritis (RA) in order to understand the impact on the individual and on healthcare resources and benchmark care against published standards and guidelines. METHODS: A project was designed to explore the experiences of individuals with sero-positive RA who had been diagnosed for three years or less. Qualitative semi-structured interviews were used and combined with process mapping to explore the experiences of a purposeful sample of individuals with RA. The information generated was mapped and variances explored. Ethical approval was not required as the data were collected outside the National Health Service. RESULTS: Twenty-two participants' stories were mapped. Fifty per cent of participants sought a medical opinion within three weeks of symptom onset and the majority received a disease-modifying anti-rheumatic drug within six months from first presenting symptoms. Work-related issues were highlighted by 13 participants, and seven of these experienced job losses directly attributed to their diagnosis. CONCLUSIONS: This unique mapping approach used qualitative research and process mapping to compare patient experiences against recognized standards and guidelines. These twenty-two stories reveal important insights into the challenges experienced in negotiating these healthcare journeys and the impact upon the individual as a result of variances in standards of care received. The participants in this study were chiefly self-motivated, informed and articulate, and did not reflect the broad ethnic, social or cultural diversity in the UK. Limitations must also be considered in relation to perceptions and recall of participants over a three-year period, as these may have altered over time and illness experience.