Romatoit artritli hastalarda el kavrama kuvveti ve üst ekstremite fonksiyonel özürünün incelenmesi

Öz

Amaç: Bu çalışmanın amacı, romatoit artritli (RA) hastalarda el kavrama kuvvetini sağlıklı bireyler ile karşılaştırmak ve kavrama kuvvetinin fonksiyonel özürlülük ve yaşam kalitesiyle ilişkisini belirlemekti.

Yöntem: Çalışmaya 29 RA’lı ve 30 aynı yaşta sağlıklı birey dahil edildi. El bileği ulnar deviyasyon, fleksiyon ve ekstansiyon açısı gonyometre ile değerlendirildi. Kavrama kuvveti ve enduransı, dijital kavrama cihazı ile ölçüldü. El ile ilişkili aktivite limitasyonu Duruöz El İndeksi (DEİ) ile değerlendirildi. Fiziksel özürlülük durumu, Stanford Sağlık Değerlendirme Anketi (SSDA) ile belirlendi. Yaşam kalitesi, Romatoid Artrit Yaşam Kalitesi Skalası (RAYKS) ile değerlendirildi.

Bulgular: Sağlıklı kişilerle hastaların kuvvet ve endurans ölçümleri karşılaştırıldığında sağlıklı bireyler yönünde anlamlı bir fark vardı (p<0.001). RA’lı hastaların dominant el kavrama kuvvet ve endurans testleri ile SSDA, DEİ ve RAYKS skorları arasında negatif yönde orta seviyede anlamlı bir ilişki vardı (p<0.05).

Tartışma: Çalışmanın sonuçları, RA’lı hastalarda el kavrama kuvveti ve enduransındaki zayıflık ile üst ekstremite fonksiyonel özürlülük seviyesinin ilişkili olduğunu destekledi. RA’lı hastalarda günlük yaşam aktivitelerinde fonksiyonelliği artıracak kavrama kuvveti ve endurans gibi özel ihtiyaçların izlenmesini öneriyoruz.

Anahtar Kelimeler

• Artrit,Romatoid,Özürlülük Değerlendirmesi,El Kuvveti,Yaşam Kalitesi

Investigation of grip strength and upper extremity functional disability in patients with rheumatoid arthritis

Öz

Purpose: The aim of this study were to compare handgrip strength between patients with rheumatoid arthritis (RA) and healthy individuals, and to determine the correlation between their handgrip strength and the upper extremity functional disability and health related quality of life.

Methods: Twenty-nine RA patients and 30 age-matched healthy subjects were recruited for the study. The degree of ulnar deviation, flexion, and extension of the wrist were measured using a goniometer. Handgrip strength and endurance weremeasured using a digital grip analyzer. The Duruoz Hand Index (DHI) was used to assess the hand-related activity limitation. Physical disability was measured using the Stanford Health Assessment Questionnaire (HAQ). Quality of life was assessed using the Rheumatoid Arthritis Quality of Life scale (RAQoL).

Results: There were significant differences between patients with RA and healthy controls in terms of strength and endurance test in favor of healthy controls (p<0.001). Moderate negative correlations were found in dominant handgrip strength and endurance tests with HAQ, DHI and RAQoL scores in patients with RA (p<0.05).

Conclusion: The results of the present study supported that lower handgrip strength and endurance was related to upper extremity functional disability in patients with RA. We suggest that specific needs such as handgrip strength and endurance to maximize function in performing activities of daily living should be monitored in patients with RA.

Anahtar Kelimeler

• Arthritis; rheumatoid,Disability evaluation,Handgrip strength,Quality of life

Kaynakça

1. 1. Singh H, Kumar S, Talapatra P, et al. Assessment of hand functions in rheumatoid arthritis using SF-SACRAH (short form score for the assessment and quantification of chronic rheumatoid affections of the hands) and its correlation to disease activity. Rheumatol Int. 2012;32:3413-3419.
2. 2. Nicklasson M, Jonsson H. Experience of participation as described by people with hand deformity caused by rheumatic disease. Br J Occup Ther. 2012;75:29-35.
3. 3. Poole JL. Hand Function in Rheumatoid Arthritis. Hand Function: Springer; New York.2014:55-62.
4. 4. Cha SM, Shin HD, Kim KC,. et al. Comparison of grip strength among 6 grip methods. J Hand Surg. 2014;39:2277-2284.
5. 5. Fraser A, Vallow J, Preston A, et al. Predicting'normal'grip strength for rheumatoid arthritis patients. Rheumatology. 1999;38:521- 528.
6. 6. Van der Giesen F, Nelissen R, van Lankveld W, et al. Swan neck deformities in rheumatoid arthritis: A qualitative study on the patients' perspectives on hand function problems and finger splints. Musculoskeletal Care. 2010;8:179-188.
7. 7. Adams J, Burridge J, Hammond A, et al. The effects of early rheumatoid arthritis on dominant and non-dominant hand impairment and function. J Hand Ther Br. 2005;10:93-97.
8. 8. Bearne LM, Coomer AF, Hurley MV. Upper limb sensorimotor function and functional performance in patients with rheumatoid arthritis. Disabil Rehabil. 2007;29:1035-1039.

9. 9. Poole JL, Santhanam DD, Latham AL. Hand impairment and activity limitations in four chronic diseases. J Hand Ther. 2013;26:232-237.
10. 10. Britsemmer K, Ursum J, Gerritsen M, et al. Validation of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: slight improvement over the 1987 ACR criteria. Ann Rheum Dis. 2011;70:1468-1470.
11. 11. Cambridge-Keeling C. Range-of-motion measurement of the hand. In: Huntetr JM, Mackin EJ, Callahan AD, ed. Rehabilitation of the hand. St Louis: The Mosby Company. 2002:169-182.
12. 12. Fess EE. Grip Strength. 2nd edition. Chicago: American Society of Hand Therapists; 1992.
13. 13. Helliwell P, Howe A, Wright V. Functional assessment of the hand: reproducibility, acceptability, and utility of a new system for measuring strength. Ann Rheum Dis. 1987;46:203-208.
14. 14. Duruöz M, Poiraudeau S, Fermanian J, et al. Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol. 1996;23:1167-1172.
15. 15. Ramey DR, Raynauld JP, Fries JF. The health assessment questionnaire 1992. Status and review. Arthritis Care Res. 1992;5:119-129.
16. 16. Küçükdeveci AA, Sahin H, Ataman S, et al. Issues in cross-cultural validity: Example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Care Res. 2004;51:14-19.
17. 17. Hunt S, McEwen J, McKenna S. Measuring health status: a new tool for clinicians and epidemiologists. JR Coll Gen Pract. 1985;35:185-188.
18. 18. Kutlay S, Küçükdeveci AA, Gönül D, et al. Adaptation and validation of the Turkish version of the Rheumatoid Arthritis Quality of Life Scale. Rheumatol Int. 2003;23:21-26.
19. 19. Birtane M, Kabayel DD, Uzunca K, et al. The relation of hand functions with radiological damage and disease activity in rheumatoid arthritis. Rheumatol Int. 2008;28:407-412.
20. 20. Thorsen H, Hansen TM, McKenna SP, et al. Adaptation into Danish of the Stanford health assessment questionnaire (HAQ) and the rheumatoid arthritis quality of life scale (RAQoL). Scand J Rheumatol. 2001;30:103-109.
21. 21. Lamb SE, Williamson EM, Heine PJ, et al. Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial. Lancet. 2015;385:421-429.