scholarly journals Hand impairment and functional ability: A matched case comparison study between people with rheumatoid arthritis and healthy controls

Hand Therapy ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 115-122 ◽  
Author(s):  
Melissa Packer ◽  
Mark Williams ◽  
Dinesh Samuel ◽  
Jo Adams
Keyword(s):  
Rheumatoid Arthritis ◽  
Grip Strength ◽  
Functional Ability ◽  
Healthy Controls ◽  
Pinch Grip ◽  
Case Comparison ◽  
Matched Case ◽  
And Function ◽  
Hand Impairment ◽  
Healthy Participants

Introduction The aim of this study was to compare hand impairment and function in a cohort of patients with rheumatoid arthritis and matched healthy participants. Methods A matched case comparison research design comparing hand impairment and functional ability between patients with rheumatoid arthritis and healthy participants (males or females, aged ≥ 50 years). Functional ability was assessed using the Michigan Hand Questionnaire, power and pinch grip strength and the nine-hole peg test. Results A total of 100 participants (50 patients with rheumatoid arthritis and 50 matched healthy participants) were recruited. Patients with rheumatoid arthritis reported significantly lower overall hand function, activities of daily living, work, aesthetics, satisfaction ( p < 0.001) and significantly higher pain scores when compared with healthy controls. The patients with rheumatoid arthritis had significantly lower maximum power and pinch grip strength in both left and right hands ( p < 0.001) when compared with healthy controls. The rheumatoid arthritis group took significantly longer to complete the nine-hole peg test using both right and left hands compared with healthy controls ( p < 0.001, respectively). Additionally, in rheumatoid arthritis patients, a significant moderate, positive correlation between power grip strength and activities of daily living (r = 0.584, n = 50, p < 0.01) and a weak-to-moderate, significant negative correlation between power grip strength and pain (r = −0.314, n = 50, p < 0.05) were reported. Conclusion Despite the recent substantial improvement of drug therapy and disease control, the functional impact of rheumatoid arthritis on hand pain and function remains significant.

scholarly journals POS0514 IMPORTANCE OF BODY MASS MEASUREMENT AND THE GRIP STRENGTH TEST TO PREDICT FALLS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 491.2-491
Author(s):  
M. Tada ◽  
Y. Yamada ◽  
K. Mandai ◽  
N. Hidaka
Keyword(s):  
Rheumatoid Arthritis ◽  
Survival Rate ◽  
Grip Strength ◽  
Muscle Mass ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Free Survival ◽  
Leg Muscle ◽  
And Function

Background:We previously reported that the prevalence of sarcopenia was 28% in patients with rheumatoid arthritis (RA) in a cohort study 1. RA patients have a high risk of falls and fractures 2. However, the predictors of falls and fractures in RA patients are not known.Objectives:Whether evaluation of muscle mass and function at baseline could predict falls and fractures during four-year follow-up was investigated.Methods:The four-year follow-up data from a prospective, observational study (CHIKARA study: Correlation researcH of sarcopenIa, sKeletal muscle and disease Activity in Rheumatoid Arthritis) were used. Muscle mass was measured by a body impedance analyzer, and leg muscle mass was calculated. The leg muscle score (max: 100, min: 0) reflected the ratio of leg muscle mass to overall weight. Grip strength as an indicator of muscle function was evaluated using a digital, hand-held, isokinetic dynamometer. The correlations between muscle mass or function and falls or fractures were analyzed by survival rates and Cox hazard ratios. Leg muscle mass and grip strength were investigated by receiver operating characteristic (ROC) curve analysis for correlations with falls or fractures.Results:A total of 100 RA patients (female: 78%, mean age: 66.1 years) were enrolled; 35 patients had falls, and 19 patients had fractures during the four-year follow-up. The leg muscle score, grip strength, age, and fractures at baseline were significantly correlated with falls. The cut-off values of the leg muscle score and grip strength were calculated to be 84.5 points (sensitivity: 0.79, specificity: 0.43) and 15.9 kg (sensitivity: 0.56, specificity: 0.70), respectively, by ROC curve analysis. The patients were divided into four groups by their leg muscle scores and grip strength; the numbers of falls and fractures are shown in Table 1 for each group. The fall-free survival rate was significantly lower in the group with low leg muscle score and low grip strength (35.3%) than in the other groups (P=0.002) (Figure 1). The hazard ratio for the both low group was significantly increased, 3.6-fold (95%CI: 1.1-11.5), compared to that in the both high group.Table 1.Numbers of falls and fractures by category of leg muscle score and grip strengthLG + GS+(n=34)LG - GS+(n=12)LG + GS-(n=37)LG - GS-(n=17)P value*Falls, N6515110.010Fractures, N34660.072LG+: leg muscle score >84.5 points, GS+: grip strength >15.9kg, LG-: leg muscle score ≤84.5 points, GS+: grip strength ≤15.9kg*: compared in four groups by Kruskal-Walls test.Figure 1.Fall-free survival rate in the four groupsConclusion:RA patients with both low leg muscle score and low grip strength at baseline were at high risk for falls during the four-year follow-up period. Evaluation of muscle mass and function can predict falls in RA patients.References:[1]Tada, M., Yamada, Y., Mandai, K. & Hidaka, N. Matrix metalloprotease 3 is associated with sarcopenia in rheumatoid arthritis - results from the CHIKARA study. Int J Rheum Dis21, 1962-1969, doi:10.1111/1756-185X.13335 (2018).[2]van Staa, T. P., Geusens, P., Bijlsma, J. W., Leufkens, H. G. & Cooper, C. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum54, 3104-3112, doi:10.1002/art.22117 (2006).Disclosure of Interests:None declared

scholarly journals Eotaxin-1/CCL11 is involved in cell migration in rheumatoid arthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kuninobu Wakabayashi ◽  
Takeo Isozaki ◽  
Yumi Tsubokura ◽  
Sayaka Fukuse ◽  
Tsuyoshi Kasama
Keyword(s):  
Rheumatoid Arthritis ◽  
Cell Migration ◽  
Mrna Expression ◽  
The Self ◽  
Pcr Analysis ◽  
Healthy Controls ◽  
Tnf Α ◽  
Synovial Fluids ◽  
And Function ◽  
Fibroblast Like Synoviocytes

AbstractEotaxin-1 (CCL11) induces the migration of different leukocyte types by interacting with CCR3. In rheumatoid arthritis (RA), fibroblast-like synoviocytes (FLS) are pathogenic effectors and a major CCR3-expressing cell. The aim of this study was to investigate the expression and function of CCL11 in RA FLS. The expression of CCL11 and CCR3 was evaluated by ELISA, immunofluorescence and quantitative PCR analysis. The CCL11 levels in serum and synovial fluids (SFs) from RA patients were significantly higher than those in serum from healthy controls and SFs from osteoarthritis patients. CCL11 and CCR3 were expressed in the RA synovial tissue lining layers. The secretion of CCL11 in RA FLS-conditioned medium and the mRNA expression of CCL11 and CCR3 were induced by TNF-α. Furthermore, CCL11 induced the mRNA expression of CCL11 and CCR3. Application of a CCR3 antagonist reduced TNF-α-induced CCL11 secretion from RA FLS. CCL11 induced the migration of RA FLS and monocytes. RA FLS migration was decreased by treatment with CCL11 siRNA. The migration of monocytes to medium conditioned with CCL11 siRNA-transfected and TNF-α-stimulated RA FLS was reduced. These data indicate that the self-amplification of CCL11 via CCR3 may play an important role in cell migration in RA.

What can Handgrip Strength tell the Therapist about Hand Function?

2005 ◽  
Vol 10 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Helen Tyler ◽  
Jo Adams ◽  
Bridget Ellis
Keyword(s):  
Grip Strength ◽  
Clinical Assessment ◽  
Handgrip Strength ◽  
Hand Function ◽  
Treatment Progress ◽  
And Function ◽  
Hand Impairment

Power handgrip strength is recorded by clinicians as a quick and viable measure of hand impairment and function that can serve as a useful evaluation of hand status and treatment progress. This paper explores the procedure and reliability of measuring handgrip using different equipment. The extent of usefulness of grip strength as an indicator of structural impairment and ability measures in patient populations is questioned and the relevance of recording grip strength as part of a clinical assessment is summarised.

scholarly journals P115 Quantitative MRI of muscles is different in rheumatoid arthritis patients compared to healthy controls

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Matthew Farrow ◽  
John Biglands ◽  
Steven Tanner ◽  
Elizabeth Hensor ◽  
Maya Buch ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Grip Strength ◽  
Muscle Volume ◽  
Quantitative Mri ◽  
Muscle Pathology ◽  
Healthy Controls ◽  
Newly Diagnosed ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Rheumatoid arthritis (RA) can present with the loss of muscle mass and a decrease in strength and functional capability. Quantitative MRI offers a non-invasive measurement of muscle status which could improve the understanding of muscle pathology in RA. The purpose of this study was to assess whether MRI-based measurements of T2, fat fraction (FF), diffusion tensor imaging and muscle volume can detect differences between the muscles of RA patients and healthy controls in the thigh; and to assess how different stages of the disease present differently. Methods 39 RA patients were recruited, comprised of 3 groups: 13 newly diagnosed treatment naïve (Group 1 - New RA: 10/13 female, mean age 63 years, mean CRP 31.5, mean EMS 71 minutes), 13 in clinical remission DAS28 &lt;2.6 for at least 1 year (Group 2 - Remission RA: 10/13 female, mean age 67 years, mean CRP 12.1, mean disease 74 months, mean EMS 2 minutes), 13 RA with at least 1 year diagnosis, DAS28 &gt;3.2 ± raised CRP/ESR ± DMARD/targeted therapy escalation ± requiring steroid therapy (Group 3 - Resistant RA: 10/13 female, mean age 65, mean CRP 17.4, mean disease 123 months, mean EMS 63 minutes). 13 healthy controls were also recruited. All 4 groups were age and gender matched. MRI of the dominant thigh was performed using a STEAM-EPI imaging sequence to assess diffusion: mean diffusivity (MD) and fractional anisotropy (FA), 2-point Dixon imaging to assess FF and a fat-suppressed turbo-spin echo sequence to measure T2. All participants had knee extension/flexion and grip strength torque measured using isokinetic dynamometer. Results A one-way ANOVA analysis demonstrated significant differences in T2, FF and muscle volume between RA patients and healthy controls, but no difference in MD or FA. There was no significant difference between the RA groups. T2 and FF were higher in RA patients whilst muscle volume was lower. Muscle volume was significantly correlated with early morning stiffness (rs = 0.4, p = 0.001), DAS28 (rs = 0.4, p = 0.001) and grip strength (rs = 0.5, p &lt; 0.001). All RA patients showed weaker strength compared to the healthy controls. Although the patients in remission (group 2) had better results compared to New (group 1) and Resistant RA patients (group 3), they performed worse than the healthy controls in all strength assessments. Conclusion Quantitative MRI can detect changes in the muscles of RA patients, whether they are newly diagnosed, in remission or with persistently active disease. Difference in T2, FF and muscle volume were apparent even at diagnosis, suggesting muscle changes in RA occur early. Despite effective RA therapy, patients in remission show worse MRI parameters and strength compared to healthy individuals. These warrant attention in improving the muscle strength and quality throughout the spectrum of the RA continuum. Disclosures M. Farrow: None. J. Biglands: None. S. Tanner: None. E. Hensor: None. M. Buch: None. P. Emery: None. A. Tan: None.

scholarly journals The Japanese Version of the Patient-Rated Elbow Evaluation is a Useful Outcome Measure that Potentially Reflects Hand Function in Patients with Rheumatoid Arthritis who Underwent Total Elbow Arthroplasty

2021 ◽  
Author(s):  
Ryozo Harada ◽  
Keiichiro Nishida ◽  
Yoshiyuki Matsuyama ◽  
Kenzo Hashizume ◽  
Takuro Wada ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Grip Strength ◽  
Outcome Measures ◽  
Hand Function ◽  
Japanese Version ◽  
Japanese Patients ◽  
Total Elbow Arthroplasty ◽  
Elbow Arthroplasty ◽  
Almost All ◽  
And Function

Abstract Objective We examined the relationship between The Japanese version of Patient-Related Elbow Evaluation (PREE-J) and other established subjective and objective outcome measures in Japanese patients with rheumatoid arthritis (RA) who underwent total elbow arthroplasty (TEA). Patients and Methods This study involved 46 elbows of 40 RA patients. We collected clinical data one year after surgery, including the PREE-J, the Mayo Elbow Performance Score (MEPS), Disability of the Arm, Shoulder, and Hand (DASH), and Hand20. The correlation and responsiveness to PREE-J were evaluated compared with other outcome measures pre-and postoperatively. Results Almost all outcome measures were improved significantly after surgery. Preoperative PREE-J was significantly correlated with preoperative DASH, Hand20, and MEPS. Interestingly, postoperative PREE-J did not correlate with postoperative MEPS. Multiple regression analyses revealed that preoperative grip strength (B = -0.09; 95% CI -0.17 to -0.01, p = 0.03) and preoperative Hand20 (B = 0.31, 95% CI 0.03 - 0.58, p = 0.03) were significant factors those might influenced the postoperative PREE-J. Conclusions The PREE-J was shown to correlate well with other preoperative outcome measures among the RA patients included in the current study. The postoperative PREE-J after TEA was influenced by the preoperative grip strength and function of the hand.

scholarly journals Immediate and short-term effects of three commercial wrist extensor orthoses on grip strength and function in patients with rheumatoid arthritis

1996 ◽  
Vol 9 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Erica B. Stern ◽  
Steven R. Ytterberg ◽  
Hollis E. Krug ◽  
Gerald T. Mullin ◽  
Maren L. Mahowald
Keyword(s):  
Rheumatoid Arthritis ◽  
Grip Strength ◽  
Short Term ◽  
Wrist Extensor ◽  
And Function ◽  
Short Term Effects

Hybrid laparoscopic versus open Pylorus-Preserving Pancreatoduodenectomy: retrospective matched case comparison in 80 patients

2014 ◽  
Vol 52 (08) ◽  
Author(s):  
UF Wellner ◽  
S Küsters ◽  
C Busch ◽  
O Sick ◽  
P Bronsert ◽  
...  
Keyword(s):  
Case Comparison ◽  
Matched Case

Relationship of HLA-DRB1 Alleles and Rheumatoid Arthritis in West South of Iran

2017 ◽  
Vol 9 (03) ◽  
Author(s):  
Karim Mowla ◽  
Elham Rajaee M. D. ◽  
Mehrdad Dargahi-MalAmir M. D. ◽  
Neda Yousefinezhad ◽  
Maryam Jamali Hondori
Keyword(s):  
Rheumatoid Arthritis ◽  
Environmental Factors ◽  
Rheumatoid Factor ◽  
Dna Extraction ◽  
Wrist Joint ◽  
Blood Sampling ◽  
Healthy Controls ◽  
Relationship Of ◽  
Synovial Pannus

Background: Rheumatoid arthritis is a systemic multifactor disease that presented with symmetrical polyarthritis more preferably in small wrist joint and ankle. Synovial pannus cause destruction and deformities in joints. The main reason of this disease in unknown, but past researchesshowed that genetically factor play important role beside environmental factors in susceptibility to this entity. Method:100 patients with rheumatoid arthritis diagnosed upon ACR 2010 criteria enrolled study. 92 healthy patents also enrolled DNA studying. of both group was extracted through DNA extraction kits by blood sampling. HLA-DRB1 typing was done by PCR-SSP method. Results: There were no significant differences in HLADRB1 *04, HLADRB1*08 and HLADRB1*11 alleles presentation between patients and healthy controls. Only there were statically significant correlation between HLA-DRB1*08 and Rheumatoid factor positive patents. (P = 0.025).

scholarly journals Prevalence and risk factors for bone loss in rheumatoid arthritis patients from South China: modeled by three methods

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhuoran Hu ◽  
Lei Zhang ◽  
Zhiming Lin ◽  
Changlin Zhao ◽  
Shuiming Xu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Lumbar Spine ◽  
Bone Loss ◽  
South China ◽  
Serum Vitamin ◽  
Tumor Necrosis Factor Inhibitor ◽  
Healthy Controls ◽  
Mineral Density ◽  
Serum Vitamin D

Abstract Background To explore the prevalence of bone loss among patients with rheumatoid arthritis (RA) and healthy controls (HC) and further explored the risk factors for osteopenia and osteoporosis of RA patients. Methods A cross-sectional survey was undertaken in four hospitals in different districts in South China to reveal the prevalence of bone loss in patients. Case records, laboratory tests, and bone mineral density (BMD) results of patients were collected. Traditional multivariable logistic regression analysis and two machine learning methods, including least absolute shrinkage selection operator (LASSO) and random forest (RF) were for exploring the risk factors for osteopenia or osteoporosis in RA patients. Results Four hundred five patients with RA and 198 HC were included. RA patients had lower BMD in almost BMD measurement sites than healthy controls; the decline of lumbar spine BMD was earlier than HC. RA patients were more likely to comorbid with osteopenia and osteoporosis (p for trend < 0.001) in the lumbar spine than HC. Higher serum 25-hydroxyvitamin D3 level and using tumor necrosis factor inhibitor in the last year were protective factors; aging, lower body mass index, and increased serum uric acid might be risk factors for bone loss. Conclusions RA patients were more prone and earlier to have bone loss than HC. More attention should be paid to measuring BMD in RA patients aging with lower BMI or hyperuricemia. Besides, serum vitamin D and all three measurement sites are recommended to check routinely. TNFi usage in the last year might benefit bone mass.

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