To Assess The Correlation Of Early Morning Stiffness With Functional Disability In Patients With Rheumatoid Arthritis.

Jasminder Singh; Ashish Gupta; Harpreet Singh; Jaikrit Bhutani; Kusum Yadav; Amit Kumar; Prabhudev VH; Gurjinder Singh

Volume : IX, Issue : VIII, August - 2020

To Assess The Correlation Of Early Morning Stiffness With Functional Disability In Patients With Rheumatoid Arthritis.

Jasminder Singh, Ashish Gupta, Harpreet Singh, Jaikrit Bhutani, Kusum Yadav, Amit Kumar, Prabhudev Vh, Gurjinder Singh

Abstract :

Background: Early morning stiffness (EMS) has long been recognized as a characteristic feature of rheumatoid arthritis (RA). However it is no more included in the 2010 ACR/EULAR classification criteria or other major instruments for evaluating disease activity in RA. In this cross–sectional study, we aimed to study the correlation of EMS with functional disability. Methods: A total of 145 patients with RA as per ACR 1987 criteria reporting to rheumatology clinic of our institute were enrolled. In addition to the duration of EMS, the patients were assessed by Indian health assessment questionnaire (HAQ) scores for functional disability by calculating disability index (HAQ–DI). Also clinical disease activity index (CDAI) was calculated for assessment of disease activity. Results: Out of total 145 patients, 5.5% reported no EMS, 31% reported EMS of ≤ 15 minutes duration, 28.27% between 16 to 59 minutes, whereas 35% reported EMS of ≥ 1 one hour. The mean HAQ–DI score was 0.80 � 0.69. Overall HAQ–DI was absent 12.41%, <1 in 46.9%, ≥ 1 to < 2 in 33% and ≥ 2 to <3 in 7.5%. The mean CDAI score of 24.93 � 19.71. On statistical analysis, EMS correlated significantly with HAQ–DI as well as CDAI (p value <0.001 for both comparisons). The HAQ–DI also correlated significantly with CDAI (p–value 0.00). Conclusion: EMS appears to correlate well with functional disability and disease activity. Therefore it should continue to be monitored in RA patients, especially those with low disease activity where it may be the only indication of clinically active disease.