Hand function in 45 patients with sporadic inclusion body myositis

The purpose of this study was to explore hand function in patients with sporadic inclusion body myositis (sIBM) using the Sollerman Hand function test, finger range of motion, hand- and pinch strength, and fine motor ability as well as subjective estimate of hand- and grip function. Forty-five outpatients with definite sIBM were investigated using handgrip-, lateral-, and pinch strength, active finger range of motion (AROM), fine motor ability with Purdue Pegboard test, Sollerman Hand function test, and patients' estimated hand- and grip function. The association between these variables were assessed using correlation statistics. A second test occasion was performed in 16 patients in order to investigate the intra-rater reliability. We found that the reduction of hand- and pinch strength was more pronounced (37% right, 31% left hand) than lateral strength (50%) in relation to normal values. AROM was impaired in 25 (56%) in the right and 29 (64%) in the left hand. Fine motor ability was fairly well preserved; mean right/ left 70 and 60% of normal. AROM deficit was found to be present in 50% of patients 7 years after perceived hand weakness. This is important since it was found to impair the usefulness of the different strength measures, while limitations due to AROM deficit were not found regarding the Sollerman and to a lesser extent the Purdue Pegboard tests. Results of the test-retest showed very good reliability. Our results indicate that impairment of hand function is frequent and severe in sIBM patients. Reduction in AROM is frequent, and it is important to identify since it affects the usefulness of handgrip measurements, and further that may be treatable. Several different tests are probably needed in order to describe the patients' limitations and to capture changes over time. Compensatory strategies when gripping test items is a problem especially in patients with AROM deficits. Research on validity and reliability of these tests in sIBM patients are lacking. Copyright © 2012 John Wiley & Sons, Ltd.