Ceceli Esma, Gül Sebahat, Borman Pınar, Uysal Selma Ramadan, Okumuş Müyesser
Department of Physical Medicine and Rehabilitation, Ankara Education and Research Hospital, Zirvekent Blokları D Blok No: 13, Ankara, Turkey.
Hand (N Y). 2012 Sep;7(3):335-40. doi: 10.1007/s11552-012-9434-0.
We aimed to investigate the effect of hand osteoarthritis (HOA) on hand strength, dexterity, and upper extremity functional scores, as well as to determine the relation of radiological severity of HOA with these parameters.
Sixty patients and 40 controls were enrolled in the study. The presence of hand pain, nodes, and tenderness in hand joints was determined. Grip and pinch strengths were measured by Jamar dynamometer and pinch meter, dexterity was assessed by Purdue pegboard test, and upper extremity function was determined by disabilities of arm, shoulder and hand (DASH) test. Hand radiographs were evaluated according to the Kallman grading scale.
The mean age of the patients and control subjects were 58.9 ± 4.8 and 56.6 ± 5.8 years, respectively. The level of hand pain and tenderness, and the number of nodes were significantly higher in the patient group than in control subjects. The mean grip and pinch strengths were lower in the patient group,: however, the difference was significant only in left lateral and left three chuck pinch. In hand dexterity, all scores except Purdue 1 were significantly lower in the patient group. In the functional evaluation DASH outcome, questionnaire scores of the patient and control groups were 48.3 ± 26.3 and 39.5 ± 23.5, respectively (p > 0.05). In the patient group, Kallman scores indicating radiological severity were found to be correlated with age, DASH scores, grip and pinch strengths, and Purdue scores (except Purdue assembly). Pain by visual analog scale was significantly higher in the patient group and correlated significantly with DASH scores.
In patients with HOA, using standardized tests for evaluations may not be adequate. The determination of grip-pinch strength, dexterity and functional disability will lead to a clearer definition of the needs of the patients and will likely increase the gains from the rehabilitation programs.
我们旨在研究手部骨关节炎（HOA）对手部力量、灵活性和上肢功能评分的影响，并确定HOA的放射学严重程度与这些参数之间的关系。
60例患者和40例对照者纳入本研究。确定手部疼痛、结节和手部关节压痛情况。使用Jamar握力计和捏力计测量握力和捏力，通过普渡钉板测试评估灵活性，通过手臂、肩部和手部功能障碍（DASH）测试确定上肢功能。根据卡尔曼分级量表对手部X线片进行评估。
患者组和对照组的平均年龄分别为58.9±4.8岁和56.6±5.8岁。患者组的手部疼痛和压痛程度以及结节数量显著高于对照组。患者组的平均握力和捏力较低：然而，仅左侧外侧和左侧三指捏的差异具有统计学意义。在手部灵活性方面，患者组除普渡1外的所有评分均显著较低。在功能评估DASH结果中，患者组和对照组的问卷评分分别为48.3±26.3和39.5±23.5（p>0.05）。在患者组中，显示放射学严重程度的卡尔曼评分与年龄、DASH评分、握力和捏力以及普渡评分（普渡组装除外）相关。患者组视觉模拟量表的疼痛评分显著更高，且与DASH评分显著相关。
在HOA患者中，使用标准化测试进行评估可能不够充分。确定握力-捏力、灵活性和功能障碍将有助于更明确地定义患者的需求，并可能增加康复计划的收益。
