Hand Grip Strength in Elderly Rheumatoid Arthritis Patients

Abstract

Aim: Previous studies have shown that rheumatoid arthritis and aging are independent risk factors for decreased hand grip strength. However, little is known about how coexisting rheumatoid arthritis would affect the reduced hand grip strength in the elderly population. Therefore, the aims of this study were to compare the hand grip strength of elderly female rheumatoid arthritis patients with controls and to investigate the factors associated with hand grip strength in the patients with rheumatoid arthritis.

Material and Methods: This cross-sectional study included 45 elderly women with rheumatoid arthritis and 43 age-matched controls. All subjects were provided with self-reported questionnaires measuring physical disability, anxiety and depression, sleep quality, cognitive impairment, and fatigue severity. Hand grip strength was measured with hand dynamometer. The disease activity was assessed by the Disease Activity Score.

Results: There were no significant differences in values of age, body mass index, physical disability, anxiety and depression, sleep quality, cognitive impairment, fatigue severity, and grip strength between the groups. Disease period, physical disability, and disease activity were variables which showed statistically significant negative correlation with grip strength in rheumatoid arthritis patients. In further linear regression analysis, it is found that only long disease duration was associated with decreased grip strength.

Conclusion: Rheumatoid arthritis does not seem to significantly affect aging-related muscle strength loss. Disease duration was found to be the only independent factor associated with hand grip strength in elderly rheumatoid arthritis patients.

Keywords

• Hand strength,rheumatoid arthritis,sarcopenia

Yaşlı Romatoid Artrit Hastalarında El Kavrama Gücü

Abstract

Amaç: Önceki çalışmalar romatoid artritin ve yaşlanmanın, azalmış el kavrama gücü için bağımsız risk faktörleri olduğunu göstermiştir. Bununla birlikte, bir arada var olan romatoid artritin yaşlı popülasyondaki azalmış el kavrama gücünü nasıl etkileyeceği konusunda çok az şey bilinmektedir. Bu nedenle, bu çalışmanın amaçları, yaşlı kadın romatoid artritli hastaların el kavrama gücünü kontrollerle karşılaştırmak ve romatoid artrit hastalarında el kavrama gücü ile ilişkili faktörleri araştırmaktır.

Gereç ve Yöntemler: Bu kesitsel çalışmaya 45 romatoid artritli yaşlı kadın ve 43 yaşa göre eşleştirilmiş kontrol dahil edildi. Tüm deneklere fiziksel özürlülük, anksiyete ve depresyon, uyku kalitesi, bilişsel bozulma ve yorgunluk şiddetini ölçen kendi kendine bildirilen anketler verildi. El kavrama gücü, el dinamometresi ile ölçüldü. Hastalık aktivitesi, Hastalık Aktivite Skoru ile değerlendirildi.

Bulgular: Gruplar arasında yaş, vücut kitle indeksi, fiziksel özürlülük, anksiyete ve depresyon, uyku kalitesi, bilişsel bozulma, yorgunluk şiddeti ve kavrama gücü değerleri açısından anlamlı fark yoktu. Hastalık süresi, fiziksel özürlülük ve hastalık aktivitesi romatoid artrit hastalarında kavrama kuvveti ile istatistiksel olarak anlamlı düzeyde negatif korelasyon gösteren değişkenlerdi. Sonraki doğrusal regresyon analizinde, sadece uzun hastalık süresinin kavrama kuvvetinin azalması ile ilişkili olduğu bulundu.

Sonuç: Romatoid artrit, yaşlanmaya bağlı kas kuvveti kaybını önemli ölçüde etkilemiyor gibi görünmektedir. Hastalık süresi, yaşlı romatoid artrit hastalarında el kavrama gücü ile ilişkili tek bağımsız faktör olarak bulunmuştur.

Keywords

• El gücü,romatoid artrit,sarkopeni

References

1. Bohannon RW. Quantitative testing of muscle strength: issues and practical options for the geriatric population. Top Geriatr Rehabil. 2002;18(2):1-17.
2. Bohannon RW, Magasi S. Identification of dynapenia in older adults through the use of grip strength t-scores. Muscle Nerve. 2015;51(1):102-5.
3. Higgins SC, Adams J, Hughes R. Measuring hand grip strength in rheumatoid arthritis. Rheumatol Int. 2018;38(5):707-14.
4. Syddall H, Cooper C, Martin F, Briggs R, Aihie Sayer A. Is grip strength a useful single marker of frailty? Age Ageing. 2003;32(6):650-6.
5. Sferra da Silva G, de Almeida Lourenço M, de Assis MR. Hand strength in patients with RA correlates strongly with function but not with activity of disease. Adv Rheumatol. 2018;58:20.
6. Dedeoğlu M, Gafuroğlu Ŭ, Yilmaz Ö, Bodur H. The relationship between hand grip and pinch strengths and disease activity, articular damage, pain and disability in patients with rheumatoid arthritis. Turk J Rheumatol. 2013;28(2):69-77.
7. Petchiappan V, Selvam S, Dhanush M, Prabu N. Assessment of handgrip strength in patients with rheumatoid arthritis and fibromyalgia-do they differ? -An observational study. Arch Med Vol. 2018;10(4):3.
8. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569-81.

9. Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980;23(2):137-45.
10. Kucukdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A. Issues in cross-cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford health assessment questionnaire. Arthritis Rheum. 2004;51(1):14-9.
11. Prevoo ML, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38(1):44-8.
12. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
13. Aydemir Ö, Güvenir T, Küey L, Kültür S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk J Psychiatry. 1997;8(4):280-7.
14. Ağargün MY, Kara H, Anlar Ö. The validity and reliability of the Pittsburgh sleep quality index. Turk J Psychiatry. 1996;7(2):107-15.
15. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
16. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Reliability and validity of the standardized mini mental state examination in the diagnosis of mild dementia in Turkish population. Turk J Psychiatr. 2002; 13(4): 273-81.
17. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46(10):1121-3.
18. Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, et al. The validity and reliability of the fatigue severity scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30(1):81-5.
19. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am. 1984;9(2):222-6.
20. Alomari MA, Keewan EF, Shammaa RA, Alawneh K, Khatib SY, Welsch MA. Vascular function and handgrip strength in rheumatoid arthritis patients. Sci World J. 2012;2012:580863.
21. Innes EV. Handgrip strength testing: a review of the literature. Aust Occup Ther J. 1999;46(3):120-40.
22. Beenakker KG, Ling CH, Meskers CG, de Craen AJ, Stijnen T, Westendorp RG, et al. Patterns of muscle strength loss with age in the general population and patients with a chronic inflammatory state. Ageing Res Rev. 2010;9(4):431-6.
23. Palamar D, Er G, Terlemez R, Ustun I, Can G, Saridogan M. Disease activity, handgrip strengths, and hand dexterity in patients with rheumatoid arthritis. Clin Rheumatol. 2017;36(10):2201-8.
24. Bodur H, Yilmaz O, Keskin D. Hand disability and related variables in patients with rheumatoid arthritis. Rheumatol Int. 2006;26(6):541-4.