The relationship of sensorimotor and function with activities of daily living and disease specific parametres in patients with rheumatoid arthritis

Yıl 2021, Cilt: 4 Sayı: 6, 784 - 789, 24.09.2021

Songül Keskin Kavak , Nebahat Sezer , Lale Aktekin

https://doi.org/10.32322/jhsm.960328

Öz

Objective: To evaluate the level of effect on the sensorimotor functions of the hand in patients with rheumatoid arthritis (RA) and investigate the relationship between this level and patients’ daily life activities and disease-specific parameters.
Material and Method: This case-control study involved the evaluation of 80 patients with RA and 50 healthy volunteers aged 20-65 years. The coarse and fine grip strength of the patients was evaluated with hand dynamometer and pinch meter. The sensory evaluation of the hand was undertaken using the Semmes-Weinstein monofilament test (SWMT). The hand skill level was evaluated with Duru Oz Hand Index (DHI). The daily living activities of the patients were investigated using the Health Assessment Questionnaire (HAQ). The Disease Activity Score 28 (DAS28) was used to evaluate disease activity.
Results: The mean DAS28 score of the RA group was at a mild level (DAS 28 <3.2). No statistically significant difference was found between the RA group and the control group in terms of daily life activities (HAQ scores). The grip strength and the hand skill level (DHI) were statistically significantly lower in the RA group compared to the control group. In the sensory examination of the RA group using SWMT, while 83% of the patients were evaluated as normal, 15% were determined to have diminished light touch sensation. However, there was no statistical difference between the RA and control groups in terms of sensory evaluation.
Conclusion: As a result of the quantitative evaluations used in our study, the RA group was determined to have impaired fine skills and grip strength. Consistent with the literature, these findings had a negative effect on the daily life activities and function of these patients. In our knowledge there is no study with SMWT in RA patients. In our study, there wasn’t statistical difference between the RA and control groups in terms of sensory evaluation with SMWT. Because of our patients have low disease activity, further studies are needed in patients with higher disease activity for evaluation sensorial functions.

Anahtar Kelimeler

Rheumatoid arthritis, Health Assessment Questionnaire, Disease Activity Score, Semmes-Weinstein monofilamenttest.

Kaynakça

• Towheed TE, Anastassiades TP. Rheumatoid hand practical approach to assessment and management. Can Fam Physician 1994; 40: 1303-9.
• Dellhag B, Bjelle A. A five-year followup of hand function and activities of daily living in rheumatoid arthritis patients. Arthritis care and research, 1999, 12: 33-41.
• Bodur H, Yilmaz O, Keskin D. Hand disability and related variables in patients with rheumatoid arthritis. Rheumatology international, 2006, 26.6: 541-544.
• Calder KM, Martın A, Lydiate J, MacDermid J, Galea V, MacIntyre N. Sensory nerve action potentials and sensory perception in women with arthritis of the hand. J Neuroengineer Rehabil 2012; 9: 27-37.
• Muramatsu K, Tanaka H, Taguchi T. Peripheral neuropathies of the forearm and hand in rheumatoid arthritis: diagnosis and options for treatment. Rheumatol Int 2008; 28: 951-7. 9.
• Dellhag B, Hosseini N, Bremel T, Ingvarsson PE. Disturbed grip function in women with rheumatoid arthritis. J Rheumatol 2001; 28: 2624-33. 9.
• Dellhag B, Burckhardt CS. Predictors of hand function in patients with rheumatoid arthritis. Arthrit Rheumat 1995; 8: 16-20.
• Duruöz M T, Poiraudeau S, Fermanian J, et al. Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. Journal Rheumatol 1996; 23: 1167-72.
• Mathiowetz V, Weber K, Kashman N. Adult norms for the nine hole peg test of finger dexterity. OTJR: Occupat Participat Health 1985; 5: 24-38.
• Mathiowetz V, Weber K, Kashman N, Volland G, et al. Grip and pinch strength evaluations. J Hand Surg 1984; 9A: 223-5.
• M Van Riel, Kanıtlanmış romatoid artritli hastaların değerlendirilmesi ve sonuçları. (Karatay S Çev.Ed) Hochberg romatoloji cilt 1. Rota Tıp yayıevi İzmir 2011; 357-64.
• Küçükdeveci 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: 14.
• Erol A M,Ceceli E, Ramadan S, Borman P. Sensory examination of rheumatoid hand and the relationship with magnetic resonance imaging findings. Ege Tıp Derg / Ege J Med 2014; 53: 200-20.
• Duruöz MT. Romatizmal hastalıkların değerlendirilmesinde kullanılan fonksiyonel el göstergeleri. Türk Fiz Tıp Rehab Derg 1998; 3: 44.
• Gürçay E, Alanoğlu E, Tuncay R,Uşan H, Çakçı A. Romatoid elde Duruöz el skalasının ve kavrama beceri testinin değerlendirilmesi. Turkiye Klinikleri J Physic Med Rehabilit 2004, 4: 1-6.
• Dedeoğlu M, Gafuroğlu U, Yılmaz 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: 69-77.
• Prajs K, Fliciński J, Brzosko I, Przepiera-Bedzak H, Ostanek L, Brzosko M. Quality of life and activity of disease in patients with rheumatoid arthritis. Ann Acad Med Stetin 2006; 52: 39-43.
• Gullick NJ, Ibrahım F, Scott IC, et al. Real world long term impact of intensive treatment on disease activity, disability and health-related quality of life in rheumatoid arthritis. BMC Rheumatol 2019; 3: 6.
• Birtane M, Kabayel D, Uzunca K, et al. The relation of hand functions with radiological damage and disease activity in rheumatoid arthritis. Rheumatol Int 2008, 28: 407-12.
• Özeri Z, Duyur Çakıt B, Taşkın S, Genç H, Saraçoğlu M, Erdem HR. The Relationships Among Functional Impairment, Disability and Articular Damage in Rheumatoid Hand. FTR Bil Der J PMR Sci 2008; 2: 53-8.
• Silva G, Lourenço M, Assis M. Hand strength in patients with RA corralates strongly with functıon but not with activity of disease. Adv Rheumatol 2018; 58: 20.
• Çetin E, Çağlar N, Örnek GT, et al. Demographic and clinical properties and the current medical treatments. Istanbul Med J 2010; 11: 154-8.
• Wolfe F, Cathey MA. The assessment and prediction of functional disability in rheumatoid arthritis.J Rheumatol 1991; 18: 1298-306.
• Taştekin N, Uzunca K, Birtane M, Kabayel D, Öztürk G. Romatoid artritli hastalarda, el eklemlerindeki hareket açıklığı ve el kavrama kuvvetlerinin hastalık aktivasyonu, el fonksiyonları ve özürlülük ile ilişkisi. Romatizma 2006; 21: 13-7.
• Craig AB, Strauss MB, Daniller A, Miller S. Foot sensation testing in the patient with diabetes: introduction of the quick and easy assessment tool. Wounds 2014; 26: 221-31.
• Raji P, Ansari NN, Naghdi S , Forogh B, Hasson S. Relationship between Semmes-Weinstein monofilaments perception test and sensory nerve conduction studies in carpal tunnel syndrome. J NeuroRehabilitation 2014; 35: 543-52.
• McCallister WV, Ambrose HC, Katolik LI, Trumble TE. Comparison of pullout button versus suture anchor for zone I flexor tendon repair. J Hand Surg Am 2006; 31: 246-51.
• Silva PG, Jones A, Araujo PM, Natour JÜ. Assessment of light touch sensation in the hands of systemic sclerosis patients. Clinics (Sao Paulo) 2014; 69: 585.