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 Disability

The objective of study is to evaluate the hand functions and quality of life in rheumatoid arthritis patients. 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  Demographic variable  Disease duration  Disease duration  Functional classification(ACR)  Functional classification(ACR)  Hand measuruments(grip strenght,distance between tip of finger and their bases (DTFB))  Hand measuruments(grip strenght,distance between tip of finger and their bases (DTFB))

SACRAH Questionnaire ( Score for Assessment and Quantification Chronic Rheumatic Affections Of Hands ) 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.) 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±12.07 Female 139(%65.3) Male 74(%34.7) Means of disease duration female  8.87 male  6.91 (p:0.000 ) female  8.87 male  6.91 (p:0.000 ) Functional classification(ACR) I → %38.2 I → %38.2 II----- → %41.3 II----- → %41.3 III---- → %20.5 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

Correlation Between SACRAH Total Score and Grip Strenght,DTFB Grip Strenght- SACRAH Total Score DTFB-SACRAH Total Score CorrelationCoefficientr:-0.698p:0.001r:0.544p:0.003

Internal Consistency Of SACRAH Total And Subscale Score Score Cronbach Alpha Hand Function 0.89 Morning Stiffness 0.81 Pain0.86 Total0.96

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

Comparing Scores Of SF-36 Subscale According To Disease Duration

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

Conclusions: QoL Sex Functional Class Disease Duration

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