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Hand function in women and men with early rheumatoid arthritis: A prospective study over three years (the Swedish TIRA project)
Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Arbetsterapi. Linköpings universitet, Hälsouniversitetet.ORCID-id: 0000-0002-1607-187X
Linköpings universitet, Institutionen för molekylär och klinisk medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Arbetsterapi. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för molekylär och klinisk medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet.ORCID-id: 0000-0002-0153-9249
2006 (Engelska)Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 35, nr 1, s. 15-19Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To describe the course of hand function in women and men during the first 3 years after diagnosis of recent-onset rheumatoid arthritis (RA), to investigate sex differences in hand function, and to study correlations between and within hand function assessments.

Methods: A total of 276 patients (69% women) with RA of a maximal duration of 12 months were recruited to the study. Hand function was assessed by the Grip Ability Test (GAT) and Signals of Functional Impairment (SOFI). Peak and average grip force over 10 s in the right and left hand was measured by an electronic device.

Results: Hand function was affected at diagnosis, but had improved significantly at the 3-months' follow-up and then remained stable (but still affected) in both women and men. As assessed by SOFI, hand function was worse in men than in women, whereas women had significantly lower grip force. GAT, grip force, and SOFI correlated weakly. The average and peak values of grip force correlated strongly, as did the grip force in the right and the left hand.

Conclusion: Hand function was profoundly affected at diagnosis of RA, but improved significantly within 3 months and remained stable (but still affected) over 3 years. As expected, women on average had significantly lower grip force than men.

Ort, förlag, år, upplaga, sidor
Informa Healthcare, 2006. Vol. 35, nr 1, s. 15-19
Nyckelord [en]
Hand function, course, sex differences, rheumatoid arthritis, impairment, assessment
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:liu:diva-13327DOI: 10.1080/03009740510026562ISI: 000235183300003OAI: oai:DiVA.org:liu-13327DiVA, id: diva2:18349
Tillgänglig från: 2008-06-02 Skapad: 2008-06-02 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
Ingår i avhandling
1. Aspects of Disability in Rheumatoid Arthritis: a five-year follow-up in the Swedish TIRA project
Öppna denna publikation i ny flik eller fönster >>Aspects of Disability in Rheumatoid Arthritis: a five-year follow-up in the Swedish TIRA project
2008 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Rheumatoid arthritis (RA) is a progressive disease, often leading to disability. Because the disease course develops rapidly during the first years after diagnosis, more knowledge is needed about the early disease course to minimize later disability. This thesis describes the course of disability in early RA such as hand function, pain intensity, activity limitation and sick leave. In addition, this thesis compares disability between women and men and compares disability between RA patients and referents.

This thesis is primarily based on data from the 320 patients that were included in the multi-centre project in Sweden called ‘Early interventions in rheumatoid arthritis’ (TIRA). A wide range of outcome variables was registered between 1996 and 2006 during regular follow-ups from time for diagnosis through the eight-year follow-up. Outcome regarding disease activity and disability of RA patients still remaining in TIRA at the three and five year follow-up respectively are used in this thesis. Data concerning sick leave were obtained for the patients during six years (1993-2001) – three years before and three years after diagnosis. Referents were included in two of the studies. Data regarding disability in referents were obtained according to hand function and activity limitation using the Health Assessment Questionnaire (HAQ). Data for sick leave were obtained for six years in referents, for the same period as the RA patients.

For most variables, disability in RA was most pronounced at time of diagnosis but before intervention started. Disability was then reduced already at the 3-month follow-up and thereafter affected but stable during the following five years. The exception was participation, reflected by sick leave, a variable that was stable from inclusion to three years from diagnosis. Activity limitation, pain intensity and sick leave in RA that represents different aspects of disability were explained by other aspects of disability and contextual factors rather than by disease activity. RA affects women and men differently in some aspects. Women had more severe course of activity limitations than men according to HAQ. Men were more affected than women in range of motion, although the differences were small in a clinical perspective. However, pain intensity and frequency of sick leave did not differ between women and men. Patients with RA have pronounced disability in relation to referents although several variables improve soon after diagnosis. This discrepancy refers to hand function as well as activity limitations and sick leave. The frequency of sick leave increased during the year before diagnosis in relation to referents and was thereafter high compared to sick leave in referents.

Ort, förlag, år, upplaga, sidor
Linköping University Electronic Press, 2008
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1063
Nyckelord
Rheumatoid arthritis (RA), disability, hand function, pain intensity, ADL, sick leave, prediction
Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
urn:nbn:se:liu:diva-11956 (URN)978-91-7393-908-9 (ISBN)
Disputation
2008-06-05, Berzeliussalen, Ingång 65, Campus US, Linköpings universitet, Linköping, 09:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2008-06-02 Skapad: 2008-06-02 Senast uppdaterad: 2015-11-19

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Björk, MathildaThyberg, IngridHaglund, LenaSkogh, Thomas

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Scandinavian Journal of Rheumatology
Medicin och hälsovetenskap

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