Assessment of hand functions in patients with Behcet disease

Objective: Behçet's disease is a chronic, systemic vasculitis that affects multiple organ systems. Hand functions are crucial for individuals to maintain independence in daily activities. This study was designed to comprehensively assess hand functions in Behçet's patients and to investigate whether there is a loss of fine motor skills. Materials and Methods: The study included 40 Behçet's patients diagnosed according to the International Study Group for Behçet's Disease criteria and 41 healthy individuals as a control group, who presented to the Physical Medicine and Rehabilitation Outpatient Clinic of Dicle University Faculty of Medicine between March 2024 and November 2024. Hand functions were evaluated using the Duruöz Hand Index (DHI), Purdue Pegboard Test, and grip strength measurements. Hand grip strength was assessed using a SAEHAN hand dynamometer and pinch meter, with measurements taken for both dominant and non-dominant hands. Disease activity was assessed with the Behçet's Disease Current Activity Form (BDCAF), and quality of life was evaluated using the Health Assessment Questionnaire (HAQ). Pain intensity was measured using the Visual Analog Scale (VAS). Statistical analyses were performed to compare differences between groups and to examine the relationship between disease duration and hand function loss. Results: Hand grip strength in Behçet's patients (right hand: 25.0 ± 10.6 kg; left hand: 20.6 ± 10.3 kg) was significantly lower compared to the control group (p<0.05). Hand functions such as lateral grip, palmar grip, and fingertip grip were also found to be lower in Behçet's patients. Purdue Pegboard Test scores were significantly lower in Behçet's patients (p<0.001), indicating a decline in fine motor skills. Additionally, Duruöz Hand Index (DHI) and HAQ scores were higher in Behçet's patients, reflecting limitations in daily living activities. The mean pain level measured by VAS was 3.7 ± 2.4 in Behçet's patients. A negative correlation was found between VAS and grip strength in the right hand (p<0.001) and left hand (p<0.001). Furthermore, a negative correlation was also identified between VAS and Purdue1 (p<0.05) as well as Purdue2 scores (p<0.05). Conclusion: Behçet's disease negatively affects hand functions in individuals. These findings emphasize the importance of assessing hand functions in the rehabilitation process of Behçet's patients and highlight the need for rehabilitation approaches to address hand function loss. Keywords: Behçet's disease, hand functions, hand grip, fine motor coordinations