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Investigating performance-based hand functions in patients with systemic sclerosis

Untersuchung der leistungsbasierten Handfunktion bei Patienten mit systemischer Sklerose

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Abstract

Objective

Systemic sclerosis (SSc) is a connective tissue disorder characterized by collagen deposits in various organs. Skin involvement is one of the most common symptoms and along with vascular damage, may deteriorate hand functions. However, the status of hand functions has generally been investigated using patient-reported measures in patients with SSc. The aim of the present study was to investigate performance-based hand functions in patients with SSc using the Sollerman Hand Function Test (SHFT).

Methods

A total of 39 patients with SSc (33 females) were included in the study. Twenty-four patients were classified as limited cutaneous SSc (lcSSc), while 15 patients were classified as diffuse cutaneous SSc (dcSSc). Hand-related physical characteristics were evaluated using the Modified Hand Mobility in Scleroderma Test, grip strength, and pinch strengths. The Duruoz Hand Index (Cochin Hand Functional Disability Scale), Disability of Arm, Shoulder, and Hand Questionnaire, Health Assessment Questionnaire, and Scleroderma Health Assessment Questionnaire were used as patient-reported measures. Performance-based hand functions were evaluated using SHFT.

Results

No significant differences were observed between lcSSc and dcSSc subtypes regarding performance-based and patient-reported hand functions (p > 0.05). SHFT scores significantly correlated with hand-related physical characteristics and patient-reported hand functions (p < 0.05). The highest correlation was determined between SHFT and the Duruoz Hand Index (rho: −0.652, p < 0.001).

Conclusion

According to our results, performance-based hand functions seem not to be affected by disease subtype. Performance-based hand functions may partially be captured by the patient-reported outcomes, especially the Duruoz Hand Index, in patients with SSc.

Zusammenfassung

Ziel

Die systemische Sklerose (SSc) ist eine Bindegewebserkrankung, welche durch Kollagenablagerungen in verschiedenen Organen gekennzeichnet ist. Eines der häufigsten Symptome stellt die Hautbeteiligung dar, die in Kombination mit einer Gefäßschädigung auch die Funktionen der Hand beeinträchtigen kann. Allgemein wurde allerdings der Status der Handfunktionen bisher mittels Parametern gemäß den subjektiven Angaben von SSc-Patienten untersucht. Ziel der vorliegenden Studie war es, die leistungsbezogenen Handfunktionen bei Patienten mit SSc anhand des Sollerman Hand Function Test (SHFT) zu ermitteln.

Methoden

Dazu wurden 39 Patienten mit SSc (davon 33 Frauen) in die Studie einbezogen; bei 24 Patienten wurde die Erkrankung als limitierte kutane SSc (lcSSc) eingestuft, während sie bei 15 Patienten als diffuse kutane SSc (dcSSc) klassifiziert wurde. Handbezogene körperliche Merkmale wurden mithilfe des Modified Hand Mobility in Scleroderma Test, der Griffstärke und Kneifkraft beurteilt. Der Duruoz Hand Index (Cochin Hand Functional Disability Scale), Disability of Arm, Shoulder, and Hand Questionnaire, Health Assessment Questionnaire und der Scleroderma Health Assessment Questionnaire wurden als Parameter der subjektiven Angaben von Patienten eingesetzt. Die leistungsbasierten Handfunktionen wurden mittels SHFT beurteilt.

Ergebnisse

Zwischen den Subtypen lcSSc und dcSSc wurden keine signifikanten Unterschiede in Bezug auf leistungsbasierte Handfunktionen und Handfunktionen nach patientenbezogenen Angaben (p > 0,05) festgestellt. Die SHFT-Werte waren in signifikanter Weise mit den handbezogenen körperlichen Merkmalen und den Handfunktionen nach Patientenangaben korreliert (p < 0,05). Dabei wurde die höchste Korrelation zwischen SHFT und dem Duruoz Hand Index (rho: −0,652; p < 0,001) festgestellt.

Schlussfolgerung

Den vorliegenden Ergebnissen zufolge scheinen die leistungsbasierten Handfunktionen nicht vom Krankheitssubtyp beeinflusst zu werden. Leistungsbasierte Handfunktionen bei Patienten mit SSc können mittels der von Patienten berichteten Ergebnisse erfasst werden, insbesondere mit dem Duruoz Hand Index.

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Authors and Affiliations

  1. Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey

    Emre Alp Akatay & Oguz Ustun

  2. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey

    Deniz Bayraktar, Devrim Can Sarac, Busranur Atalay, Irem Ramazanoglu, Ilyas Tekin & Tugba Kurum

  3. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey

    Eda Otman, Idil Kurut Aysin, Mustafa Ozmen & Servet Akar

  4. Rheumatology Clinic, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey

    Sercan Gucenmez

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  1. Emre Alp Akatay
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  2. Deniz Bayraktar
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Corresponding author

Correspondence to Deniz Bayraktar.

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Conflict of interest

E.A. Akatay, D. Bayraktar, E. Otman, O. Ustun, I. Kurut Aysin, D.C. Sarac, B. Atalay, I. Ramazanoglu, I. Tekin, T. Kurum, S. Gucenmez, M. Ozmen, and S. Akar declare that they have no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Ulf Müller-Ladner, Bad Nauheim

Uwe Lange, Bad Nauheim

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Akatay, E.A., Bayraktar, D., Otman, E. et al. Investigating performance-based hand functions in patients with systemic sclerosis. Z Rheumatol 83 (Suppl 1), 183–190 (2024). https://doi.org/10.1007/s00393-022-01267-5

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