Background Juvenile idiopathic arthritis (JIA), among the most common chronic diseases of childhood, can be associated with pain. reduced range of motion, decreased muscle strength and functionality (1).
Objectives The aim of this study was to assess the relationships between wrist pain and functional performance, grip and pinch strength in children and adolescents with JIA.
Methods Cross-sectional study design was included 42 (36 female. 6 male) children and adolescents with JIA aged between 8 and 18 years. Patients who have at least one affected wrist included in the study. Sociodemographic data and clinical features were assessed by physical therapists. Hand grip strength was assessed with Jamar dynamometer Lateral, tip and palmar pinch strengths were assessed with Baseline pinchmeter. Wrist pain during the activity was evaluated with Numeric Rating Scale (NRS). A score of 0 indicated “no pain” and 10 indicated “extreme pain” for NRS. Functional performance of hand was assessed with “Jebson Taylor Hand Functional Test” (JTHFT). JTHFT consists 7 subtests: writing a 24-letter. card turning, picking up small common objects and placing them in a container, stacking checkers, stimulated feeding, moving light objects and moving heavy objects. All tests except writing performed on both right and left hand for JTHFT.
Results The mean age and duration of disease was 13.05±3.04 (age range 8–18) and 6.55±3.78 years. respectively. Patient population consisted of 28 patients with polyarticular arthritis. 14 patients with oligoarticular arthritis. 39 of 42 patient's wrists were affected bilaterally. Significant relationships were found between writing and right palmar pinch strength (r= -0.34 p=0.023), right hand grip strength and right stimulated feeding (r=-0.32 p=0.039), left hand grip strength and left moving heavy objects (r=-0.33 p=0.028). Also, significant relationships were found between right lateral pinch strength and stimulated feeding (r=-0.33 p=0.028) and right stacking checkers (r=-0.31 p=0.039). For right side, significant relationships were found between palmar pinch and moving light objects (r=-0.35 p=0.020), moving heavy objects (r=-0.32 p=0.039), stimulated feeding (r=-0.36 p=0.017), stacking checkers (r=-0.36 p=0.017), card turning (r=-0.34 p=0.026) and JTHFT-total (r=-0.40 p=0.008).
Conclusions The results of our study showed that hand grip and pinch strengths considerably decreased in children and adolescents with JIA, according to the normal means of the grip strengths of healthy children and adolescents reported in the literature (2). Our study suggested that decreased hand grip and pinch strengths may result impairment daily functions but wrist pain does not effect grip strengths or functional performance in children and adolescents with JIA. Therefore, we conclude that the grip training program will be effective in improving the functional performance of children and adolescents with JIA.
Ravelli A, Martini A (2007) Juvenile idiopatic arthritis. Lancet 369 (9563):767–778.
Mathiowetz, Virgil, Diana M. Wiemer, and Susan M. Federman. Grip and pinch strength: norms for 6-to 19-year-olds. American Journal of Occupational Therapy 40.10 (1986): 705–711.
Disclosure of Interest None declared
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