Abstract
Background/Aims
There is currently no consensus regarding sex-related differences in pain intensity and functional abilities among patients with hand osteoarthritis (OA). In this study we determine sex-related differences in pain intensity and functional ability among patients with hand OA, as assessed by a self-report questionnaire and by performance-based tests.
Methods
Using the AUSCAN tool for symptom and functional assessment of hand OA with dynamometry we prospectively accessed patients meeting the ACR criteria for hand osteoarthritis. Using this analysis, assessments of pain and function were compared in male and female patients. The outcome measures included self-reported pain measures, functional assessment and dynamometry measures.
Results
The study population included 106 patients (90 females and 16 males) with a mean age of males 48.44 (7.48) and females 52.67 (9.43). All patients with symptomatic hand osteoarthritis meeting ACR Criteria. When accessing difference between sexes, men were found to be significantly heavier (p = 0.003) and have greater grip and pinch strength.As part of function and pain assessments there was a significant correlation between difficulty with fine motor skills such as difficulty doing buttons, difficulty when doing jewellery, or peeling vegetables associated with pain when turning objects e.g. doorknobs, taps and faucets for men in comparison to women. Difficulty in these fine motor skills also correlated with stiffness on wakening and pain on lifting heavy objects regardless of sex. A Mann-Whitney U test was run on 106 participants to determine if there were differences in pain or functional scores between males and females. This reviled Median score for males () and females () was statistically significantly different,There were sex differences noted in the correlation associated with pain with rotational movements e.g. turning objects and functional difficulty with fine motor movements including difficulty when doing up buttons ( Males r(14) = -0.109, p = 0.698, Females r(88) =0.489, p = <0.01 value.= ), difficulty when doing jewellery ( Males r(14) =-0.265, p = 0.339.= Females r(88) = 0.570, p = <0.01) , difficulty peeling vegetables ( Males r(14) = -0.207, p = 0.458 Females r(88) = 0.519, <0.01 )
Conclusion
The results demonstrate the presence of sex differences in patients suffering from hand osteoarthritis self-reported functional ability and pain scales. These differences indicate the need for further studies to explore the mechanisms of hand OA and to understanding the specific impact of gender on the development and progression of disease. With further understanding we can obtain the proper strategy to provide better individualised treatment. It also highlights that rehabilitation programs should consider these differences and each patients’ performance limitations in order to address the specific needs of each individual patient. In doing so, improved pain and functional status will improve morbidity in hand OA
Disclosure
B. Dinneen: None. D. Heath: None. M. Ghaffar: None. M. O'Sullivan: None. C. Silke: None. B. Whelan: None.
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