Assess the relationship between hand-wrist functions and wrist proprioception and upper extremity stability in children with juvenile idiopathic arthritis

The aim of the study was to examine whether there is a relationship between proprioceptive impairment and upper limb stability and hand-wrist functions in children diagnosed with JIA. A total of sixty children, 20 JIA patient with wrist involvement, 20 JIA patient without wrist involvement and 20 healthy controls, were included in the study. Wrist joint position sense was evaluated by measuring joint re-position error in four movements as flexion, extension, radial deviation and ulnar deviation. General functional status, subjective hand functions, and objective hand functions were assessed by using Childhood Health Assessment Questionnaire (CHAQ), Duruoz Hand Index and Purdue Pegboard Test respectively. Upper limb stability was evaluated by using İsometric Scapular Muscle Endurance Test. Joint position sense (in all directions except radial deviation) and manual dexterity (except assembly) was found negatively affected in JIA patients with wrist involvement compared to healthy controls (p<0.05). No differences (except radial deviation) were observed between JIA patients without wrist involvement and healthy controls. JIA patients with wrist involvement reported poorer hand functions compared to JIA patients without wrist involvement (p<0.05). Scapular Muscle Endurance was moderately related to CHAQ Disability Index score and Purdue Pegboard Test Single Hand score in JIA patients with wrist involvement, PPT Assembly score was strongly correlated with scapular muscle endurance. There was a moderately relationship between Scapular Muscle Endurance and Purdue Pegboard Test Both Hand score in JIA patients with without involvement (p<0.05).The results of this study show that joint position sense and related manual dexterity is diminished in JIA patients with wrist involvement. According to our results in wrist involved JIA patients, scapular endurance was found more related to hand functions. Hand therapy programs might help improving joint position sense acuity. It might be a beneficial strategy to work on scapular muscles in JIA patients with poor hand functions. KeyWords: arthritis, juvenile, proprioception