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Hand function in women and men with early rheumatoid arthritis: A prospective study over three years (the Swedish TIRA project)
Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-1607-187X
Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-0153-9249
2006 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 35, no 1, 15-19 p.Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Informa Healthcare, 2006. Vol. 35, no 1, 15-19 p.
Keyword [en]
Hand function, course, sex differences, rheumatoid arthritis, impairment, assessment
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13327DOI: 10.1080/03009740510026562ISI: 000235183300003OAI: oai:DiVA.org:liu-13327DiVA: diva2:18349
Available from: 2008-06-02 Created: 2008-06-02 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Aspects of Disability in Rheumatoid Arthritis: a five-year follow-up in the Swedish TIRA project
Open this publication in new window or tab >>Aspects of Disability in Rheumatoid Arthritis: a five-year follow-up in the Swedish TIRA project
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Linköping University Electronic Press, 2008
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1063
Keyword
Rheumatoid arthritis (RA), disability, hand function, pain intensity, ADL, sick leave, prediction
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:liu:diva-11956 (URN)978-91-7393-908-9 (ISBN)
Public defence
2008-06-05, Berzeliussalen, Ingång 65, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2008-06-02 Created: 2008-06-02 Last updated: 2015-11-19

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Björk, MathildaThyberg, IngridHaglund, LenaSkogh, Thomas

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