Article

This study investigates the effects of kinematic disturbances in
rheumatoid thumb on patient's hand functions via objective and patient-perceived
measurements. Method Twenty-one patients with rheumatoid arthritis (RA) and 21
healthy age- and gender-matched individuals were recruited to receive the
objective evaluations, including the Purdue Pegboard Test, Jamar dynamometer,
pinch-meter, Permanent Impairment Scale and self-administrated measurements,
including the Health Assessment Questionnaire (HAQ) and Manual Ability Measure-36
(MAM-36). An electromagnetic tracking system was used to measure thumb
kinematics. The differences in the measures between the RA and control groups and
the dominant and non-dominant hands of the RA group were examined. The
relationships between the thumb kinematics and hand functional capabilities, as
well as impairment levels, were also explored. Results The RA group showed
significantly smaller thumb movement capabilities and hand strength, as well as
worse scores in hand dexterity, MAM-36 and HAQ than healthy controls. The
movement workspace of the RA thumb showed moderate correlations with the factors
of hand strength, dexterity, impairment scale, MAM-36 and HAQ scores. Conclusions
The findings indicate deficits related to the movement capability of the RA thumb
may negatively influence hand dexterity and functional hand performance, as well
as life quality, for the patients with RA. Implications for Rehabilitation A
deformed rheumatoid thumb might limit the movement workspace of the thumb and
consequently impair the hand performance as well as the life quality. The
dominant thumb of the RA patients might have greater structural and functional
deterioration than the non-dominant side. Suitable joint protection strategies,
exercises and orthotics should be early applied to the RA patients for preserving
hand functions.

Langue : ANGLAIS