Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population

Area of Science:

• Rheumatology
• Occupational Therapy
• Rehabilitation Medicine

Background:

• Early rheumatoid arthritis (RA) significantly impacts upper limb function.
• Assessing upper limb function in RA requires understanding the relationship between self-report, therapist assessment, and structural impairments.

Purpose of the Study:

• To investigate the correlation between self-reported upper limb function (Disability of the Arm, Shoulder and Hand - DASH), therapist-assessed function (Grip Ability Test - GAT), and structural impairments (handgrip, active hand motion, metacarpophalangeal joint ulnar deviation) in early RA.
• To determine the most accurate measures for assessing upper limb ability in early RA patients.

Main Methods:

• Thirty-six patients with early RA were recruited from outpatient occupational therapy departments.
• Upper limb function was measured using the DASH questionnaire and GAT.
• Structural impairments were assessed via bilateral power handgrip, goniometry for metacarpophalangeal (MCP) joint ulnar deviation, and active wrist motion.

Main Results:

• Strong correlations (> 0.7) were observed between the DASH and GAT.
• Bilateral power handgrip strength showed strong correlations with both functional assessments.
• Ulnar deviation at the MCP joints exhibited weak to moderate correlations with functional measures, particularly on the non-dominant side.

Conclusions:

• Handgrip strength is a reliable indicator of upper limb ability in early RA.
• Ulnar deviation at the MCP joints has a limited association with upper limb functional activity and ability.
• The DASH questionnaire demonstrated greater discrimination in assessing upper limb ability compared to the GAT in this early RA population.