Factors Associated With Hand and Upper Arm Functional Disability in People With Rheumatoid Arthritis: A Systematic Review

Abstract

Objective. This original systematic review aimed to summarize evidence within observational studies on the factors associated with hand functional disability in adults with rheumatoid arthritis (RA).Methods. A rigorous extensive systematic literature search was conducted in 6 medical databases for peerreviewed English language observational studies that explore the factors associated with hand function for people with RA. Factors were critically classified under the domains of the International Classification of Functioning, Disability and Health (ICF) framework and health-related factors. The methodologic quality was determined using the appraisal tool for cross-sectional studies. Factors related to hand function that were investigated in ≥2 studies were explored using a best-evidence synthesis.Results. Twenty articles from 1,271 citations met the inclusion criteria. All presented cross-sectional data (5 high-quality and 15 low-quality articles), resulting in limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicated that a diverse range of positive and negative factors were associated with hand function. However, key factors were hand strength, disease activity, and pain intensity. It is evident that few sociodemographic factors have been explored for the association with hand function.Conclusion. Although the level of evidence was limited, modifiable factors such as grip strength, disease activity, and pain were identified as the most influential factors on hand function in people with RA. The findings of the present review indicate that important sociodemographic factors that impact hand function in individuals with RA have not yet been considered or reported in clinical research.Presented by Mr. Arab Alkabeya in partial fulfillment of the requirements for a

Lower hand grip in rheumatoid arthritis patients is associated with low finite element analysis using high resolution peripheral quantitative computed tomography scan of the 2nd metacarpophalangeal joint

“…It has been shown that functionality of the dominant hand is more affected when synovial inflammation is present, and so disease activity was identified as one of the most influential factors on hand function in RA patients. 21 Actually, when RA is within higher disease activity, many other joint parts are affected such as skeletal muscle, cartilage, ligaments and tendons; in this way, as well as synovitis, the worsening of these structures leads to a decrease in physical hand function. 22 In our sample, a relationship between hand function and disease activity was found, confirming these previous findings.…”

Value of musculoskeletal ultrasound in assessment of rheumatoid hand function

“…Dedeoglu and his colleagues [26] in their study determined that grip strength was significantly related to disability and impairment, disease activity, and articular damage. A systematic review of twenty articles by Arab Alkabeya and colleagues [27] found out that grip strength and disease activity were identified as the most influential factors on hand function in people with RA. Similar to this study, Taştekin et al [28] and Dedeoglu et al [26] reported that grip strength was negatively correlated with the DAS 28 whereas in patients with relatively early RA and relatively lesser deformities, hand strength is affected more by disease activity.…”

Assessing Health-Related Quality of Life Among Survivors of Testicular Cancer: A Systematic Review

“…As observed in previous critical appraisals using AXIS, a percent value was predetermined at the beginning of this study to identify publications as high or low quality (Arab Alkabeya et al, 2019; Boxberger and Reimers, 2019; Henderson et al, 2019). For this study’s critical appraisal, the authors predetermined the value of a high-quality publication as total appraisal scores equal to or exceeding 70% of the total (i.e., at least 14 out of 20 questions scored as 1, or a score ≥14 to compensate for some items where there was no consensus scored at 0.5).…”