Araştırma Makalesi
BibTex RIS Kaynak Göster

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

Yıl 2019, , 137 - 144, 01.08.2019
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. 

Kaynakça

  • Choy E. Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis. Rheumatology (Oxford). 2012;51 Suppl 5:v3-11.
  • Alamanos Y, Drosos AA. Epidemiology of adult rheumatoid arthritis. Autoimmun Rev. 2005;4(3):130-136.
  • Beenakker KG, Ling CH, Meskers CG, 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):431-436.
  • Summers GD, Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD. Rheumatoid cachexia and cardiovascular disease. Nat Rev Rheumatol. 2010;6(8):445-451.
  • Schaap LA, Pluijm SM, Deeg DJ, et al. Higher inflammatory marker levels in older persons: associations with 5-year change in muscle mass and muscle strength. J Gerontol A Biol Sci Med Sci. 2009;64(11):1183-1189.
  • Cooney JK, Law RJ, Matschke V, et al. Benefits of Exercise in Rheumatoid Arthritis. J Aging Res. 2011;2011.
  • Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia. Clin Nutr. 2014;33(5):737-748.
  • Madenci E, Gursoy S. Hand deformity in rheumatoid arthritis and its impact on the quality of life. The pain clinic. 2003;15(3):255-259.
  • Hakkinen A, Sokka T, Kotaniemi A, et al. Muscle strength characteristics and central bone mineral density in women with recent onset rheumatoid arthritis compared with healthy controls. Scand J Rheumatol. 1999;28(3):145-151.
  • Walker JM, Helewa A. Physical rehabilitation in arthritis. 2nd ed. St. Louis: Elsevier; 2004.
  • Wozny W, Long C, 2nd. Electromyographic kinesiology of the rheumatoid hand. Arch Phys Med Rehabil. 1966;47(11):699-704.
  • Van den Ende CH, Vliet Vlieland TP, Munneke M, Hazes JM. Dynamic exercise therapy in rheumatoid arthritis: a systematic review. Br J Rheumatol. 1998;37(6):677-687.
  • de Jong Z, Vliet Vlieland TP. Safety of exercise in patients with rheumatoid arthritis. Curr Opin Rheumatol. 2005;17(2):177-182.
  • Guidelines ACoRSoRA. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheumatism. 2002;46(2):328-346.
  • Singh JA, Saag KG, Bridges Jr SL, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis rheumatology. 2016;68(1):1-26.
  • Combe B, Landewe R, Daien CI, et al. 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis. 2017;76(6):948-959.
  • Dedeoglu M, Gafuroglu U, Yilmaz O, Bodur H. The relationship between hand grip and pinch strengths and disease activity, articular damage, pain, and disability in patients with rheumatoid arthritis: romatoid artritli hastalarda elle kavrama ve tutma guclerinin hastalik aktivitesi, eklem hasari, Agri ve engellilik ile Iliskisi. Turkish journal of rheumatology. 2013;28(2):69-78.
  • Dogu B, Sirzai H, Yilmaz F, Polat B, Kuran B. Effects of isotonic and isometric hand exercises on pain, hand functions, dexterity and quality of life in women with rheumatoid arthritis. Rheumatol Int. 2013;33(10):2625-2630.
  • Bodur H, Yılmaz Ö, Keskin D. Hand disability and related variables in patients with rheumatoid arthritis. Rheumatol Int. 2006;26(6):541-544.
  • Eberhardt K, Sandqvist G, Geborek P. Hand function tests are important and sensitive tools for assessment of treatment response in patients with rheumatoid arthritis. Scand J Rheumatol. 2008;37(2):109-112.
  • Baker JF, Von Feldt J, Mostoufi-Moab S, et al. Deficits in muscle mass, muscle density, and modified associations with fat in rheumatoid arthritis. Arthritis Care Res (Hoboken). 2014;66(11):1612-1618.
  • Uutela TI, Kautiainen HJ, Häkkinen AH. Decreasing muscle performance associated with increasing disease activity in patients with rheumatoid arthritis. PLoS One. 2018;13(4):e0194917.
  • Romero-Guzmán AK, Menchaca-Tapia VM, Contreras-Yáñez I, Pascual-Ramos V. Patient and physician perspectives of hand function in a cohort of rheumatoid arthritis patients: the impact of disease activity. BMC Musculoskelet Disord. 2016;17:392.
  • Stucki G, Schonbachler J, Bruhlmann P, Mariacher S, Stoll T, Michel BA. Does a muscle strength index provide complementary information to traditional disease activity variables in patients with rheumatoid arthritis? J Rheumatol. 1994;21(12):2200-2205.
  • Ekblom B, Lovgren O, Alderin M, Fridstrom M, Satterstrom G. Physical performance in patients with rheumatoid arthritis. Scand J Rheumatol. 1974;3(3):121-125.
  • Tiselius P. Studies on joint temperature, joint stiffness and muscle weakness in rheumatoid arthritis. An experimental and clinical investigation. Acta Rheumatol Scand. 1969;14:Suppl 14:1+.
  • Bodur H, Yilmaz O, Keskin D. Hand disability and related variables in patients with rheumatoid arthritis. Rheumatol Int. 2006;26(6):541-544.

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

Yıl 2019, , 137 - 144, 01.08.2019
https://doi.org/10.32708/uutfd.524930

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. 

Kaynakça

  • Choy E. Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis. Rheumatology (Oxford). 2012;51 Suppl 5:v3-11.
  • Alamanos Y, Drosos AA. Epidemiology of adult rheumatoid arthritis. Autoimmun Rev. 2005;4(3):130-136.
  • Beenakker KG, Ling CH, Meskers CG, 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):431-436.
  • Summers GD, Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD. Rheumatoid cachexia and cardiovascular disease. Nat Rev Rheumatol. 2010;6(8):445-451.
  • Schaap LA, Pluijm SM, Deeg DJ, et al. Higher inflammatory marker levels in older persons: associations with 5-year change in muscle mass and muscle strength. J Gerontol A Biol Sci Med Sci. 2009;64(11):1183-1189.
  • Cooney JK, Law RJ, Matschke V, et al. Benefits of Exercise in Rheumatoid Arthritis. J Aging Res. 2011;2011.
  • Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia. Clin Nutr. 2014;33(5):737-748.
  • Madenci E, Gursoy S. Hand deformity in rheumatoid arthritis and its impact on the quality of life. The pain clinic. 2003;15(3):255-259.
  • Hakkinen A, Sokka T, Kotaniemi A, et al. Muscle strength characteristics and central bone mineral density in women with recent onset rheumatoid arthritis compared with healthy controls. Scand J Rheumatol. 1999;28(3):145-151.
  • Walker JM, Helewa A. Physical rehabilitation in arthritis. 2nd ed. St. Louis: Elsevier; 2004.
  • Wozny W, Long C, 2nd. Electromyographic kinesiology of the rheumatoid hand. Arch Phys Med Rehabil. 1966;47(11):699-704.
  • Van den Ende CH, Vliet Vlieland TP, Munneke M, Hazes JM. Dynamic exercise therapy in rheumatoid arthritis: a systematic review. Br J Rheumatol. 1998;37(6):677-687.
  • de Jong Z, Vliet Vlieland TP. Safety of exercise in patients with rheumatoid arthritis. Curr Opin Rheumatol. 2005;17(2):177-182.
  • Guidelines ACoRSoRA. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheumatism. 2002;46(2):328-346.
  • Singh JA, Saag KG, Bridges Jr SL, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis rheumatology. 2016;68(1):1-26.
  • Combe B, Landewe R, Daien CI, et al. 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis. 2017;76(6):948-959.
  • Dedeoglu M, Gafuroglu U, Yilmaz O, Bodur H. The relationship between hand grip and pinch strengths and disease activity, articular damage, pain, and disability in patients with rheumatoid arthritis: romatoid artritli hastalarda elle kavrama ve tutma guclerinin hastalik aktivitesi, eklem hasari, Agri ve engellilik ile Iliskisi. Turkish journal of rheumatology. 2013;28(2):69-78.
  • Dogu B, Sirzai H, Yilmaz F, Polat B, Kuran B. Effects of isotonic and isometric hand exercises on pain, hand functions, dexterity and quality of life in women with rheumatoid arthritis. Rheumatol Int. 2013;33(10):2625-2630.
  • Bodur H, Yılmaz Ö, Keskin D. Hand disability and related variables in patients with rheumatoid arthritis. Rheumatol Int. 2006;26(6):541-544.
  • Eberhardt K, Sandqvist G, Geborek P. Hand function tests are important and sensitive tools for assessment of treatment response in patients with rheumatoid arthritis. Scand J Rheumatol. 2008;37(2):109-112.
  • Baker JF, Von Feldt J, Mostoufi-Moab S, et al. Deficits in muscle mass, muscle density, and modified associations with fat in rheumatoid arthritis. Arthritis Care Res (Hoboken). 2014;66(11):1612-1618.
  • Uutela TI, Kautiainen HJ, Häkkinen AH. Decreasing muscle performance associated with increasing disease activity in patients with rheumatoid arthritis. PLoS One. 2018;13(4):e0194917.
  • Romero-Guzmán AK, Menchaca-Tapia VM, Contreras-Yáñez I, Pascual-Ramos V. Patient and physician perspectives of hand function in a cohort of rheumatoid arthritis patients: the impact of disease activity. BMC Musculoskelet Disord. 2016;17:392.
  • Stucki G, Schonbachler J, Bruhlmann P, Mariacher S, Stoll T, Michel BA. Does a muscle strength index provide complementary information to traditional disease activity variables in patients with rheumatoid arthritis? J Rheumatol. 1994;21(12):2200-2205.
  • Ekblom B, Lovgren O, Alderin M, Fridstrom M, Satterstrom G. Physical performance in patients with rheumatoid arthritis. Scand J Rheumatol. 1974;3(3):121-125.
  • Tiselius P. Studies on joint temperature, joint stiffness and muscle weakness in rheumatoid arthritis. An experimental and clinical investigation. Acta Rheumatol Scand. 1969;14:Suppl 14:1+.
  • Bodur H, Yilmaz O, Keskin D. Hand disability and related variables in patients with rheumatoid arthritis. Rheumatol Int. 2006;26(6):541-544.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Romatoloji ve Artrit, Rehabilitasyon
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Ozan Volkan Yurdakul 0000-0003-4567-8133

Okan Küçükakkaş Bu kişi benim 0000-0001-6971-4229

Yayımlanma Tarihi 1 Ağustos 2019
Kabul Tarihi 8 Nisan 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

APA Yurdakul, O. V., & Küçükakkaş, O. (2019). Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik ve Engellilik ile İlişkilidir?. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(2), 137-144. https://doi.org/10.32708/uutfd.524930
AMA Yurdakul OV, Küçükakkaş O. Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik ve Engellilik ile İlişkilidir?. Uludağ Tıp Derg. Ağustos 2019;45(2):137-144. doi:10.32708/uutfd.524930
Chicago Yurdakul, Ozan Volkan, ve Okan Küçükakkaş. “Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik Ve Engellilik Ile İlişkilidir?”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45, sy. 2 (Ağustos 2019): 137-44. https://doi.org/10.32708/uutfd.524930.
EndNote Yurdakul OV, Küçükakkaş O (01 Ağustos 2019) Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik ve Engellilik ile İlişkilidir?. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45 2 137–144.
IEEE O. V. Yurdakul ve O. Küçükakkaş, “Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik ve Engellilik ile İlişkilidir?”, Uludağ Tıp Derg, c. 45, sy. 2, ss. 137–144, 2019, doi: 10.32708/uutfd.524930.
ISNAD Yurdakul, Ozan Volkan - Küçükakkaş, Okan. “Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik Ve Engellilik Ile İlişkilidir?”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45/2 (Ağustos 2019), 137-144. https://doi.org/10.32708/uutfd.524930.
JAMA Yurdakul OV, Küçükakkaş O. Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik ve Engellilik ile İlişkilidir?. Uludağ Tıp Derg. 2019;45:137–144.
MLA Yurdakul, Ozan Volkan ve Okan Küçükakkaş. “Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik Ve Engellilik Ile İlişkilidir?”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 45, sy. 2, 2019, ss. 137-44, doi:10.32708/uutfd.524930.
Vancouver Yurdakul OV, Küçükakkaş O. Romatoid Artritli Kadın Hastalarda Üst Ekstremitede Hangi Kasların Güçleri Hastalık Aktivitesi, Fonksiyonellik ve Engellilik ile İlişkilidir?. Uludağ Tıp Derg. 2019;45(2):137-44.

ISSN: 1300-414X, e-ISSN: 2645-9027

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