Daily activities and hand function in women with scleroderma.
OBJECTIVE
To give a detailed description of hand function and the ability to perform daily activities among patients with systemic sclerosis.


METHODS
Thirty patients with scleroderma answered a self-administered activities of daily living (ADL) questionnaire. Hand function was estimated with respect to hand mobility, dexterity, and grip force. Perceived symptoms were reported on a visual analogue scale (VAS), and skin thickness was assessed by means of the modified Rodnan skin score.


RESULTS
Finger flexion and extension were the most impaired aspects of hand mobility. Dexterity was on average reduced to 68-80%, and grip force to 46-65% compared with values for healthy persons. The predominant self-perceived problem was Raynaud's phenomenon, whereas pitting scars/ulcers were perceived as the least problem. Activities building on hand and arm function were harder to perform than activities depending on lower limb function. Raynaud's phenomenon, stiffness, grip force, and dexterity were factors with the strongest associations with ADL difficulties. Assistive devices and alternative working methods improved ADL ability.


CONCLUSIONS
Impaired hand function was related to ADL difficulties and the use of assistive devices improved ADL. This emphasizes the importance of treatments that improve hand function and of testing ergonomic tools.
Sandqvist
G
G
Department of Rheumatology, Lund University, Sweden. gunnel.sandqvist@skane.se
Eklund
M
M
Akesson
A
A
Nordenskiöld
U
U
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005384:Finger Joint / Q000503:physiopathology; D018737:Hand Strength; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D011336:Probability; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D012494:Sampling Studies; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000534:rehabilitation*; D012656:Self-Help Devices / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires