Impact of hand and face disabilities on global disability and quality of life in systemic sclerosis patients.
OBJECTIVE
In systemic sclerosis (SSc), the frequent involvement of hand and face leads to their disability. We aimed to assess influence of hand and face disability on global disability and Health related Quality of life (HRQoL).


METHODS
119 SSc patients were assessed for global disability by HAQ, HRQoL, by SF36; hand disability by HAMIS, CHFDS, fist closure and hand opening measures; face disability by MHISS and mouth opening measure.


RESULTS
Diffuse SSc (dSSc) patients present higher HAQ, lower Summary Physical Index (SPI) of SF36, major hand disability at hand (higher HAMIS, CHFDS, fist closure, lower hand opening) and face (lower mouth opening, higher MHISS) than lSSc patients (p<0.05). SPI of SF36 is negatively correlated with MHISS, CHFDS, HAMIS and positively correlated to mouth and hand opening (p<0.05). Summary Mental Index (SMI) of SF36 is negatively correlated with MHISS (p<0.05). HAQ is negatively correlated with mouth opening and positively correlated to MHISS, HAMIS, CHFDS (p<0.05). By hierarchical multiple linear regression, SPI of SF36 is significantly associated with total MHISS (B=-0.34; t=-3.78; p<0.001) and CHFDS (B=-0.27; t=-3.01; p=0.003), together, explaining 22% of SPI variance. SMI of SF36 is significantly associated only with MHISS total score (B=-0.22; t=-2.41; p=0.017), explaining 4% of its variance. HAQ is significantly associated with CHFDS score (B=0.61; t=7.90; p<0.001), explaining 36% of HAQ variance.


CONCLUSIONS
dSSc patients present higher global and local disability, and lower HRQoL in SPI than lSSc patients. Local disabilities, assessed by CHDFS and MHISS, are independently related to global disability and HRQoL.
Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy. susanna.maddalibongi@gmail.com.
S
S
Maddali-Bongi
A
A
Del Rosso
S
S
Mikhaylova
B
B
Francini
A
A
Branchi
M
M
Baccini
M
M
Matucci-Cerinic
D000203:Activities of Daily Living; D000368:Aged; D006233:Persons with Disabilities; D005148:Facial Dermatoses / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006229:Hand Dermatoses / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D045743:Scleroderma, Diffuse / Q000503:physiopathology* / Q000523:psychology; D045745:Scleroderma, Limited / Q000503:physiopathology* / Q000523:psychology; D012595:Scleroderma, Systemic / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires