The effect of rheumatoid hand and symptomatic hand osteoarthritis on health-related quality of life and hand functions

It is important to identify the limitations and deficiencies of hand and wrist with close follow-up of hand functions of the people with diseases that have hand-wrist involvement and impaired functions of the hands, such as rheumatoid arthritis (RA) and hand osteoarthritis (OA). The purpose of this study was to make a comparative evaluation of daily life activities and hand functions of rheumatoid hand and symptomatic hand osteoarthritis.The study included a total of 61 females comprising 20 patients with rheumatoid arthritis (Group 1) and 21 patients with hand osteoarthritis (Group 2) who met the American College of Rheumatology (ACR) classification-diagnosis criteria and 20 healthy subjects (Group 3) as a control group. Patient demographic characteristics were recorded. Pain was evaluated using a Likert pain scale. The presence and number of nodules in patients with hand OA, hand-wrist deformities with RA and tender joint count of all individuals were recorded. The disease activity of RA patients was determined by Disease Activity Score (DAS28). Grip and pinch strength of both hands was tested with a Jamar dynamometer and manual pinchmeter. Hand functional disability was tested with the Duruöz Hand Index (DHI) and the Jebsen Taylor Hand Function Index (JTHFI). Daily living activities were assessed by a Health Assessment Questionnaire (HAQ) score.There was no significant difference between Group 1, Group 2 and Group 3 in terms of demographic characteristics (p> 0.05). There was no significant difference between Group 1 and 2 in terms of total median scores of HAQ, DEI, JTHFI (p> 0.05). The median of the HAQ and the DEI score was reduced and the JTHFI total median score was shorter in Group 3 when compared with Groups 1 and 2 (p <0.05). The median of fingertip grip, key holding and palmar holding force was found to be significantly lower in Group 1 than Group 3 (p <0.05). There was no statistically significant difference between Group 2 and Group 1, or between Group 2 and Group 3 in terms of pinch strength median (p> 0.05). The parameters most afffecting the HAQ score were palmar holding force in Group 1 and the number of tender joints in Group 2. The parameters most affecting DHI were hand grip strength in Group 1 and the number of tender joints in Group 2. The parameter most affecting JTHFT was duration of education in Groups 1 and 2. The results of this study showed that hand grip and pinch strength were reduced, and hand functions and quality of life were impaired in RA and hand OA patients. These patients should be followed up closely and should be informed about assistive devices to facilitate the activities of daily life.