Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220047-en
Brazilian Journal of Pain
Original Article

Chronic Chikungunya arthralgia reduces functionality, quality of life and occupational performance: descriptive cross-sectional study

Artralgia crônica por Chikungunya reduz funcionalidade, qualidade de vida e performance ocupacional: estudo descritivo transversal

Antonio Felipe Lopes Cavalcante; Alexandre Hideki Okano; Maria Tereza Micussi; Clécio Gabriel de Souza; João Octávio Sales Passos; Edgard Morya; Rodrigo Pegado de Abreu Freitas

Downloads: 0
Views: 26

Abstract

BACKGROUND AND OBJECTIVES: Chikungunya virus (CHIKV) chronic polyarthralgia deteriorates general functionality and work productivity. The objective of this study was to evaluate functionality, pain, quality of life, and sleep quality of individuals with chronic CHIKV arthralgia and correlate them with clinical symptoms, work productivity, and activity impairment.

METHODS: This is a descriptive cross-sectional study with 61 chronic CHIKV arthralgia patients. Functionality was assessed using the Health Assessment Questionnaire (HAQ). Pain intensity and interference were measured by using the Visual Analog Scale (VAS) and the Brief Pain Inventory Short Form (BPI), respectively. Quality of life and sleep were evaluated using the Short Form 36 Health Survey (SF-36) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Work Productivity and Activity Impairment (WPAI) questionnaire was used to assess the effects of health in general symptoms on work.

RESULTS: Low and moderate level of function was present in 39.4% and 55.7% of the sample, respectively. Moderate pain (5.57 ± 2.25), poor sleep quality (47.54%), and sleep disturbances (42.63%) were also observed. Pearson correlations showed significant correlation between absenteeism and presenteeism with HAQ scores (p = 0.03; r = 0.39 and p = 0.01; r = 0.43, respectively), BPI interference (p = 0.02; r = 0.41 and p = 0.001; r = 0.58, respectively) and SF-36 physical score (p = 0.007; r = -0.49 and p = 0.01; r = 0.58, respectively). Activity impairment showed a significant correlation with HAQ (p = 0.01; r = 0.44), BPI interference (p = 0.006; r = 0.5), SF-36 physical score (p = 0.01; r = -0.6) and SF-36 total score (p = 0.01; r = -0.44). Overall work productivity loss only correlated with BPI interference (p = 0.04; r = 0.37).

CONCLUSION: These results suggest that CHIKV chronic arthralgia showed bilateral moderate pain in large joints that impacts activities of daily life, work productivity, and functional activity.

HIGHLIGHTS

  • Chronic chikungunya reduces functionality and causes moderate pain and poor sleep quality.
  • Clinical symptoms impact daily living activity, work productivity, and activity impairment.
  • Functionality, pain, and sleep correlate with occupational performance.

Keywords

Arbovirus infections, Chronic pain, Disability evaluation, Sleep

Resumo

JUSTIFICATIVA E OBJETIVOS: A poliartralgia crônica do vírus Chikungunya (CHIKV) deteriora a funcionalidade e a produtividade do trabalho. O objetivo deste estudo foi avaliar funcionalidade, dor, qualidade de vida e sono de indivíduos com artralgia crônica por CHIKV correlacionada com sintomas clínicos, produtividade do trabalho e comprometimento das atividades.

MÉTODOS: Trata-se de um estudo transversal descritivo com 61 pacientes crônicos de artralgia da CHIKV. A intensidade e a interferência da dor foram medidas usando a Escala Analógica Visual (EAV) e o Brief Pain Inventory Short Form (BPI), respectivamente. A qualidade de vida e o sono foram avaliados usando o Short Form 36 Health Survey (SF-36) e o Pittsburgh Sleep Quality Index (PSQI), respectivamente. O questionário Work Productivity and Activity Impairment (WPAI) foi usado para avaliar os efeitos dos sintomas gerais da saúde no trabalho.

RESULTADOS: Foi observado um nível de funcionalidade baixo em 39,4% e moderado em 55,7% da amostra. Nível de dor moderada (5,57 ± 2,25), má qualidade do sono (47,54%) e distúrbios do sono (42,63%) também foram observados. O teste de Pearson apresentou correlação significativa entre absenteísmo e presenteísmo com as pontuações de Health Assessment Questionnaire (HAQ) (p = 0,03; r = 0,39 e p = 0,01; r = 0,43 respectivamente), interferência do BPI (p = 0,02; r = 0,41 e p = 0,001; r = 0,58 respectivamente) e score físico do SF-36 (p = 0,007; r = -0,49 e p = 0,01; r = 0,58, respectivamente). O comprometimento da atividade mostrou uma correlação significativa com o HAQ (p = 0,01; r = 0,44), interferência do BPI (p = 0,006; r = 0,5), pontuação física do SF-36 (p = 0,01; r = -0,6) e pontuação total do SF-36 (p = 0,01; r = -0,44). A perda geral de produtividade no trabalho correlacionou-se apenas com a interferência do BPI (p = 0,04; r = 0,37).

CONCLUSÃO: Esses resultados sugerem que a artralgia crônica da CHIKV apresenta dor moderada bilateral em grandes articulações com impacto nas atividades de vida diária, produtividade no trabalho e atividade funcional.

DESTAQUES

  • A Chikungunya crônica reduz a funcionalidade e causa dor moderada e má qualidade do sono.
  • Os sintomas clínicos afetam atividades de vida diária, a produtividade no trabalho e comprometimento de atividades.
  • Funcionalidade, dor e sono estão correlacionados com o desempenho profissional.

Palavras-chave

Avaliação da deficiência, Dor crônica, Infecções por arbovírus, Sono

References

Nunes MRT, Faria NR, de Vasconcelos JM, Golding N, Kraemer MUG, de Oliveira LF. Emergence and potential for spread of Chikungunya virus in Brazil. BMC Med. 2015;13(1):1-10.

Collucci C. Brazil sees sharp rise in chikungunya cases. BMJ. 2016;354:i4560.

Goupil BA, Mores CN. A review of Chikungunya virus-induced arthralgia: clinical manifestations, therapeutics, and pathogenesis. Open Rheumatol J. 2019;10:129-40.

Amaral JK, Bilsborrow JB, Schoen RT. Brief report: the disability of chronic chikungunya arthritis. Clin Rheumatol. 2019;38(7):2011-4.

Tiberville SD, Moyen N, Dupuis-Maguiraga L, Nougairede A, Gould EA, Roques P, de Lamballerie X. Chikungunya fever: epidemiology, clinical syndrome, pathogenesis and therapy. Antiviral Res. 2013;99(3):345-70.

Kennedy Amaral Pereira J, Schoen RT. Management of chikungunya arthritis. Clin Rheumatol. 2017;36(10):2179-86.

Liu LE, Dehning M, Phipps A, Swienton RE, Harris CA, Klein KR. Clinical update on dengue clinical update on dengue, chikungunya, and zika: what we know at the time of article submission. Disaster Med Public Health Prep. 2017;11(3):290-9.

Martí-Carvajal A, Ramon-Pardo P, Javelle E, Simon F, Aldighieri S, Horvath H, Rodriguez-Abreu J, Reveiz L. Interventions for treating patients with chikungunya virus infection-related rheumatic and musculoskeletal disorders: a systematic review. PLoS One. 2017;12(6).

Sharif B, Garner R, Sanmartin C, Flanagan WM, Hennessy D, Marshall DA. Risk of work loss due to illness or disability in patients with osteoarthritis: a population-based cohort study. Rheumatology. 2016;55(5):861-8.

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495-9.

Cabral IV, Garcia ED, Pinto NL, Juliano Y, Veiga Filho J, Ferreira LM, Veiga DF. Increased capacity for work and productivity after breast reduction. Aesthetic Surg J. 2017;37(1):57-62.

Marques CDL, Duarte ALBP, Ranzolin A, Dantas AT, Cavalcanti NG, Gonçalves RSG. Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 – Diagnosis and special situations. Rev Bras Reumatol Engl. 2017;57(^sSuppl 2):421-37.

Maska L, Anderson J, Michaud K. Measures of functional status and quality of life in rheumatoid arthritis: Health Assessment Questionnaire Disability Index (HAQ), Modified Health Assessment Questionnaire (MHAQ), Multidimensional Health Assessment Questionnaire (MDHAQ), Health Assessment. Arthritis Care Res. 2011;63(^sSuppl. 11):4-13.

de Souza CG, da Costa JF, de Sousa Dantas D, de Abreu Freitas RP, Lopes JM, Okano AH. Evaluation of pain, functional capacity and kinesiophobia in women in the chronic stage of chikungunya virus infection: a cross-sectional study in northeastern Brazil. Acta Trop. 2019;199:104853.

Bouquillard E, Fianu A, Bangil M, Charlette N, Ribéra A, Michault A, Favier F, Simon F, Flipo RM. Rheumatic manifestations associated with Chikungunya virus infection: a study of 307 patients with 32-month follow-up (RHUMATOCHIK study). Joint Bone Spine. 2018;85(2):207-10.

Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF36 BPS) and measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res. 2011;63(^sSuppl. 11):S240-52.

Ferreira KA, Teixeira MJ, Mendonza TR, Cleeland CS. Validation of brief pain inventory to Brazilian patients with pain. Support Care Cancer. 2011;19(4):505-11.

Ferreira-Valente MA, Pais-Ribeiro JL, Jensen M. Further validation of a Portuguese Version of the Brief Pain Inventory Interference Scale. Clínica y Salud. 2012;23(1):89-96.

Laguardia J, Campos MR, Travassos C, Najar AL, Anjos LA, Vasconcellos MM. Brazilian normative data for the Short Form 36 questionnaire, version 2. Rev Bras Epidemiol. 2013;16(4):889-97.

Bertolazi AN, Fagondes SC, Hof LS, Dartora EG, Miozzo IC, de Barba ME, Barreto SS. Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Med. 2011;12(1):70-5.

Haglund E, Petersson IF, Bremander A, Bergman S. Predictors of presenteeism and activity impairment outside work in patients with spondyloarthritis. J Occup Rehabil. 2015;25(2):288-95.

Tang K, Beaton DE, Boonen A, Gignac MA, Bombardier C. Measures of work disability and productivity: Rheumatoid Arthritis Specific Work Productivity Survey (WPS-RA), Workplace Activity Limitations Scale (WALS), Work Instability Scale for Rheumatoid Arthritis (RA-WIS), Work Limitations Questionnaire (WLQ), and Work Productivity and Activity Impairment Questionnaire (WPAI). Arthritis Care Res. 2011;63(^sSuppl. 11):S337-49.

Akoglu H. User’s guide to correlation coeficients. Turkish J Emerg Med. 2018;18(3):91-3.

Salazar-Mejía CE, Galarza-Delgado DÁ, Colunga-Pedraza IJ, Azpiri-López JR, Wah-Suárez M, Wimer-Castillo BO, Salazar-Sepúlveda LL. Relationship between work productivity and clinical characteristics in rheumatoid arthritis. Reumatol Clín. 2019;15(6):327-32.

Moizéis RNC, Fernandes TAAM, Guedes PMDM, Pereira HWB, Lanza DCF, Azevedo JWV, Galvão JMA, Fernandes JV. Chikungunya fever: a threat to global public health. Pathog Glob Health. 2018;112(4):182-94.

Pegado R, Cavalcante AF, Morya E. Newer rehabilitation therapies: strategies in chikungunya chronic arthralgia. Clin Med. 2020;20(1):119-20.

Palstam A, Mannerkorpi K. Work ability in fibromyalgia: an update in the 21st century. Curr Rheumatol Rev. 2017;13(3):180-7.

Rohekar S, Pope J. Assessment of work disability in seronegative spondyloarthritis. Clin Exp Rheumatol. 2010;28(1):35-40.


Submitted date:
05/16/2022

Accepted date:
09/20/2022

6399e410a953950c55306865 brjp Articles

BrJP

Share this page
Page Sections