Tore Nurten Gizem, Zorlular Ali, Yildirim Derya, Atalay Guzel Nevin, Oskay Deran
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Cukurova University, Adana, Turkey.
Musculoskelet Sci Pract. 2024 Aug;72:103122. doi: 10.1016/j.msksp.2024.103122. Epub 2024 Jun 12.
Rheumatoid arthritis (RA) is a systemic and autoimmune disease that affects many tissues and organs in the body, especially the synovial joint and periarticular structures. One of the most affected joints is the hand joints, and there is also involvement in the wrist joint.
The purpose of this study was to assess the sensory and motor functions of the wrist with a gold standard method and to determine the relationship between the motor and sensory functions of the wrist and wrist-related pain/disability level and hand grip strength in patients with RA.
Flexor and extensor muscle strength and joint position sense of the wrist were evaluated using isokinetic dynamometer, hand grip strength was measured using dynamometer, and wrist related pain and disability was assessed by Patient Rated Wrist Evaluation (PRWE) questionnaire.
Thirty-one patients with RA and 31 healthy controls were included in the study. Control group had better results regarding wrist flexor and extensor muscle strength and wrist joint position sense than RA patients for both hands/wrists. A positive and strong correlation and a negative and weak correlation were found between muscle strength and joint position sense of the wrist and hand grip strength, respectively.
Compared to healthy subjects, RA patients showed wrist-related sensorimotor deficits. Therefore, evaluation of the wrist should not be ignored in the examination of patients with RA. In addition, when planning the treatment program of the patients, not only hand exercises but also exercises involving the wrist should be taken into consideration.
类风湿关节炎（RA）是一种全身性自身免疫性疾病，会影响身体的许多组织和器官，尤其是滑膜关节和关节周围结构。受影响最严重的关节之一是手部关节，腕关节也会受累。
本研究旨在采用金标准方法评估腕关节的感觉和运动功能，并确定RA患者腕关节的运动和感觉功能与腕关节相关疼痛/残疾程度及握力之间的关系。
使用等速测力计评估腕关节的屈肌和伸肌力量以及关节位置觉，使用测力计测量握力，并通过患者自评腕关节评估（PRWE）问卷评估腕关节相关疼痛和残疾情况。
本研究纳入了31例RA患者和31名健康对照者。在双手/双腕的腕关节屈肌和伸肌力量以及腕关节位置觉方面，对照组的结果均优于RA患者。腕关节的肌肉力量与关节位置觉之间分别存在正相关且强相关以及负相关且弱相关，与握力之间也分别存在正相关且强相关以及负相关且弱相关。
与健康受试者相比，RA患者存在腕关节相关的感觉运动功能缺陷。因此，在RA患者的检查中不应忽视腕关节的评估。此外，在制定患者的治疗方案时，不仅应考虑手部锻炼，还应考虑涉及腕关节的锻炼。
