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A challenge with the aggressive new care model for patients with rheumatoid arthritis has been determining which measures to use to assess disease activity and response to therapy. With an observed functional assessment based on the Multidimensional Health Assessment Questionnaire domains, both the physician and the patient can gain important insights into function during a standard office visit. The presence of impairments in strength, joint range of motion, pain, and coordination--including balance and dexterity--can affect patients' ability to perform functional activities. This assessment allows a physician to observe the impact of these impairments on function. It may help identify patients with significant changes in function who can benefit from effective intervention. (J Musculoskel Med. 2012;29:102-105), Treatment of patients with rheumatoid arthritis (RA) has undergone tremendous advances related to greater understanding of its pathophysiology and the introduction of effective disease-modifying medications. New management strategies for RA [...]

Knowing how rheumatoid arthritis (RA) symptoms are affecting patients' everyday activities enhances your ability to provide best 'treat to target' practice interventions. Impairments can result in activity limitations and participation restrictions. An important impairment in RA is structural joint deformities; others are pain, fatigue, and adverse emotional reactions. Persons with RA often make some type of adaptation to their activities. Activity performance may be assessed by patient self-report with directed questions and by direct observation. Knowledge about RA and perspectives on what constitutes a particular activity differ greatly among patients. A challenge during an office visit is to make an accurate assessment of patients' functional activities. Identifying problems is easier if attention is focused on specific body areas that are likely to be problematic. (J Musculoskel Med. 2012;29:78-81), Assessing function in patients with rheumatoid arthritis (RA) is a challenging but important part of the rheumatology office visit. Knowing how the symptoms of RA are affecting patients' everyday activities [...]

The reasons why patients go to physicians to seek help for musculoskeletal problems, such as pain, difficulty in climbing stairs, and reduced work time, all are aspects of human function but refer to different aspects of function. In 2001, the World Health Organization published a classification to describe the health components of functioning and disability. Included is the entirety of a person's health rather than just the consequences of his or her disease. Patient self-report measures, used in conjunction with routine office visits, provide a practical and feasible way of obtaining information about functional health. The Health Assessment Questionnaire, a frequently used tool, has played a major role in broadening the perspective of chronic disease management from biomedical measurements to include measurement of functional health. (J Musculoskel Med. 2012;29:41-43), Musculoskeletal problems are some of the main reasons why patients go to physicians or other health care professionals. The reasons for seeking help are quite variable. For example, a person [...]

Joint pain and joint damage resulting from rheumatoid arthritis (RA) lead to functional limitations that reduce patients' quality of life and make activities of daily living difficult. Recent guidelines have emphasized treat to target strategies for minimizing joint destruction in patients with RA and maximizing their functional well-being, but these strategies have not been tested in usual-care settings and have not focused on the functional improvements that occur when disease activity is reduced by medication. The Routine Assessment of Patient Index Data 3, a composite of patient self-reported measures, includes a multidimensional HAQ (MDHAQ). The MDHAQ provides questions to determine patients' ability to perform activities related to function. Additional treatment strategies that focus on directly addressing functional disabilities may be needed. (J Musculoskel Med. 2012;29:10-12), Rheumatoid arthritis (RA), which affects an estimated 1.3 million Americans, is a complex inflammatory disorder associated with synovitis and joint destruction. (1-3) Both joint pain and joint damage resulting from [...]