Abstract
Objective: To carry out a cross-sectional study of patients with rheumatoid arthritis (RA) for hand disability, articular damage and to define their relation with demographic, laboratory and clinical parameters. Methods: The study included 105 RA patients with a mean age of 49.4 years. Demographic parameters of the patients were recorded. Clinical parameters including disease duration, duration of morning stiffness, pain assessed by visual analog scale, Ritchie Articular Index, grip strength, lateral, tip and three-fingered pinch, and laboratory parameters comprising C-reactive protein, erythrocyte sedimentation rate and rheumatoid factor were evaluated in all patients. The Rheumatoid Arthritis Articular Damage (RAAD) score was used to assess the irreversible articular damage and deformities of the hand. Hand disability was assessed by the special hand disability index of Standford Health Assessment Questionnaire (HAQ). Results: Hand disabilities of various levels were detected in 81% of the patients. Disease duration, grip strength, pinch measurements, clinical and laboratory activity parameters were strongly correlated with hand disability (p<0.01). Hand disability was more related to disease activity parameters than articular damage (p<0.01 and p<0.05, respectively). Grip strength and pinch measurements were the most related parameters with hand disability. The disability scores were significantly higher in female patients (p<0.01). The RAAD score was correlated with disease duration and grip strength (p<0.01). The clinical and laboratory parameters and seropositivity were not correlated with articular damage assessed by RAAD score (p>0.05). Conclusion: Our data suggest that grip strength and pinch measurements seem to be the most related variables with hand disability and articular damage. Therefore, grip strength and pinch measurement should be included in the evaluation and follow-up of the patients with RA in hand rehabilitation units.
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References
Dellhag B, Hosseini N, Bremell T, Ingvarsson PE (2001) Disturbed grip function in women with rheumatoid arthritis. J Rheumatol 28(12):2624–2633
O’Dell JR (2001) Rheumatoid arthritis: the clinical picture. In: Koopman WJ (ed) Arthritis and allied conditions, 14th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1153–1186
Beeamy N, Buchanan WW (2001) Clinical evaluation in the rheumatic disease. In: Koopman WJ (ed) Arthritis and allied conditions, 14th edn. Lippincott Williams & Wilkins, Philadelphia, pp 51–57
Ritchie DM, Boyle JA, McInnes JM et al (1968) Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arhritis. Quart J Med N Ser XXXVII:393–406
Catherine A, Keeling C (2002) Range of motion measurement of the hand. In Mackin EJ, Callahan AD, Skirven TM, Schneider LH, Osterrman AL (eds) Rehabilitation of the hand and upper extremity, 5th edn. Mosby Inc, St Louis, MO, pp 169–182
Zijlstra TR, Moens BHJ, Bukhari MAS (2002) The rheumatoid arthritis articular damage score: first steps in developing a clinical index of long term damage in RA. Ann Rheum Dis 61:20–23
Aoliciano PL (2002) Clinical examination of the hand. In Mackin EJ, Callahan AD, Skirven TM, Schneider LH, Osterrman AL (eds) Rehabilitation of the hand and upper extremity, 5th edn. Mosby Inc, St Louis, MO, pp 120–143
Küçükdeveci A, Sahin H, Ataman S, Griffiths B, Tennant A (2004) Issues in cross-cultural validity: example from adaptation, reliability and validity of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum 51(1):14–19
Eberhardt K, Johnson PM, Rydgren L (1991) The occurence and significance of hand deformities in early rheumatoid arthritis. Br J Rheumatol 30:211–213
Towheed TE, Anastassiades TP (1994) Rheumatoid hand: practical approach to assessment and management. Can Fam Physician 40:1303–1309
Spiegel TM, Spiegel JS, Paulus HE (1987)The joint alignment and motion scale: a simple measure of joint deformity in patients with rheumatoid arthritis. J Rheumatol 14(5):887–892
Van Vugt RM, van Jaarsveld CHM, Hofman DM, Helders PJM, Bijlsma JWJ (1999) Patterns of disease progression in the rheumatoid wrist: a long term followup. J Rheumatol 26(7):1467–1473
Jones E, Hanly JG, Mooney R, Rand LL, Spurway PM, Eastwood BJ, Jones JV (1991) Strength and function in the normal and rheumatoid hand. J Rheumatol 18(9):1313–1318
Fitzpatrick R, Ziebland S, Jenkinson C, Mowat A, Mowat An (1993) A comparison of the sensivity to change of several health status instruments in rheumatoid arthritis. J Rheumatol 20(3):429–436
Wolfe F, Catley MA (1991) The assessment and prediction of functional disability in rheumatoid arhritis. J Rheumatol 18(9):1298–1306
Adams j, Burridge J, Mullee M, Hammond A, Coopper C (2004). Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population. Clin Rehabil 18(4):405–413
Sherrer YS, Bloch DA, Mitchell DM, Young DY, Fries JF (1986) The development of disability in rheumatoid arthritis. Arthritis Rheum 29:494–500, 598–600
Belghomari H, Saraux A, Allain J, Guedes C, Younou P, Goff P (1999) Risk factors for radiographic articular decstruction of hands and wrist in rheumatoid arthritis. J Rheumatol 26(12):2534–2437
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Bodur, H., Yılmaz, Ö. & Keskin, D. Hand disability and related variables in patients with rheumatoid arthritis. Rheumatol Int 26, 541–544 (2006). https://doi.org/10.1007/s00296-005-0023-1
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DOI: https://doi.org/10.1007/s00296-005-0023-1