Skip to main content
SpringerLink
Log in

Hand Function in Rheumatoid Arthritis

  • Chapter
  • First Online:
Hand Function

Abstract

Rheumatoid arthritis is a systemic, inflammatory, debilitating disease that can lead to significant hand deformities and pain which can affect hand function and performance of daily activities. This chapter reviews the structural changes and deformities that occur in the hand in persons with rheumatoid arthritis and the resulting impairments and functional disability. Assessments of hand impairments including observation and measurements of joint motion, joint tenderness and swelling, joint stability, pain, and grip and pinch strength are discussed. Finally, both performance-based tests and self-reports of hand function are presented: the Grip Ability Test; the Sequential Occupational Dexterity Assessment; the Arthritis Hand Function Test; the Jebsen Test of Hand Function; the Duruöz Hand Index; the Michigan Hand Outcomes Questionnaire; the Disability of the Arm, Shoulder and Hand Questionnaire; the Scores for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands; the ABILHand; and the Canadian Occupational Performance Measure. The psychometric properties of these tests and advantages and disadvantages of self-reports and performance-based tests are also presented. Assessment of hand function is imperative to preserve function in the hand and prevent disability. The assessments presented in this chapter should also be used as outcome measures for intervention studies designed to improve hand function in persons with RA.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Droso A. Epidemiology of rheumatoid arthritis. Autoimmun Rev. 2004;3(Suppl 1):S20–2.

    Google Scholar 

  2. Alter S, Feldon P, Terrono AL. Pathomechanics of deformities in the arthritic hand and wrist. In: Mackin EJ, Callahan AD, Skirven TM, et al., editors. Rehabilitation of the hand and upper extremity. 5th ed. St. Louis: Mosby Inc; 2002. p. 1545–54.

    Google Scholar 

  3. Chung KC, Pushman AG. Current concepts in the management of the rheumatoid hand. J Hand Surg. 2011;36A:736–47.

    Article  Google Scholar 

  4. Terrono AL. The rheumatoid thumb. J Am Soc Surg Hand. 2001;1:81–92.

    Article  Google Scholar 

  5. Ay S, Tur BS, Küҫükdeveci A. Evaluation of disability in patients with degenerative and inflammatory arthritis. Int J Rehabil Res. 2008;31:159–63.

    Article  Google Scholar 

  6. Thyberg I, Hass UA, Gerdie B, Nordenskiöld U, Skogh T. Activity limitation in rheumatoid arthritis correlates with reduced grip force regardless of sex: the Swedish TIRA project. Arthritis Rheum. 2005;53:886–96.

    Article  Google Scholar 

  7. Ferraz M, Oliveira L, Araujo P, Atra E, Walter SD. EPM-ROM scale: an evaluative instrument to be used in rheumatoid arthritis trials. Clin Exp Rheumatol. 1990;8:4991–494.

    Google Scholar 

  8. Bearne LM, Coomer AF, Hurley MV. Upper limb sensorimotor function and functional performance in patients with rheumatoid arthritis. Disabil Rehabil. 2007;29:1035–9.

    Article  Google Scholar 

  9. Van der Giesen JF, Nelissen RGHH, van Landveld WJ, Kremers-Stelten C, Peeters AJ, Stern EB, et al. Swan neck deformities in rheumatoid arthritis: a qualitative study on the patients’ perspectives on hand function problems and finger splints. Musculoskeletal Care. 2010;8:179–88.

    Article  Google Scholar 

  10. Nicklasson M, Honsson H. Experience of participation as described by people with hand deformity caused by rheumatic disease. Br J Occup Ther. 2012;75:29–35.

    Article  Google Scholar 

  11. Adams J, Burridge J, Hammond A, Cooper C. The effects of early rheumatoid arthritis on dominant and non-dominant hand impairment and function. Br J Hand Ther. 2005;10:93–7.

    Article  Google Scholar 

  12. Horsten NCA, Ursum J, Roorda LD, van Schaardenburg D, Dekker J, Hoeksma AF. Prevalence of hand symptoms, impairments and activity limitations in rheumatoid arthritis in relation to disease duration. J Rehabil Med. 2010;42:916–21.

    Article  Google Scholar 

  13. Johnsson PM, Eberhardt K. Hand deformities are important signs of disease severity in patients with early rheumatoid arthritis. Rheumatology. 2009;48:1398–401.

    Article  Google Scholar 

  14. Vlieland T, Van de Wiijk T, Jolie I, Zwinderman A, Hazes J. Determinants of hand function in patients with rheumatoid arthritis. J Rheumatol. 1996;23:835–40.

    Google Scholar 

  15. Bjork MA, Thyberg ISM, Skogh T, Gerdle BUC. Hand function and activity limitation according to health assessment questionnaire inpatients with rheumatoid arthritis and health referents: 5-year follow-up of predictors of activity limitations (The Swedish TIRA project). J Rheumatol. 2007;34:296–302.

    PubMed  Google Scholar 

  16. Hakkinen A, Kautiainen H, Hannonen P, Ylinen J, Arkela-Jautiainen M, Sokka T. Pain and joint mobility explain individual subdimensions of the health assessment questionnaire (HAQ) disability index in patients with rheumatoid arthritis. Ann Rheum Dis. 2005;64:59–63.

    Article  CAS  Google Scholar 

  17. Poole J, Cordova K, Brower L. Reliability and validity of a self-report of hand function in persons with rheumatoid arthritis. J Hand Ther. 2006;19:12–7.

    Article  Google Scholar 

  18. Adams J, Burridge J, Mullee M, Hammond A, Cooper C. Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population. Clin Rehabil. 2004;18:405–13.

    Article  CAS  Google Scholar 

  19. American Society of Hand Therapists. Clinical assessment recommendations. 2nd ed. Chicago: The Society; 1992.

    Google Scholar 

  20. Eberl DR, Fasching V, Rahlfs V, Schleyer I, Wolf R. Repeatability and objectivity of various measurements in rheumatoid arthritis. A comparative study. Arthritis Rheum. 1976;19:1278–86.

    Article  CAS  Google Scholar 

  21. McCormack HM, Horne DJ, Sheather S. Clinical application of visual analogue scales: a critical review. Psychol Med. 1988;18:1007–19.

    Article  CAS  Google Scholar 

  22. Van der Heijde DM, van ‘t Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, et al. Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis. 1990;49:916–20.

    Article  Google Scholar 

  23. Van Gestel AM, Prevoo ML, van ‘t Hof MA, van Rijskijk HM, van de Putte LB, van Riel PL. Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis: comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism criteria. Arthritis Rheum. 1996;39:3–40.

    Google Scholar 

  24. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg. 1984;9:222–6.

    Article  CAS  Google Scholar 

  25. Katz P. Patient outcomes in rheumatology. 2011: a review of measures. Arthritis Care Res. 2011;63:S1–S490.

    Article  Google Scholar 

  26. Dellhag B, Bjelle A. A grip ability test for use in rheumatology practice. J Rheumatol. 1995;41:138–63.

    Google Scholar 

  27. Van Lankveld W, van’t Pad Bosch P, Bakker J, Terwindt S, Franssen M, van Riel P. Sequential occupational dexterity assessment (SODA): a new test to measure hand disability. J Hand Ther. 1996;9:27–32.

    Article  Google Scholar 

  28. Van Lankveld WG, Graff MJ, van’t Pad Bosch P. The short version of the sequential occupational dexterity assessment based on individual tasks’ sensitivity to change. Arthritis Care Res. 1999;12:417–24.

    Article  Google Scholar 

  29. Backman C, Mackie H, Harris J. Arthritis hand function test: development of a standardized assessment tool. Occup Ther J Res. 1991;11:246–56.

    Article  Google Scholar 

  30. Jebsen RH, Taylor N, Trieschmann RB, Trotter MJ, Howard LA. An objective and standardized test of hand function. Arch Phys Med Rehabil. 1969;50:311–9.

    CAS  PubMed  Google Scholar 

  31. Duruöz MT, Poiraudeau S, Fermanian J, Menkes C, Amor B, Dougados M, Revel M. Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol. 1996;23:1167–72.

    PubMed  Google Scholar 

  32. Chung K, Pillsbury M, Walters M, Hayward R. Reliability and validity testing of the Michigan hand outcomes questionnaire. J Hand Surg. 1998;23:575–87.

    Article  CAS  Google Scholar 

  33. Waljee JF, Chung KC, Kim HM, Burns PB, Burke FD, Wilgis EFS, Fox DA. Validity and responsiveness of the Michigan hand questionnaire in patients with rheumatoid arthritis: a multicenter, international study. Arthritis Care Res. 2010;62:1569–77.

    Article  Google Scholar 

  34. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand). Am J Ind Med. 1996;29:602–8.

    Article  CAS  Google Scholar 

  35. Beaton D, Wright J, Katz J, the Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three-item reduction approaches. J Bone Joint Surg Am. 2005;87:1038–46.

    PubMed  Google Scholar 

  36. Leeb BF, Sautner J, Andel I, Rintelen B. SACRAH: a score for assessment and quantification of chronic rheumatic affects of the hands. Rheumatology. 2003;42:1173–413.

    Article  CAS  Google Scholar 

  37. Sautner J, Andel I, Rintelen B, Leeb BF. Development of the M-SACRAH, a modified shortened version of SACRAH (Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands). Rheumatology. 2004;43:1409–13.

    Article  CAS  Google Scholar 

  38. Rintelen B, Haindl PM, Mai TH, Sautner J, Maktari A, Leeb BF. A tool for the assessment of hand involvement in rheumatic disorders in daily routing – the SF_SACRAH (short form for the assessment and quantification of chronic rheumatic affections of the hands). Osteoarthr Cartil. 2009;17:59–63.

    Article  CAS  Google Scholar 

  39. Penta M, Tesio L, Arnould C, Zancan A, Thonnard JL. The ABILHAND: a Rasch-built measure of manual ability. Arch Phys Med Rehabil. 1998;79:1038–42.

    Article  CAS  Google Scholar 

  40. Durez P, Fraselle V, Houssiau F, Thonnard JL, Nielens H, Penta M, et al. Validation of the ABILHAND questionnaire as a measure of manual ability in patients with rheumatoid arthritis. Ann Rheum Dis. 2007;66:1098–105.

    Article  Google Scholar 

  41. MacDermid JC, Tottenham V. Responsiveness of the Disability of the Arm, Shoulder, and Hand (DASH) and the Patient RatedWrist/Hand Evaluation (PRW/HE) in evaluating change after hand therapy. J Hand Ther. 2004;17:18–23.

    Article  Google Scholar 

  42. MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma. 1998;12:577–86.

    Article  CAS  Google Scholar 

  43. Law M, Baptiste S, Carswell A, McColl MA, Polatajko H, Pollock N. Canadian occupational performance measure. Toronto: CAOT Publications ACE; 2005.

    Google Scholar 

  44. Dedding C, Cardol M, Eyssen ICJM, Dekker J, Beelen A. Validity of the Canadian occupational performance measure: a client-centred outcome measurement. Clin Rehabil. 2004;18:660–7.

    Article  Google Scholar 

  45. Wressle E, Lindstrand J, Neher M, Marcusson J, Henriksson C. The Canadian occupational performance measure as an outcome measure and team tool in a day treatment programme. Disabil Rehabil. 2003;25:497–506.

    Article  Google Scholar 

  46. Macedo AM, Oakley SP, Panayi GS, Kirkham BW. Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted, comprehensive occupational therapy. Arthritis Rheum. 2009;61:1522–30.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of New Mexico, Albuquerque, NM, USA

    Janet L. Poole

Authors
  1. Janet L. Poole
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Janet L. Poole .

Editor information

Editors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Rheumatology Division, Marmara University Medical School, Istanbul, Turkey

    Mehmet Tuncay Duruöz

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Poole, J.L. (2019). Hand Function in Rheumatoid Arthritis. In: Duruöz, M. (eds) Hand Function. Springer, Cham. https://doi.org/10.1007/978-3-030-17000-4_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-17000-4_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16999-2

  • Online ISBN: 978-3-030-17000-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation