Reaes Fabio Mazetti, Ivo Mauricio Menezes Aben Athar, Scarcella Daniele Dos Santos, Almeida Ligia Cortez, Suzuki Rosana Mayumi, Rezende Marcia Uchoa DE
. Osteometabolic Diseases Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Acta Ortop Bras. 2018 Jan-Feb;26(1):41-47. doi: 10.1590/1413-785220182601184420.
To evaluate the effect of a clinical management program involving education on hand function in patients with rhizarthritis.
One hundred and eight patients with rhizarthritis and multiple arthritis (191 hands with clinical and radiographic rhizarthritis) followed for two years as part of an educational program on osteoarthritis were administered the SF-36, DASH, and HAQ questionnaires and measured for the strength of their palmar grip, pulp to pulp pinch, key (lateral) pinch, and tripod pinch at the time of inclusion and after 24 months. Age, race, level and frequency of physical activity, sex, body mass index, percentage of body fat, and degree of osteoarthritis were correlated to the test outcomes.
Women improved less than men on the HAQ (p=0.037). Each 1% reduction in fat percentage increased the chance of HAQ score improvement by 9.2% (p=0.038). Physical activity did not influence improvement in the parameters evaluated (p>0.05). Palmar grip improvement was affected by age and presence of rhizarthritis (p<0.05); patients with unilateral rhizarthritis improved 5.3 times more than patients without the disease (p=0.015), while improvement in palmar grip strength decreased 6.8% per year (p=0.004). Pulp pinch grip strength improved more in women than in men (p=0.018).
Patients with rhizarthritis and multiple arthritis improved quality of life and grip strength through clinical treatment, an educational program, and fat loss.
评估一项包含手部功能教育的临床管理项目对类风湿性关节炎患者的效果。
作为骨关节炎教育项目的一部分,对108例类风湿性关节炎和多关节炎患者(191只手有临床和影像学类风湿性关节炎表现)进行了为期两年的随访,在纳入研究时和24个月后,让他们填写SF-36、DASH和HAQ问卷,并测量其掌部握力、指尖对指尖捏力、钥匙(外侧)捏力和三指捏力。将年龄、种族、身体活动水平和频率、性别、体重指数、体脂百分比和骨关节炎程度与测试结果进行相关性分析。
在HAQ问卷上,女性的改善程度低于男性(p=0.037)。体脂百分比每降低1%,HAQ评分改善的机会增加9.2%(p=0.038)。身体活动对所评估参数的改善没有影响(p>0.05)。掌部握力的改善受年龄和类风湿性关节炎的影响(p<0.05);单侧类风湿性关节炎患者的改善程度是无该病患者的5.3倍(p=0.015),而掌部握力每年下降6.8%(p=0.004)。女性的指尖捏力改善程度大于男性(p=0.018)。
类风湿性关节炎和多关节炎患者通过临床治疗、教育项目和减肥改善了生活质量和握力。