Article Text

AB1174-HPR Effects of Disease Activity on Hand Functions in Rheumatoid Arthritis
  1. Z. Tuna1,
  2. D. Onbulak2,
  3. D. Oskay1,
  4. S.M. Günay3,
  5. R. Mercan4
  1. 1Physiotherapy and Rehabilitation, Faculty of Health Sciences
  2. 2Physiotherapy and Rehabilitation, Institute of Health Sciences, Ankara
  3. 3Physical Therapy and Rehabilitation, Faculty of Medicine, Bursa
  4. 4Department of Internal Medicine Division of Rheumatology, Faculty of Medicine, Ankara, Turkey


Background Rheumatoid arthritis (RA) is a chronic inflammatory disease with exacerbation and remission periods. Patients tend to limit their physical activity levels further during the exacerbations in addition to already existing physical inactivity due to the chronic disease course. Such a decrease in physical activity results in impairments in activities of daily life requiring musculoskeletal structures especially the hand.

Objectives The aim of this study is to evaluate the relationship between the disease activity and hand functional level.

Methods Patients (30-60 years) with RA from both inpatient and outpatient departments participated in the study. Disease activity was determined with Disease Activity Score-28 (DAS-28) and functional level of hand was assessed by grip and pinch (lateral, bipod, tripod) strength measurements and Nine-Hole Peg Test. All participants completed Michigan Hand Outcome Questionnaire in order to determine the disability level of hand.

Results Fifty patients (29 inpatients and 21 age-matched outpatients) participated in the study. Comparison of the two groups showed that DAS-28 scores were significantly different (p<0,05). DAS-28 scores were significantly inversely correlated to all three pinch strenghts, Nine-Hole Peg Test and Michigan scores (p<0,05). Intra-group correlations showed no relationship between DAS-28 scores and hand functions in the outpatient group (p>0,05); however, inpatient group showed a significant correlation between the disease activity and hand functional tests (p<0,05).

Conclusions Our results showed that disease activity is in an inverse relationship with the functional level of hand in patients with RA. Additionally, that relationship still exists in the inpatient group, indicating the increase in disease activity results in more impairment of hand despite the outpatient group showed no relationship between the outcomes. Therefore, hand therapy should be established as a crucial part of the treatment of RA even in the flaring period of the disease.


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  3. Öksüz Ç, Akel BS, Oskay D, Leblebicioglu G, Hayran KM. Cross-Cultural Adaptation, Validation, and Reliability Process of the Michigan Hand Outcomes Questionnaire in a Turkish Population J Hand Surg 2011;36A:486–492.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3115

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