Background Hand osteoarthritis (OA) affects 51% of women over 65 years. The distal and proximal interphalangeal joints and the first carpometacarpal joints are usually involved. This leads to pain as well as functional impairment in terms of stiffness, reduced grip force and limitations on daily activities.
Objectives The objective of this study was to measure impairment in terms of grip force, extension force, pain and stiffness, in order to determine a threshold value of grip force indicative of impaired hand function and to assess patient-reported limitations in hand function.
Methods The study comprised 53 women with hand OA. Grip force was measured with the Grippit instrument, the extension finger force was measured with a recently developed instrument, Ex-it, while pain and stiffness were graded using a visual analogue scale. Hand activities were evaluated with Resht’s test and with the patient-reported Quick Disabilities of the Arm Shoulder and Hand (DASH) Questionnaire.
Results Women with a grip force below 104 N had significantly greater difficulties performing hand activities, and more pain and stiffness than women with a grip force above 104 N.
Conclusions A grip force of 104 N appears to provide a good indication for associations between hand function and hand activities. This threshold value could be useful in hand training, working outside home and designing of technical equipment.
Botha-Scheepers S, Riyazi N, Watt I, Rosendaal F R, Slagboom E, Bellamy N, Breedveld FC and Kloppenburg M, 2009. Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study. Ann Rheum Dis 68 1260.
Brorsson S, Nilsdotter A, Sollerman C and Hilliges M, 2008. A new force measurement device for evaluatin finger extension functionin the healthy and rheumatoid arthritic hand. Technol Health Care.
Innes E, 1999. Handgrip strength testing: A review of the literature. Australian Occupational Therapy Journal 46: 120-40.
Kjeken I, 2010. Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis. Scand J Occup Ther.
Kjeken I, Dagfinrud H, Slatkowsky-Christensen B, Mowinckel P, Uhlig T, Kvien TK and Finset A, 2005. Activity limitations and participation restrictions in women with hand osteoarthritis: patients’ descriptions and associations between dimensions of functioning. Ann Rheum Dis 64: 1633-8.
Nordenskiold U, 1997. Daily activities in women with rheumatoid arthritis. Aspects of patient education, assistive devices and methods for disability and impairment assessment. Scand J Rehabil Med Suppl 37:1-72.
Nordenskiold U, Grimby G, Hedberg M, Wright B and Linacre JM, 1996. The structure of an instrument for assessing the effects of assistive devices and altered working methods in women with rheumatoid arthritis. Arthritis Care Res 9:358-67.
Philips CA, 1989. Rehabilitation of the patient with rheumatoid hand involvement. Phys Ther 69:1091-8.
Stamm T, van der Giesen F, Thorstensson C, Steen E, Birrell F, Bauernfeind B, Marshall N, Prodinger B, Machold K, Smolen J and Kloppenburg M, 2009. Patient perspective of hand osteoarthritis in relation to concepts covered by instruments measuring functioning: a qualitative European multicentre study. Ann Rheum Dis 68:1453-60.
Disclosure of Interest None Declared