Which Muscles’ Strength in Upper Extremity are Related to Disease Activity, Functionality, and Disability in Patients with Rheumatoid Arthritis?

Yıl 2019, Cilt: 45 Sayı: 2, 137 - 144, 01.08.2019

Ozan Volkan Yurdakul , Okan Küçükakkaş

https://doi.org/10.32708/uutfd.524930

Öz

The aim of this study is to investigate which
muscle groups are affected in dominant upper extremity, and relation of these
effects with disease activity, functionality, disability in patients with
rheumatoid arthritis (RA) which causes muscle strength loss. 30 RA patients, 30 healthy volunteers were included in this
study. In patient group, "disease activity score-28 (DAS28)",
"upper extremity functional index-15 (UEFI-15)", "health
assessment questionnaire (HAQ)" scores were calculated. From dominant
upper extremities of volunteers; maximum and average muscle strengths of thumb
interphalangeal (IP), metacarpophalangeal (MCP), proximalinterphalangeal (PIP)
and MCP joint flexors of other fingers, wrist and elbow flexors/extensors,
flexor, extensor, internal rotator (IR), external rotator (ER),
abductor/adductor muscles of shoulder were measured. Total PIP/MCP (PIPtotal,
MCPtotal) values of patients were obtained. There was no significant difference between patient and control groups
in age/height. In muscle strengths;
thumb IP, MCP/PIPtotal, MCPtotal, wrist flexion mean and
maximum values were significantly lower in RA group than control group; mean
shoulder extension, maximum adduction/abduction, mean muscle strengths were low
in RA group. DAS28, finger flexors, wrist extensors, shoulder muscles except ER
were negatively related; UEFI-15 scores, wrist extensor, shoulder girdle
muscles were positively related. HAQ scores were associated with mean wrist
flexion, elbow extension, shoulder girdle muscles. Although hand and wrist
muscles are the most affected by disease activity, it has been observed that
elbow and shoulder girdle muscles affect functionality and disability more.
Total strength of upper extremity muscles has been associated with disease
activity, functionality and disability. 

Anahtar Kelimeler

rheumatoid arthritis, muscle strenght, DAS28, UEFI-15, HAQ

Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik ve Engellilik ile İlişkilidir?

Öz

Bu çalışmada kas gücü kaybına neden olan romatoid
artrit (RA) hastalarında; dominant üst ekstremitede hangi kas gruplarının
etkilendiğinin, bu etkilenmelerin hastalık aktivitesi, fonksiyonellik ve
engellilik ile ilişkisinin araştırılması amaçlanmıştır. Çalışmaya 30 RA hastası,
30 sağlıklı gönüllü dahil edildi. Hasta grubunda "hastalık aktivite skoru-28 (DAS28)”, “üst ekstremite fonksiyonel indeksi-15 (UEFI-15)” ve “sağlık
değerlendirme anketi (HAQ)” skorları hesaplandı. Gönüllülerin dominant üst
ekstremitelerinden; başparmak interfalanjiyal (IP) ve metakarpofalanjiyal
(MKF), diğer parmakların proksimal interfalanjiyal (PIP) ve MKF eklem
fleksörlerinden, el bileği ile dirsek fleksör ve ekstansörleri ile omuzun
fleksör, ekstansör, iç rotator (IR), dış rotator (ER), abduktör ve addüktör
kaslarının maksimum ve ortalama kas güçleri ölçüldü. Hastaların toplam PIP ve
MKF (PIPtoplam, MKFtoplam) değerleri elde edildi. Hasta ve kontrol grubu arasında yaş ve boy açısından anlamlı fark görülmemiştir.
Kas güçleri açısından;
RA grubunda, başparmak IP ve MKF ile PIPtoplam, MKFtoplam
ve el bileği fleksiyonunun maksimum ve ortalama değerleri, kontrol grubundan
anlamlı düşük tespit edilirken; omuz ekstansiyonu ortalama ve adduksiyon,
abduksiyon maksimum ve ortalama kas güçleri RA grubunda düşük tespit edilmiştir.
DAS28 ile parmak fleksörleri, el bilek ekstansörleri ve dış rotatorlar
haricindeki omuz kasları negatif ilişkiliyken; UEFI-15 skorları ile bilek
ekstansör ve omuz kuşağı kasları pozitif ilişkili bulunmuştur. HAQ skorlarının ortalama
el bilek fleksiyonu, dirsek ekstansiyonu ve omuz kuşak kasları ile ilişkili
olduğu saptanmıştır. El ve el bileği kasları hastalık aktivitesinden en çok etkilenenler olmalarına
rağmen dirsek ve omuz kuşağı kaslarının fonksiyonelliği ve engelliliği daha çok
etkilediği görülmüştür. Üst ekstremite kaslarının toplam kuvveti, hastalık
aktivitesi; fonksiyonellik ve engellilik ile ilişkili bulunmuştur. 

Anahtar Kelimeler

romatoid artrit, kas gücü, DAS28, UEFI-15, HAQ

Kaynakça

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