Balçova Thermal SpA,Physical Therapy And Rehabilitation Center, İzmir/TURKEY MSc.,PT.,Burcu APLAK ARIN

EVALUATION Of HAND FUNCTIONS AND QUALITY Of LIFE(SF-36)IN RHEUMATOID ARTHRITIS PATIENTS

Pain Stiffness Quality of life Fatigue Functional capacity Physical Disability

The objective of study is to evaluate the hand functions and quality of life in rheumatoid arthritis patients.

Material –Method:

213 Norwegian cases with RA Combine therapy 3 weeks(3 active,2 passive) Assessment  Demographic variable  Disease duration  Functional classification(ACR)  Hand measuruments(grip strenght,distance between tip of finger and their bases (DTFB))

SACRAH Questionnaire ( S core for A ssessment and Quantification C hronic R heumatic A ffections Of H ands ) Hand functions (17 questions):locking a door,turning the handle of door,writing,cutting with a kitchen-knife e.g.

Morning stiffness (2 questions) Pain(4 questions)

Exclusion Criteria:

Patients who have secondary problems(neurological,cardiopulmonary, orthopaedical e.g.) Patients who were unable to complete the therapy course Patients who had hand operations Functional class IV

RESULTS

Mean age of cases 49.63

Means of disease duration female  8.87 male  ± 12.07

Female 139(%65.3) Male 74(%34.7) 6.91 (p:0.000

) Functional classification(ACR) I------→%38.2

II-----→%41.3

III----→%20.5

We determined significantly possitive findings in grip strenght and DTFB measuruments in male than female.(p:0.004)

Comparing Scores of SACRAH total and subscale pre and post treatment

60,00 50,00 40,00 30,00 20,00 10,00 0,00 pre post HF MS Pain TS

Correlation Between SACRAH Total Score and Grip Strenght,DTFB Correlation Coefficient Grip Strenght SACRAH Total Score r:-0.698

p:0.001

DTFB-SACRAH Total Score r:0.544

p:0.003

Internal Consistency Of SACRAH Total And Subscale Score Score Cronbach Alpha Hand Function 0.89

Morning Stiffness Pain Total 0.81

0.86

0.96

The differences between pre and post treatment scores of eight subscale in male were significantly high.(p<0.05) The differences between role of physical functioning,bodily pain,social functioning and menthal health domains were no significant in female.(p>0.05)

Comparing Two Summary Scores Among Male and Female

45 40 35 30 25 20 15 10 5 0 PCS MCS Female Male

40 30 20 10 0

Comparing Scores Of SF-36 Subscale According To Disease Duration

60 50 under 5 years over 5 years PF RP BP SF RE

PF,BP,GH and SF subscale scores were determined significantly higher in cases who have functional class I and II than III

Conclusions:

Sex Disease Duration QoL Functional Class

The SACRAH score may be an useful tool in measuring the degree rheumatic hand functions and effectiveness of therapy.

Our study shows that comprehensive physiotherapy increases the quality of life and ability of doing activity of daily living in rheumatoid arthritis patients.