A multidisciplinary hand clinic for patients with rheumatic diseases: a pilot study.
To describe the characteristics, management strategies and outcomes of patients with rheumatic diseases and complex hand function problems referred to a multidisciplinary hand clinic. Assessments (baseline and after three months of follow-up) included sociodemographic and disease characteristics and various hand function measures. The most frequently mentioned impairments and limitations of the 69 patients enrolled in the study pertained to grip, pain, grip strength, and shaking hands. Fifty-six patients received treatment advice, conservative therapy (n=39), surgery (n=12), or a combination of both (n=5). In 38 of 56 patients (68%) the recommended treatment was performed, and 33 completed the follow-up assessment. On average, patients improved, with an increase in grip strength and the Michigan Hand Outcomes Questionnaire scores reached statistical significance. Two-thirds of patients with rheumatic conditions visiting a multidisciplinary hand clinic reportedly followed the treatment advice (recommendations), with an overall trend toward a beneficial effect on hand function. To further determine the added value of a structured, multidisciplinary approach a controlled comparison with other treatment strategies is needed.
Department of Rheumatology, Leiden University Medical Center, The Netherlands. f.j.van_der_giesen@lumc.nl
F J
FJ
van der Giesen
R G H H
RG
Nelissen
P M
PM
Rozing
J H
JH
Arendzen
Z
Z
de Jong
R
R
Wolterbeek
T P M
TP
Vliet Vlieland
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000503:physiopathology / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008947:Mixed Connective Tissue Disease / Q000503:physiopathology / Q000628:therapy*; D009426:Netherlands; D009788:Occupational Therapy; D019637:Orthopedic Procedures; D010044:Outpatient Clinics, Hospital; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D013165:Splints; D016896:Treatment Outcome