Fatima Ezzahra Abourazzak

The relationship between physical performance measures, bone mineral density, falls, and the risk of peripheral fracture: a cross-sectional analysis

BackgroundSeveral factors, in addition to low bone mineral density (BMD), have been identified as risks for fractures, including reduced levels of physical activity, poor balance and low physical performance. The aim of this study was to evaluate the relationship between physical performance measures, BMD, falls, and the risk of peripheral fracture in a population sample of Moroccan women.Methods484 healthy women were included. Three measures were used to assess physical performance: timed get-up-and-go test TGUGT, five-times-sit-to-stand test 5 TSTS and 8-feet timed walk 8 FTW. The association between physical performance measures and BMD, peripheral fracture and falls was performed by univariate and multivariate analysis.ResultsThe mean age was 55.1 years. Higher TGUGT, 5 TSTS, 8 FTW test scores were associated with lower BMD measured at different sites (p range from < 0.001 to 0.005). The relationship between the three tests and BMD in all measured sites remained significant after multiple linear regression (p range from <0.001 to 0.026). In the group of post-menopausal patients, the scores of TGUGT and 8 FTW were significantly higher in fractured patients compared with patients without. After logistic regression, a score of TGUGT > 14.2 sec, a score of 5 TSTS > 12.9 sec and a score of 8 FTW > 4.6 sec respectively, increased the probability of anterior peripheral fracture by 2.7, 2.2 and 2.3 (OR = 2.7; 95% CI = 1.2–6.4, OR = 2.2; 95% CI = 1.1–5.2; and OR = 2.3; 95% CI = 1.1–5.1). There was a significant positive correlation between the number of fall/year and the 3 tests. This correlation persisted after poisson regression.ConclusionThis study suggested that low physical performance is associated with low BMD, and a high risk of history of falls and fractures.

Two distinct patterns of ankylosing spondylitis in Moroccan patients

Ankylosing spondylitis (AS) is characterised by a geographic differences in terms of prevalence and clinical expression of the disease. The aim of our study was to describe the actual features of AS in Morocco and we wanted to examine a large population of patients for evidence of phenotypic clustering that could suggest the presence of distinct clinical entities. We investigated 117 patients with a diagnosis of primary AS according to the modified New York criteria. All patients were evaluated according to a standardised data collection form, including demographic variables and disease history with clinical and radiological features. To analyse our data and try to individualise clinical subsets, we applied a two-step cluster analysis using log-likelihood distance measures. Patient’s mean age at onset was 25.51xa0±xa010.8 year. The mean BASDAI and BASFI score was 33.5xa0±xa020.3 and 38.9xa0±xa027.5, respectively. Radiographic damage was present in 99.1% of the subjects and radiographic hip involvement in 47.3%. Only 52.6% of patients had been treated with disease modifying antirheumatic drugs. Cluster analysis detected two distinct populations within the data set. Statistically significant differences were found between the two groups particularly concerning activity of the disease, age at onset and the hygienic conditions. Our study revealed that the Moroccan AS was active and severe and suggested that the age at onset and the precarious hygienic level has the greatest capacity to predict activity and severity of the disease.

Psychometric evaluation of a Moroccan version of health assessment questionnaire for use in Moroccan patients with rheumatoid arthritis

Objective of the study is to test the reliability and validity of a translated version of health assessment questionnaire (HAQ) on Moroccan patients with rheumatoid arthritis (RA). We led a prospective study from July 2004 to September 2005. A total of 100 Moroccan patients were recruited. After translation to dialect Arabic, back translation, expert committee review and pretesting of the questionnaire, it was administered to the selected patients and tested for construct validity, reliability and internal consistency. The construct validity was evaluated by correlating the yield of the questionnaire with other disease activity and severity parameters. The questionnaire was administered again after a time interval of between 2 and 10xa0days for evaluation of the reliability of this test. All the items were tested for their loyalty to the principal component. The adapted questionnaire showed a good internal consistency. Cronbach’s alpha test was 0.994. The test–retest showed a strong reliability with a kappa test ranging from 0.70 to 0.92 for all domains. Intraclass correlation coefficient for the total score was 0.987. The Moroccan HAQ showed a strong validity. It correlates significantly with disease activity and severity parameters. The unidimentionality has been demonstrated. About 71.5% of all variabilities was accounted for by the first principal component. The Moroccan Arabic dialect version of HAQ is a reliable and valid instrument that can be self-administered by Moroccan RA patients to assess their functional disability.

Factors influencing quality of life in Moroccan postmenopausal women with osteoporotic vertebral fracture assessed by ECOS 16 questionnaire

ObjectiveThe aim of the study was to evaluate factors influencing quality of life (QOL) in Moroccan postmenopausal women with osteoporotic vertebral fracture assessed by the Arabic version of ECOS 16 questionnaire.Methods357 postmenopausal women were included in this study. The participants underwent bone mineral density (BMD) measurements by DXA of the lumbar spine and the total hip as well as X-ray examination of the thoraco-lumbar spine to identify subclinical vertebral fractures. Patients were asked to complete a questionnaire on clinical and sociodemographic parameters, and osteoporosis risk factors. The Arabic version of the ECOS16 (Assessment of health related quality of life in osteoporosis questionnaire) was used to assess quality of life.ResultsThe mean age was 58 ± 7.8 years, and the mean BMI was 28.3 ± 4.8 kg/m2. One hundred and eight women (30.1%) were osteoporotic and 46.7% had vertebral fractures. Most were categorized as Grade1 (75%). Three independent factors were associated with a poor quality of life: low educational level (p = 0,01), vertebral fracture (p = 0,03), and history of peripheral fracture (p = 0,006). Worse QOL was observed in the group with vertebral fracture in all domains except pain: Physical functioning (p = 0,002); Fear of illness (p = 0,001); and Psychosocial functioning (p = 0,007). The number of fractures was a determinant of a low QOL, as indicated by an increased score in physical functioning (p = 0,01), fear of illness (p = 0,007), and total score (p = 0,01) after adjusting on age and educational level. Patients with higher Genant score had low QOL in these two domains too (p = 0,002; p = 0,001 respectively), and in the total score (p = 0,01) after adjusting on age and educational level.ConclusionOur current data showed that the quality of life assessed by the Arabic version of the ECOS 16 questionnaire is decreased in post menopausal women with prevalent vertebral fractures, with the increasing number and the severity of vertebral fractures.