Osteoartrit ve Romatoid Artritli Hastalarda Elin Fiziksel Özelliklerinin El Fonksiyonu Üzerine Etkilerinin Değerlendirilmesi.

Yıl 2021, Cilt: 11 Sayı: 1, 68 - 75, 01.04.2021

Gülnihal Deniz Ahmet Kavakli Özen Kan Şikoğlu Ahmet Zafer Perilioğlu Yıldız Ece Murat Ögetürk Furkan Bilek

Öz

Amaç: Osteoartrit (OA) dünyada ve ülkemizde en sık karşılaşılan eklem hastalığıdır. Romatoid artrit (RA) sinovyal enflamasyonla karakterize kronik, sistemik bir hastalıktır. OA ve RA’da el bileği ile el eklemleri ilk ve en sık etkilenen eklemlerdir. El eklemlerinin tutulumu, hastaların yaşam kalitesinde belirgin bir azalmaya yol açar. Bu çalışmada RA ve OA hastalarındaki el kavrama kuvveti ve eklem hareket açıklıklarının (EHA) sağlıklı bireylerle karşılaştırılması ve hastaların günlük yaşam aktivitelerindeki bağımsızlığının değerlendirilmesi amaçlandı.
Materyal ve Metot: Çalışmamızda Fırat Üniversitesi Hastanesi Fizik Tedavi ve Rehabilitasyon Polikliniğinde ve Romatoloji Polikliniğinde takip edilen, yaşları 30 ile 60 arasında olan, Amerikan Romatoloji Birliği (ACR) kriterlerine göre RA tanısı konulmuş 62 kadın, 52 OA’lı kadın ve 52 sağlıklı kadın olmak üzere toplam 166 birey değerlendirmeye alındı. El kavrama kuvveti elektronik el dinamometresi, parmak kavrama kuvveti ise parmak dinamometresi ile ölçüldü. El bileği ve parmakların EHA ölçümleri için standart gonyometre ve parmak gonyometresi kullanıldı. El bileği çevresi ve çapı ile el uzunluk ölçümü standart antropometrik ölçüm aletleriyle gerçekleştirildi. Ayrıca çalışmaya alınanların tamamına sağlık değerlendirme anketi (HAQ) uygulanarak özürlülük düzeyi belirlendi.
Bulgular: Tüm olgularda, el ve parmak kavrama kuvvetleri, el bileği ve parmakların EHA ölçümleri ile el bileği çevre ve çap değerleri arasında istatistiksel olarak anlamlı fark bulundu (p<0,001). Hasta ve sağlıklı bireylerin el uzunluk ölçümünde istatistiksel olarak anlamlı bir fark bulunmadı (p>0,05). Tüm olgularda, HAQ skoru ile el ve parmak kavrama kuvveti arasında negatif yönde çok güçlü korelasyon bulundu.
Sonuç: OA’lı ve RA’lı hastalarda anatomik bütünlüğün bozulması, EHA’nın, el ve parmak kavrama kuvvetlerinin azalması ve ağrı, hastaların günlük yaşam aktivitelerindeki bağımsızlığını etkilemiştir.

Anahtar Kelimeler

Osteoartrit, Romatoid Artrit, Kavrama Kuvveti, Hareket Açıklığı

In Patients with Osteoarthritis and Rheumatoid Arthritis, Effects of Hand Physical Features on Hand Function.

Öz

Objective: Osteoarthritis and Rheumatoid Arthritis, is one of the most common joint diseases in our country and in the world. Hand joint involvement and functions are of the most important factors that determine the impacts of the disease on daily activities. We aimed to determine the impact of the disease on the daily life activities by comparing hand grip strength and joint range of motion in healthy individuals and patients.
Material and Method: In this study, 166 female were included; 52 of which are healthy female, 62 of which are female patients with Rheumatoid Arthritis and 52 of which are female patients with Osteoarthritis. Grip and pinch strength were measured using the electronic hand and finger dynamometer. Standard and finger goniometer were used for range of motion measurement of wrist and fingers. Circumference and diameter of wrist and length of hand were measured with standard anthropometric measurement tools. Disability was scored by using health assessment questionnaire (HAQ).
Results: Hand and finger grip strength, range of motion measurement of wrist and fingers, and measurement of wrist circumference and diameter values of all patients and healthy groups were found statistically significant difference (p<0.001). Hand length measurements of patients and healthy individuals there was no statistically significant difference (p>0.05). HAQ scores correlated negatively with grip and pinch strength were found in all individuals.
Conclusions: It was observed that the impairment of anatomical integrity , decreasing of grip and pinch strength, and pain affect independent daily life activities in the patients with Osteoarthritis and Rheumatoid Arthritis.

Anahtar Kelimeler

Osteoarthritis, Rheumatoid Arthritis, Grip Strength, Range of Motion.

Kaynakça

• 1. Demirel P. Comparison Of Hand Anthropometric Measurements And Grip Strength In Different Sports Branches: Master Of Science Thesis. Zonguldak: Karaelmas University, Institute of Health Sciences Deparmant of Anatomy, 2005.
• 2. Nordenskiold U, Grimby G. Assesment of disability in women with rheumatoid arthritis in relation to grip force and pain. Disabil Rehabil. 1997; 19 (1): 13-9.
• 3. Di Cesare PE, Abramson SB. Pathogenesis of osteoarthritis. In: Harris ED, Budd RC, Firstein GS, Genovese MC, Sergent JS, Ruddy S, et al, ed. Kelly’s Textbook of Rheumatology. 7th edition. Philedelphia. Saundersp. 1493-513 , 2005.
• 4. Haris ER Jr. Rheumatoid Arthritis: pathophysilogy and implications for therapy. N Egly J Med. 1990; 322: 1277-89.
• 5. Grabiner MD, Rasch PJ. Kinesiology and Applied Anatomy. Philadelphia: Lea and Febiger p. 151-68, 1989.
• 6. İnce Parpucu T. To Research Reliability and Validity Hand Held Dynamometer In Assesment For Wrist Muscle Strength In Healthy Young İndividuals: Master Of Science Thesis, Isparta: Süleyman Demirel Üniversity, Institute of Health Sciences Deparmant of Anatomy, 2009.
• 7. Karaaslan Y. Osteoartrit. Ankara: MD., 2000.
• 8. Lipsky PE. Rheumatoid Arthritis. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL (Editors). Harrıson’s Principles of Internal Medicine. New York: McGraw-Hill p. 1968-77, 2005.
• 9. Fries JF, Spitz P, Krainez RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980; 23: 137-45.
• 10. Küçükdeveci A, Şahin H, Ataman Ş, Griffiths B, Tennant A. Issue 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: 14-9.
• 11. Taştekin N, Uzunca K, Birtane M, Demirbağ Kabayel D, Öztürk G. The Relationship of Range of Motion and Grip Strength of the Hand with Disease Activity, Hand Functions and Disability in Patients with Rheumatoid Arthritis. Romatizma. 2006;21: 13-7.
• 12. Bölükbaşı N. Osteoartritin Klinik Değerlendirmesinde Kullanılan Ölçütler. Turkiye Klinikleri Journal of Physical Medicine Rehabilitation. 2002; 2(3), 171-176. (Turkish)
• 13. Kılınçer C, Zileli M. Görsel analog hasta tatmini skalası. Balkan Medical Journal. 2006; 3: 113-8. (Turkish)
• 14. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip And Pinch Strength: Normative Data For Adults. Arch Phys Med Rehabil. 1985; 66(2): 69-74.
• 15. Evcik D, Kızılay B. Correlation Of Hand Grip Strength And Disability In Daily Living Activities In Geriatric Patients. Turkish Journal of Geriatrics. 2001; 4: 11-4.
• 16. Ekimler Süslü F. The Effects of Hand Osteoarthritis on Hand Strength, Hand Functions, Manuel Dexterity and Daily Activities of Life in Post-menopausal Women: Expertise thesis, Isparta: Süleyman Demirel Üniversity, Department of Physical Medicine and Rehabilitation, 2008.
• 17. Haidar SG, Kumar D, Bassi RS, Deshmukh SC. Average versus maximum grip strength: Which is more consistent? J Hand Surg[Br] 2004; 29: 82-4.
• 18. Halpern CA, Fernandez JE. The effect of wrist and arm postures on peak pinch strength. J Hum Ergol. 1996; 25: 115–30.
• 19. Otman SA, Demirel H, Sade A. Tedavi hareketlerinde temel değerlendirme prensipleri. 2.baskı, Ankara, Sinem. 1998. (Turkish)
• 20. Alpar R. Spor Bilimlerinde Uygulamalı İstatistik. 2. Basım, Ankara: Nobel Yayın, 2001. (Turkish)
• 21. Nicolay CW, Walker AL. Grip strength and endurance: Influences of anthropometric variation, hand dominance and gender. Int J Ind Ergon. 2005;35: 605-18.
• 22. Gabriel YF Ng, Andy CCF. Does elbow position affect strength and reproducibility of power grip measurements? Physiotherapy 2001; 87: 68-72.
• 23. Minor MA, Hewett JE, Webel RR, Dreisinger TE, Kay DR. Exercise tolerance and disease related measures in patients with rheumatoid arthritis and osteoarthritis. J Rheumatol. 1988;15: 905-11.
• 24. Balogun JA, Akinloye SA. Grip strength as a function of age, height, body weight and quetelet index. Physiotherapy Theory and Practice. 1991;7: 111-9.
• 25. Özkan B, Keskin D, Bodur H, Barça N. The effect of radiological hand osteoarthritis on hand function. Clin Rheumatol. 2007;26(10):1621-5.
• 26. Bagis S, Sahin G, Yapici Y, Cimen OB, Erdogan C. The effect of hand osteoarthritis on grip and pinch strength and hand function in postmenopausal women. Clin Rheumatol. 2003;22(6): 420-4.
• 27. Köse N, Arıkan H, Çalgüneri M. Comparision of hand grip strength and assesment methods in osteoarthritis, rheumatoid arthritis and healty individuals. Fizyoterapi ve Rehabilitasyon. 2000;11(3):110-8.
• 28. Pollard L, Choy EH, Scott DL. The consequences of rheumatoid arthritis: Quality of life measures in the individual patient. Clin Exp Rheumatol. 2005;23 (Suppl. 39): 43-52.
• 29. Hagen KB, Kvien TK, Bjorndal A. Musculoskeletal pain and quality of life in patients with noninflammatory joint pain compared to rheumatoid arthritis: a population survey. J Rheumatol. 1997;24: 1703-9.
• 30. Altındağ Ö, Altındağ A, Soran N, Tabur H. Depression and disability in patients with rheumatoid arthritis and osteoarthritis. Bulletin of Clinical Psychopharmacology. 2007;Vol: 17, N: 1.
• 31. Stamm T, Mathis M, Aletaha D, Kloppenburg M, Machold K, Smolen J. Mapping hand functioning in hand osteoarthritis: comparing self-report instruments with a comprehensive hand function test. Arthritis Rheum. 2007;57(7): 1230-7.
• 32. Kulaksız G, Gözil R. The Effect of hand preference on hand anthropometric measurements in healthy individuals. Annals of Anatomy. 2002;184: 257-65.
• 33. Chuang MC, You M, Cai D, Chen CC. Isometric Muscle Strength of Chinese Young Males In Taiwan. Ergonomics. 1997;40(5): 576-90.
• 34. Nordenskiold U, Grimby G. Assesment of disability in women with rheumatoid arthritis in relation to grip force and pain. Disabil Rehabil. 1997; 19 (1): 13-9.
• 35. Ekblom B, Lövgren O, Alderin M, Fridström M, Sätterström G. Physical performance in patients with rheumatid arthritis Scand J Rheumatol. 1974;3: 121-5.
• 36. Wolfe F, Cathey MA. The assessment and prediction of functional disability in rheumatoid arthritis. J Rheumatol. 1991;18: 1298-306.
• 37. Jones G, Cooley HM, Bellomy N. A cross sectional study of the association between Haberdan’s nodes, radiographic osteorathritis of the hands, grip strenght, disability and pain. Osteoarthritis Cartilage. 2001;9: 606-11.
• 38. Kurtaran A, Sulubulut N, Selçuk B, Akyüz M. Effect Of Osteoartritis On Hand Functions. Fiziksel Tıp Dergisi 2003;6(3): 7-10.
• 39. Çimen BÖ, Bağış S, Şahin G, Biçer A, Yapıcı Y, Kanık A, et al. Relationship between hand osteoarthritis and benign joint hypermobility. Romatizma. 2003;18 (1): 27-31.
• 40. Fraser A, Vallow J, Preston A, Cooper RG. Predicting normal grip strength for reumatoid arthritis patients. Rheumatol (Oxford). 1999;38: 521-8.
• 41. Callahan LF, Pincus T, Huston JW, Brooks RH, Nance EP Jr, Kaye JJ. Measures of activityand damage in rheumatoid arthritis: depiction of changes and prediction of mortality over five years. Arthritis Care Res. 1997;10: 381-94.
• 42. Sarıdoğan M. Clinical Findings Of Osteoarthritis According To The Joints. Turkish journal of geriatrics supplement. 2011;14 (1): 31-6.
• 43. Dinçer F, Özdemir O, Samut G. Diagnosis and Treatment of Hand Osteoarthritis. J PMR Sci. 2011;14 Suppl: 12-8.