SEEK: Salford Environment for Expertise and Knowledge

October 2012

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

Hammond, A & Tyson, S 2012, 'Activity Limitations Experienced by People with Rheumatoid Arthritis On Biologic Medications and Their Use of Ergonomic Methods', Arthritis & Rheumatism, 64(10), p.S1030.



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.
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.

Publication Details

Arthritis & Rheumatism, 64(10), p.S1030.