Activity limitation and participation restriction in Osteoarthritis and Rheumatoid arthritis: findings based on the National Health and Nutritional Examination Survey

Abstract

Background: Osteoarthritis (OA) and Rheumatoid arthritis (RA) are the most common joint diseases leading to chronic pain and disability. Given the chronicity and disabling nature of OA and RA, they are likely to influence full participation of individuals in the society. An activity limitation occurs when a person has difficulty executing an activity; a participation restriction is experienced when a person has difficulty participating in a real-life situation. The aim of this study was to examine the associations between OA and RA and the domains of activity limitation and participation restriction.

Methods: A cross-sectional study design comprised 3604 adults from the 2009 to 2018 National Health and Nutrition Examination Survey (NHANES). All participants aged ≥ 20 years with complete data were included. Activity limitation and participation restriction were assessed by reported difficulty in performing 14 tasks selected from Physical Functioning Questionnaire. Data on OA and RA were obtained from Medical Conditions Questionnaire. Weighted logistic regression model was used to examine the associations between OA and RA and the selected tasks.

Results: Over 36% of participants had limitations. Both OA (OR = 2.11) and RA (OR = 2.36) were positively associated with activity limitation and participation restriction (p < 0.001). Poor or fair health was associated with difficulty in physical functioning, with highest odds observed in leisure activities (OR = 2.05), followed by difficulty in attending social events (OR = 1.99), walking for a quarter mile (OR = 1.97), preparing meals (OR = 1.93) and walking up ten steps (OR = 1.92).

Conclusion: Adults with OA and RA had nearly similar odds of having activity limitations and participation restrictions. Difficulty in executing most activities of daily living (ADLs) has significant association with poor or fair health. Holistic interdisciplinary care to individuals with OA or RA focusing on ADLs and environmental factors may improve health status.

Keywords: Activity limitation; International Classification of Functioning, Disability and Health (ICF).; Osteoarthritis; Participation restriction; Physical functioning; Rheumatoid arthritis.