Pos1446 anthropometric Measurements in Upper Extremity Rehabilitation of Patients With Rheumatic Diseases

Abstract

Background:The chronic nature of rheumatic diseases has a negative impact in quality of life. Pain and loss of function in the upper extremity cause a progressive difficulty to perform daily activities, often requiring integral physical rehabilitation programs. Anthropometric measurements habitually take prolonged periods of time, given the extensive nature of physical examination in rheumatic patients. It is unknown which factors are most efficient to better reflect the functional status of the rheumatic patient.Objectives:Determine the most efficient anthropometric measurements in the upper extremity to assess the functional status of rheumatic patients in rehabilitation programs.Methods:Thirty-six patients were recruited from Rheumatology consultation of University Hospital “Dr. José Eleuterio González” in Monterrey, Mexico. Patients had a complete physical examination by a board-certified rheumatologist, which referred patients to Physical Rehabilitation consultation if necessary. A cross-sectional study was carried out in these patients with Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (1), measurement of ranges of motion (ROM) and hand strength with the Mathiowetz protocol (2). Analysis was performed through Principal Components Analysis including Total Variance Explained (TVE), Rotated Component Matrix (RCM) and dendrograms.Results:From the total of patients, 34 (94.4%) were women with a mean age of 34 years (SD 11.33). The most common diagnosis was rheumatoid arthritis (47.2%) followed by osteoarthritis (8.3%). The mean disability score in DASH was 29.3% (DE 23.36). The TVE analysis found that 3 elements explained 48.6% of the total variance, and 13 elements explained 89.4%. RCM correlations among hand strength parameters ranged from 0.51 to 0.93, whereas ROM correlation values were below 0.4. Graph 1 depicts data dispersion for ROM, grip strength and pinch gauge by dynamometer.Graph 1.Two main clusters are observed in the RCM plot of the data. In the center and superior to the x axis, a conglomeration corresponding to ROM is shown, consisting of radial and ulnar deviation; flexion, extension, abduction and adduction in carpal bones, metacarpophalangeal joints, and proximal and distal interphalangeal joints of the five fingers of both hands, accordingly. To the right and across the x axis, another cluster depicts the grip strength and tip, key, and lateral pinch gauge of the fingers according to the Mathiowetz protocol. Closeness of data points portray a higher similarity among variances in the second cluster.Conclusion:Hand strength is the most efficient parameter to assess the functional status of the upper extremity in rheumatic patients in rehabilitation programs.References:[1]Arreguín Reyes, R., López López, C. O., Alvarez Hernández, E., Medrano Ramírez, G., Montes Castillo, M., & Vázquez-Mellado, J. (2012). Evaluation of hand function in rheumatic disease. Validation and usefulness of the Spanish version AUSCAN, m-SACRAH and Cochin questionnaires. Reumatologia clinica, 8(5), 250–254. https://doi.org/10.1016/j.reuma.2012.03.005[2]Mathiowetz, V., Kashman, N., Volland, G., Weber, K., Dowe, M., & Rogers, S. (1985). Grip and pinch strength: normative data for adults. Archives of physical medicine and rehabilitation, 66(2), 69–74.Disclosure of Interests:None declared