Günay S M, Tuna Z, Oskay D
Uludag University Ataturk Rehabilitation Practice and Research Center, Bursa.
Reumatismo. 2016 Dec 31;68(4):183-187. doi: 10.4081/reumatismo.2016.943.
Rheumatoid arthritis (RA) often results in impairments in upper extremities, especially in the small joints of hand. Involvement of hand brings limitations in activities of daily living. However, it is commonly observed that patient-reported functional status of hand does not always corresponds to their actual physical performance in the clinical setting. The aim of this pilot study is to investigate the relationship between patient self-reported and objectively measured hand functions in patients with RA. Twenty-six patients (51±13 years) with RA diagnosis participated in the study. Hand grip and pinch (lateral, bipod, tripod) strengths were measured and Jebsen Hand Function Test (JHFT) was performed for objective functional performance. Duruöz Hand Index and Beck Depression Inventory - Turkish version were completed by patients. Grip and all three-pinch strength results significantly correlated with Duruöz Hand Index scores (p<0.05). JHFT results except the sentence writing also correlated with the Duruöz scores (p<0.05). Our results showed that self-reported outcome scales might be used for determining functional level of hand in patients with RA in rheumatology practice. Objective quantitative functional tests are the best methods in evaluating functional level of hand, but require valid and reliable equipment with accurate calibration. Therefore, in case of unavailability of objective assessment tools, patient-reported scales may also reflect the real status of hand functions.
类风湿性关节炎（RA）常导致上肢功能受损，尤其是手部小关节。手部受累会给日常生活活动带来限制。然而，在临床环境中通常观察到，患者报告的手部功能状态并不总是与其实际身体表现相符。这项初步研究的目的是调查类风湿性关节炎患者自我报告的手部功能与客观测量的手部功能之间的关系。26名确诊为类风湿性关节炎的患者（年龄51±13岁）参与了该研究。测量了握力和捏力（侧捏、二指捏、三指捏）强度，并进行了杰布森手部功能测试（JHFT）以评估客观功能表现。患者完成了杜鲁奥兹手部指数和贝克抑郁量表土耳其语版。握力和所有三种捏力强度结果均与杜鲁奥兹手部指数评分显著相关（p<0.05）。除句子书写外，JHFT结果也与杜鲁奥兹评分相关（p<0.05）。我们的结果表明，在风湿病实践中，自我报告的结果量表可用于确定类风湿性关节炎患者的手部功能水平。客观定量功能测试是评估手部功能水平的最佳方法，但需要有效且可靠的设备并进行精确校准。因此，在没有客观评估工具的情况下，患者报告的量表也可能反映手部功能的实际状况。
