OBJECTIVES:Evaluation and characterization of hand function in patients with rheumatoid (RA) arthritis and, secondarily, identification of the use of adaptive equipments. MATERIAL AND METHODS:Firstly, a written informed consent was obtained and then an anonymous questionnaire was filled by RA outpatients after observation at the rheumatology consultation with no other musculoskeletal or neuromuscular disorders that would determine major functional impairment of hand function. Sociodemographic and clinical variables were collected and the Cochin Hand Functional Scale (CHFS) was applied. Classical deformities of hand and/or wrist were observed and recorded by the attending physician. RESULTS:A total of 79 patients were enrolled. In the overall sample, most patients were female A sample of 79 patients, mostly female (69.60%), with a mean age of 59.72 ± 11.77 years and with a mean diagnosis duration of 11.72 ± 8.29 years. The majority (73.40%) had at least one hand or wrist deformity, the most frequent being atrophy of the interosseous muscles followed by ulnar deviation of the metacarpophalangeal joints and piano key deformity of the wrist. The mean CHFS score was 17.94 ± 18.26 points with a minimum and maximum value recorded of 0 and 80 points, respectively. The presence of hand deformities, Health Assessment Questionnaire score (HAQ), hand pain and diagnosis duration were correlated with the CHFS score. Six patients had assistive devices and only in one case it was used to overcome hand's functional impairment. CONCLUSIONS:Most patients presented at least one classic RA deformity after a mean diagnosis duration of approximately 12 years and under pharmacological treatment. Despite this, most patients scored significantly below CHFS maximum score, but only 18 reported no difficulty in any of the tasks mentioned in the scale. The fact that only a minority of these patients had assistive devices should alerts us to the need for a more thorough functional assessment and identification of needs among RA patients.

译文

目的:评估和表征风湿性关节炎(RA)患者的手功能,其次,确定使用自适应设备的能力。
材料与方法:首先,在获得风湿病学咨询后,RA门诊患者在获得书面知情同意书后填写了匿名调查表,没有其他肌肉骨骼或神经肌肉疾病会决定手功能的主要功能障碍。收集社会人口统计学和临床​​变量,并应用科钦手功能量表(CHFS)。主治医师观察并记录了手和/或腕部的典型畸形。
结果:共纳入79例患者。在总体样本中,大多数患者为女性。A例患者为79名患者,大部分为女性(69.60%),平均年龄为59.72±11.77岁,平均诊断持续时间为11.72±8.29年。多数(73.40%)至少有一只手或腕部畸形,最常见的是骨间肌萎缩,其后是掌指关节尺侧偏斜和腕部钢琴键畸形。 CHFS的平均得分为17.94±18.26分,记录的最低和最高分别为0和80分。手部畸形的存在,健康评估问卷评分(HAQ),手部疼痛和诊断持续时间与CHFS评分相关。 6例患者有辅助设备,只有一种情况用于克服手部功能障碍。
结论:大多数患者在平均诊断时间约12年后并接受药物治疗后出现至少一种典型的RA畸形。尽管如此,大多数患者的评分均显着低于CHFS最高评分,但只有18名患者报告称该量表中提到的任何任务均无困难。这些患者中只有一小部分具有辅助设备,这一事实应使我们警觉到需要进行更彻底的功能评估并确定RA患者的需求。

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