Maintenance of physical function with advancing age is vital to continued independent living, which is highly valued by older people. Although commonly associated with the ageing process, loss of functional ability may well be accelerated by inactivity and subsequent decreasing physical capacities, such as muscle performance or balance abilities. The impact of increased levels of activity on physical performance and functional ability was investigated by a single blind randomised controlled study.Two intervention programs, one based on increased levels of physical activity and the second on increased levels of social activity, were provided to a group of community-living participants aged 75 years and over. Another group, receiving no intervention was also included. The exercise intervention offered twice weekly sessions of exercise over a 16-week period. This was designed and supervised by physiotherapists. The social intervention offered a weekly, two-hour session over 13 weeks. Baseline, post-intervention and follow-up assessments measured aspects of physical performance (muscle, balance, gait and step height performance) and functional ability (tiredness of limbs, mobility tiredness and the need for assistance with mobility and activities of daily living). In addition, all participants completed a monthly health and falls report. One hundred and forty-nine subjects were admitted into the study with 108 completing the intervention phase and all four assessments.Analysis of data indicated that the exercise intervention was effective in improving muscle performance (shoulder abduction mean difference 13.00, 95%CI 11.63-14.37; hip abduction mean difference 5.97, 95%CI 4.73-7.20; knee flexion mean difference 4.10, 95%CI 3.32-4.88; dorsiflexion mean difference 4.72, 95%CI 3.74-5.71), dynamic balance ability (Functional Reach mean difference 11.45, 95%CI 9.41-13.48), ++ / maximal gait speed (mean difference 0.62, 95%CI 0.50-0.74) and step height performance (mean difference 0.19, 95%CI 0.01-0.29). Improvements in dynamic balance and maximal walk performance were maintained for a period of four months following cessation of the intervention. The social program did not affect aspects of physical performance.Functional improvements were evident for both exercise and social subjects. Immediate improvements in limb tiredness (upper mean difference 0.37, 95%CI -0.11-0.84; lower mean difference 0.63, 95%CI 0.37-0.89) and mobility tiredness (mean difference 1.43, 95%CI 1.16-1.70) and activities of daily living dependence (mean difference 0.25, 95%CI -0.23-0.75) were demonstrated. Four and eight months later, exercise subjects had maintained the improvement in mobility tiredness and activities of daily living dependence. Mobility dependence showed a delayed improvement in both the exercise and social intervention participants. This improvement was not evident immediately following intervention, but emerged at both the four and eight month follow-up assessments.An intention to treat analysis (involving both completing and non-completing subjects) confirmed the usefulness of the exercise intervention as a strategy to improve and maintain functional ability in older subjects, specifically with regard to tiredness of the lower limbs, tiredness during mobility tasks and activities of daily living dependence. In addition, following the cessation of the exercise intervention, participants reported less mobility tiredness and dependence in activities of daily living tasks over the following eight-month period.The relationship between physical performance and functional ability indicated that muscle performance and limb tiredness were significantly associated. Decreased muscle performance of the upper limb was associated with reports of increased ++ / tiredness during functional activities involving the upper limb, such as combing hair and dressing the upper body. Similarly, decreased muscle performance of the lower limb, especially proximally, was associated with increasing tiredness of the lower limb during functional activities. Further, decreased proximal muscle performance of both the upper and lower limb was significantly associated with decreasing independence in the performance of physical activities of daily living. These results indicate the significant influence of muscle performance on functional ability, especially on tiredness of the limbs and activities of daily living dependence.The ability to predict future functional limitation, based on decreasing physical performance, was examined and shown to be of limited value. Hip muscle performance and changes in usual gait speed were poorly associated with increased lower limb tiredness and dependence in physical activities of daily living respectively. The lack of a robust relationship between variables of physical performance and functional ability measures indicates that loss of physical performance is not strongly associated with the development of functional limitations.Self-reported falls were monitored throughout the study. A significant increase in the number of participants reporting falls was evident in both the social intervention group and the control group throughout the study. In contrast, there was no change in the number of exercise participants reporting falls. These results suggest that the exercise intervention was effective at minimising the usual increase in the number of older people experiencing falls over time.The results of this study suggest that the exercise intervention program was effective in improving physical performance in elderly subjects. This also resulted in improved functional ability. Positive effects continued ++ / following completion of the program as improvements in mobility and activities of daily living tasks were demonstrated for a further eight months. By contrast, the social intervention program appeared to influence only the need for help with mobility tasks in the longer term.Increased physical activity, in the form of an exercise intervention program, specifically designed for community-living elderly people, can improve and maintain functional ability, both immediately and for up to eight months following the completion of the program. As such, involvement in exercise, even in the short-term, should be encouraged as a means of maintaining physical independence in later life. Therapists devising exercise programs specifically for older people should ensure that the associated outcome measures incorporate assessments of functional ability and not simply measures of impairment. This study has demonstrated that a real benefit of increased physical activity in older people may well be the increased physical independence associated with participation.

The purpose of the present investigation is to add to existing research on functional ability as it relates to the diagnosis of mild cognitive impairment (MCI) by modifying a report-based measure, me Scales of Independent Behavior-Revised (SIB-R), to use in an elderly population. Self- and informant-reports (e.g. spouse) of participants' functional status were obtained on the modified SIB-R (mSIB-R) from a sample of community-dwelling, non-demented older adults, ranging in age from 66 to 92. Participants also completed various measures of motor skills, cognitive functioning and a performance-based measure of functional ability. The mSlB-R demonstrated sound psychometric properties as a comprehensive measure of functional ability in this population, but the nature of functional ability measured is impacted by the mode of report (self. other). Higher cognitive functioning is associated with functional independence; however. the functional ability-cognition relationship differed depending on the mode of report and the aspect of functional ability examined. When baseline mSIB-R and an index of one-year functional decline were used in longitudinal analysis. both baseline and decline scores were useful in predicting cognitive status in three years. However, baseline functional ability did not provide additive information over and above cognitive measures in this regard. Similarly, born baseline and decline scores did not predict changes in cognitive status over three years. Using attrition as me outcome measure, functional ability and cognitive measures both predicted attrition from the study three years later. These. results suggest that functional disability is observed among community-dwellers with varying degrees of cognitive impairment, but the inclusion of functional disability in the diagnostic criteria of MCI do not appear to improve the prediction of long term cognitive status changes. Moreover, characteristics of individuals who drop out of studies differed from those who remained, suggesting that attrition effects need to be considered in longitudinal studies. / Graduate

BACKGROUND Chronic pain is a common condition in children with juvenile idiopathic arthritis (JIA), affecting their ability to participate in physical activity, a necessary and integral part of a child’s growth and maturation. Resistance training specifically displays a paucity of research in children with JIA, and could potentially be a beneficial form of exercise training for this population. The purpose of this study was to determine the safety, feasibility, and effects of a six week resistance training program on pain in children with JIA. METHODS Seven JIA patients (8-18 years) participated in a home-based, three days per week exercise training program. Pain was measured using an electronic pain diary (PinGo©) for Android tablets. Participants answered questions initially a week prior to training, once a day on non-exercise days and three times a day (before exercise, after exercise, and end of day) on exercise days for a total of seven weeks. Secondary outcome measures included muscle size, muscle strength, and functional ability, measured at baseline and following the 6 week exercise program. Statistical analyses included attaining the average number of exercise sessions completed, pain changes over the seven weeks (averaged over the initial week and then biweekly) via repeated measures ANOVA, dependent t tests between before and after exercise pain intensity and affect, and dependent t tests between secondary outcomes. RESULTS Seven participants completed an average of 13.0 ± 3.6 exercise sessions out of a possible 18. The repeated measures ANOVA revealed no significant differences between pain scores over the seven weeks within each individual (p>0.05). When all participants were pooled dependent t tests before and after exercise showed no differences in pain intensity or pain affect (p>0.05). Secondary measures revealed a significant difference between vastus lateralis thickness before compared to after training (p<0.05). CONCLUSIONS The results of this study suggest that a 6 week home-based resistance training program was tolerable in children with JIA and did not cause a clinically significant increase in pain or any other adverse events. The uniqueness of this exercise program was that it was home-based, allowing children to undertake this emerging form of healthcare within their home environment. As well, the training program was able to significantly improve aspects of fitness in this population. Further research of resistance training in children with JIA is necessary to attain definitive results of its effects and optimal levels of resistance exercise in this population.

The functional abilities of 319 elderly individuals with dementia were assessed using an objective, performance-based measure (the Direct Assessment of Functional Abilities) and caregiver’s report (through the Assessment of Daily Activities and Dementia Severity Rating Scale). The association between the objective measure and caregiver report was examined. Logistic regression analyses demonstrated that caregivers’ reports of instrumental activities of daily living and basic activities of daily living were significantly associated with an objective measure of these functional abilities. Additionally, potential moderating variables were examined. None of the caregiver variables of gender, age, education level, caregiver-care recipient relation, prior and current relationship closeness, and frequency of contact were significant moderators of the association between caregiver report and the objective measure. Caregiver depression, anxiety, emotional status, and distress did not moderate this association. Additionally, none of the care recipient variables of cognitive status, depression, psychiatric symptoms, or dementia duration moderated the association between caregivers’ reports and the objective measure; however, the care recipients’ sensory motor impairments (hand, vision, or hearing impairments) significantly moderated the association between the objective measure and caregiver reports on one measure of functional ability. That is, when the caregiver report indicated mild/moderate functional impairment, the care recipient was 6.52 times as likely to be classified in the more severe group on the objective measure when sensory motor impairments were severe (p < 0.02), whereas the caregiver report and the objective measure were not associated for those care recipients whose caregiver report score indicated severe impairment when sensory motor impairments were mild/moderate (p = 0.24). These results provide some support for the use of proxy reports of functional abilities, with caution advised when the care recipient displays sensory motor impairments.

Student Number: 9602675T Master of Science in Physiotherapy. Faculty of Health Sciences / The purpose of the study was to compare the outcome in patients following primary total hip arthroplasty, between those receiving a mobility programme alone, as compared to bed exercises and a mobility programme, at discharge from hospital. Thirty-six patients were randomly allocated to either the control or experimental group using a concealed allocation process. The control group received a programme of supervised bed exercises and were mobilised according to the standard postoperative mobility protocol. The experimental group were mobilised according to standard protocol. On the third/fourth and sixth/seventh day postoperatively, patients were assessed by a blinded assessor on functional ability, pain at rest, and active range of hip flexion and abduction. The results indicated no difference in functional ability (p=0.99), pain at rest (p=0.83) and active range of hip flexion (p=0.19) or abduction (p=0.12), on the seventh/eight day postoperatively, between the control and experimental groups. In conclusion bed exercises appear to offer no additional benefit to patients post THA, during the acute hospitalisation phase. However this should not be extrapolated to THA patients who have prolonged bed rest periods postoperatively.

Apie 70% vaikų, sergančių lėtiniais artritais, suaugusiųjų amžių pasiekia su tam tikru negalios lygiu ir kasdienės veiklos apribojimu. Todėl ypač aktualu nagrinėti vaikams lėtinių artritų priežastis bei prognostinius veiksnius ankstyvose sąnarių ligos stadijose. Mūsų darbo tikslas buvo nustatyti ar ūminėje ligos fazėje nustatomų laboratorinių, imunologinių ir interleukinų (MRP8/14 (kalprotektinas), IL-6, IL-33) rodiklių pokyčiai, funkcinės būklės vertinimas bei ligos aktyvumas gali prognozuoti vaikams lėtinę sąnarių ligą. Atliktas tyrimas parodė, kad artritu susirgusiems vaikams MRP8/14 (kalprotektino) ir Il-6 koncentracijos buvo reikšmingai didesnės nei kontrolinės grupės vaikams tiek serume, tiek sinoviniame skystyje (p<0,01). Kalprotektinas ir IL-6 ūminėje ligos stadijoje stipriai koreliavo su ligos aktyvumo rodikliais (ENG, CRB, sąnarių pobūdžiu (poliartritu), rytiniu sąnarių sustingimu). Taip pat nustatėme, kad didelės kalprotektino (> 5785 ng/ml) ir IL-6 (> 5,5 pg/ml) koncentracijos ūminėje artrito stadijoje buvo nustatytos tiems pacientams, kuriems sąnarių liga įgavo lėtinę eigą. Vertinome tai, kaip reikšmingus lėtinės sąnarių ligos kriterijus. Šiame darbe sergančių artritų vaikų funkcinė būklė ir vaiko gyvenimo kokybė pirmą kartą Lietuvoje buvo įvertinta naujai įdiegiamu ne tik Lietuvoje, bet ir pasaulyje, įvairiapusiu jaunatvinių artritų vertinimo klausimynu JAMAR, bei duomenys palyginti su seniau Lietuvoje naudojamu vaiko sveikatos būklės vertinimo klausimynu... [toliau žr. visą tekstą] / The earlier studies proved that nearly 70% of children with chronic arthritis reach the adulthood with a certain level of disability and restriction of daily activities. Therefore, it is very important to analyse the causes of arthritis and prognostic factors in the early stages of disease. The aim of our study was to determine whether the changes of laboratory, immunological and interleukins (MRP8/14 (calprotectin), IL-6, IL-33) indexes, assessment of functional condition, and disease activity may predict a chronic arthritis in children. The study showed that MRP8/14 (calprotectin) and Il-6 concentrations in the serum and synovial fluid of children with arthritis were significantly higher than in the control group of healthychildren (p<0.01). During the acute stage of disease, calprotectin and IL-6 concentrations strongly correlated with variables of disease activity (ESR, CRP, polyarthritis, morning stiffness of joints). Also, the analysis showed that high concentrations of calprotectin (> 5785ng/ml) and IL-6 (> 5.5 pg/ml) at the acute stage of arthritis were determined for those patients, whose were developed chronic arthritis. It was evaluated as significant criterion of the chronic joint disease. For the first time in Lithuania, the functional ability and the quality of life in children with arthritis were assessed using a newly introduced multidimensional assessment questionnaire for juvenile arthritis (JAMAR), and data was compared... [to full text]

Apie 70% vaikų, sergančių lėtiniais artritais, suaugusiųjų amžių pasiekia su tam tikru negalios lygiu ir kasdienės veiklos apribojimu. Todėl ypač aktualu nagrinėti vaikams lėtinių artritų priežastis bei prognostinius veiksnius ankstyvose sąnarių ligos stadijose. Mūsų darbo tikslas buvo nustatyti ar ūminėje ligos fazėje nustatomų laboratorinių, imunologinių ir interleukinų (MRP8/14 (kalprotektinas), IL-6, IL-33) rodiklių pokyčiai, funkcinės būklės vertinimas bei ligos aktyvumas gali prognozuoti vaikams lėtinę sąnarių ligą. Atliktas tyrimas parodė, kad artritu susirgusiems vaikams MRP8/14 (kalprotektino) ir Il-6 koncentracijos buvo reikšmingai didesnės nei kontrolinės grupės vaikams tiek serume, tiek sinoviniame skystyje (p<0,01). Kalprotektinas ir IL-6 ūminėje ligos stadijoje stipriai koreliavo su ligos aktyvumo rodikliais (ENG, CRB, sąnarių pobūdžiu (poliartritu), rytiniu sąnarių sustingimu). Taip pat nustatėme, kad didelės kalprotektino (> 5785 ng/ml) ir IL-6 (> 5,5 pg/ml) koncentracijos ūminėje artrito stadijoje buvo nustatytos tiems pacientams, kuriems sąnarių liga įgavo lėtinę eigą. Vertinome tai, kaip reikšmingus lėtinės sąnarių ligos kriterijus. Šiame darbe sergančių artritų vaikų funkcinė būklė ir vaiko gyvenimo kokybė pirmą kartą Lietuvoje buvo įvertinta naujai įdiegiamu ne tik Lietuvoje, bet ir pasaulyje, įvairiapusiu jaunatvinių artritų vertinimo klausimynu JAMAR, bei duomenys palyginti su seniau Lietuvoje naudojamu vaiko sveikatos būklės vertinimo klausimynu... [toliau žr. visą tekstą] / The earlier studies proved that nearly 70% of children with chronic arthritis reach the adulthood with a certain level of disability and restriction of daily activities. Therefore, it is very important to analyse the causes of arthritis and prognostic factors in the early stages of disease. The aim of our study was to determine whether the changes of laboratory, immunological and interleukins (MRP8/14 (calprotectin), IL-6, IL-33) indexes, assessment of functional condition, and disease activity may predict a chronic arthritis in children. The study showed that MRP8/14 (calprotectin) and Il-6 concentrations in the serum and synovial fluid of children with arthritis were significantly higher than in the control group of healthychildren (p<0.01). During the acute stage of disease, calprotectin and IL-6 concentrations strongly correlated with variables of disease activity (ESR, CRP, polyarthritis, morning stiffness of joints). Also, the analysis showed that high concentrations of calprotectin (> 5785ng/ml) and IL-6 (> 5.5 pg/ml) at the acute stage of arthritis were determined for those patients, whose were developed chronic arthritis. It was evaluated as significant criterion of the chronic joint disease. For the first time in Lithuania, the functional ability and the quality of life in children with arthritis were assessed using a newly introduced multidimensional assessment questionnaire for juvenile arthritis (JAMAR), and data was compared... [to full text]

INTRODUÃÃO: Um dos elementos principais da saÃde do idoso diz respeito à sua capacidade funcional e aptidÃo fÃsica. A escala de Katz à um dos diversos instrumentos utilizados para avaliar a capacidade funcional do idoso, mas seu desempenho para esta proposta nÃo tem sido avaliado no contexto dos serviÃos de saÃde do Brasil. Ademais, à importante para o planejamento de aÃÃes de saÃde se identificar o perfil no que se refere à aptidÃo fÃsica dos idosos brasileiros atendidos em unidades de saÃde. OBJETIVOS - O presente estudo teve como objetivos descrever o perfil funcional e a aptidÃo fÃsica de idosos atendidos em uma unidade secundÃria de saÃde na cidade de Fortaleza, CearÃ; e avaliar o desempenho da escala de Katz para rastreio da aptidÃo fÃsica quando comparada com um teste objetivo de avaliaÃÃo fÃsica desenvolvido especificamente para idosos (Senior Fitness Test). DELINEAMENTO/PARTICIPANTES: Estudo transversal com uma amostra de 133 indivÃduos (22 homens e 111 mulheres) com sessenta anos ou mais e que procuraram uma consulta com mÃdico generalista numa unidade secundÃria de saÃde, no caso especÃfico, o Centro de AtenÃÃo ao Idoso da Universidade Federal do CearÃ. RESULTADOS: A faixa etÃria dos participantes foi de 71 anos + 6,5. A maioria da amostra (86,4%) atingiu o escore da escala de Katz compatÃvel com independÃncia funcional. Por outro lado, quase a metade dos idosos (47,3%) apresentou escores crÃticos nas capacidades motoras avaliadas pelo Senior Fitness Test (forÃa, flexibilidade, potÃncia aerÃbia e mobilidade corporal). NÃo houve diferenÃa significativa quanto à aptidÃo fÃsica entre indivÃduos totalmente independentes e indivÃduos que relataram dificuldade em algum dos itens da escala de Katz. Os testes fÃsicos com Ãndices mais baixos foram os que avaliaram a potÃncia aerÃbia e flexibilidade dos mÃsculos que compÃem a cadeia posterior, enquanto que forÃa de membros inferiores e superiores foram os itens com resultados mais satisfatÃrios. Entre as variÃveis socioeconÃmicas analisadas, a idade, o sexo, a escolaridade e o arranjo familiar apresentaram associaÃÃo com alguns dos itens avaliados. CONCLUSÃO â Quase a metade de idosos atendidos em uma unidade secundÃria de saÃde apresentaram comprometimento importante da aptidÃo fÃsica, representando um segmento que necessita potencialmente de intervenÃÃo fÃsica. A escala de Katz nÃo se mostrou adequada para rastreio de comprometimento de aptidÃo fÃsica em idosos que acorrem à unidade de saÃde. / RATIONAL â Functional status is one of the key elements for the health of elderly people. Although Katz index is widely used scale for measuring functional status, its validity has not been assessed in the Brazilian context.Furthermore, detailed data on the functional status of elderly people attending secundary care health units in Brazil are not available. OBJECTIVES â the aims of this study were to describe the profile of the functional status and physical fitness of elderly patients attending secondary care health units in a Brazilian city; to assess the performance of the Katz index to screen for physical function impairment against objective tests to assess physical function (gold-standard). DESIGN/PARTICIPANTS â cross-sectional study among elderly patients attending a secundary care health unit in Brazil. RESULTS - 133 patients were enrolled (111 female, 22 male), the mean age of the sample was 71+ 6.5 years. The great majority (86.4%) was classified by the Katz index as functionally independent, but 47.3% were found with functional impairment when assessed by physical tests. There was no association between the scores of physical performance assessed by Katz index and those by the physical tests. The most critically impaired physical domains were aerobic endurance and flexibility of back muscles. The impairment of certain physical domains was associated with age and literacy. CONCLUSIONS â A high proportion of elderly patients attending a secondary care health unit showed physical function impairment, representing those who need physical intervention. In such setting Katz index is not a valid instrument to screen for physical impairment.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-17T21:08:16Z No. of bitstreams: 1 Glaucio Carneiro Costa.pdf: 1285322 bytes, checksum: 68a9e24ea8269708f461cc46ecc78e00 (MD5) / Made available in DSpace on 2018-07-17T21:08:16Z (GMT). No. of bitstreams: 1 Glaucio Carneiro Costa.pdf: 1285322 bytes, checksum: 68a9e24ea8269708f461cc46ecc78e00 (MD5) Previous issue date: 2016-12-13 / The Glittre AVD test (TGlittre) is a specific test to evaluate functional limitation in patients with chronic obstructive pulmonary disease, but it is not known whether it can be used to assess the capacity and performance of post-stroke patients. Objectives: To analyze the validation of TGlittre construct for hemiparetic patients due to stroke. METHODS: construct validity was analyzed using classical psychometry that established the use of well defined statistical methods, 30 hemiparetic adults after stroke and 20 healthy adults, matched in gender and age, according to eligibility criteria. The results were correlated to the 6-min walk test (TC6), time up and go (TUG) and functional independence measure scale (MIF) to analyze construct validity. The tests were randomized, performed on two consecutive days by the same evaluator. Data were submitted to the Shapiro Wilk normality test. The time of execution of the test between the groups was compared by the Mann-Whitney test. RESULTS: There was a strong and significant correlation between the AVD-Glittre versus the 6MT (r = -0.91, p <0.001), TUG (r = 0.82, p <0.001) 0.47, p <0.008). Conclusions: The AVD-Glittre was valid for evaluation of functional capacity and performance of hemiparetic patients after stroke. The Glittre AVD test is reliable when correlated with other tests already validated under different health conditions. / O teste de AVD Glittre (TGlittre) é um teste específico para avaliar a limitação funcional em pacientes com doença pulmonar obstrutiva crônica, porém não se sabe se pode ser utilizado para avaliar a capacidade e desempenho de pacientes pós Acidente Vascular Encefálico (AVE). Objetivos: validar o TGlittre para pacientes hemiparéticos decorrente de AVE. Métodos: a validade de construto foi analisada por meio da psicometria clássica que estabelece o emprego de métodos estatísticos bem definidos, participaram 30 adultos hemiparéticos pós AVE e 20 adultos saudáveis, pareado em gênero e idade, conforme critérios de elegibilidade. Os resultados foram correlacionados aos testes de caminhada de 6 min (TC6), time up and go (TUG) e escala de medida de independência funcional (MIF) para analisar a validade de construto. Os testes foram aleatorizados, realizados em dois dias consecutivos pelo mesmo avaliador. Os dados foram submetidos ao teste de normalidade Shapiro Wilk. O tempo de execução do teste entre os grupos foram comparados pelo teste Mann-Whitney. Resultados: houve correlação forte e significativa entre os testes AVD-Glittre versus TC6 (r=-0,91; p<0,001), TUG (r=0,82; p<0,001) e uma correlação moderada versus MIF (r=-0,47; p<0,008). Conclusões: O AVD-Glittre mostrou-se válido para avaliação da capacidade funcional e desempenho de pacientes hemiparéticos pós AVE. O teste AVD Glittre demonstra-se confiável quando correlacionado com outros testes já validados em condições de saúde distintas.

In this longitudinal pilot study, magnetic resonance imaging (MRI) and Early Erosions in Rheumatoid Arthritis (EERA) software were used to quantify bone erosive damage in the metacarpophalangeal (MCP) 2-5 joints of the worst-affected hand (i.e. greatest swelling and tenderness at baseline) of patients with rheumatoid arthritis (n=35). Firstly, Spearman’s rho (rs) was used to evaluate the correlation between total change in sum erosive damage and change in functional ability, as well as the correlation between rate of change in sum erosive damage and change in functional ability. The rs (p-value) for total change and rate of change in sum erosive damage was 0.099 (0.585) and 0.104 (0.565), respectively. Therefore, the null hypothesis that neither variable was associated with change in functional ability could not be rejected. Participants were also classified into three groups based on total change in sum erosive damage (improvement, stable or progression) and were examined for possible differences in a variety of measures using an exploratory, non-statistical approach. Most notably, participants in the improvement group had more than five times the mean sum erosive damage at baseline compared to the progression group and also appeared to be the least aggresively medicated of the three cohorts. This study is the first to apply EERA in a way that helps to address clinically important questions related to change in erosive damage and functional ability. Future studies should use the ideas and concepts generated in this pilot study to further explore the use of this highly reproducible erosion quantification software, with the ultimate goal of expanding the applications of EERA in both the research and clinical settings. / Thesis / Master of Science (MSc) / In this study, the hands of patients with rheumatoid arthritis (RA) were assessed using magnetic resonance imaging (MRI) to investigate how erosive damage to the bone changes over time. Specialized computer software entitled Early Erosions in Rheumatoid Arthritis (EERA) was used to perform this analysis. Firstly, change in erosive damage was not found to be related to change in functional ability (e.g. eating, grip, etc.). Secondly, it appeared that individuals who demonstrated improvement in bone damage over time had significant damage at the beginning of the study period. Overall, this study provides new information for researchers and clinicians in terms of how this unique software can be used to enhance our understanding of RA. Future studies will continue to explore ways in which this software can be applied to address questions that are important to RA patients.