ASSESSMENT OF HAND FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS AS A RESULT OF PHYSICAL THERAPY

Abstract

Assessment of hand function is the great importance in physical therapy for patients with rheumatoid arthritis, as the choice of rehabilitation measures and evaluation of their results depends on the functional capacity of the hand.
 The purpose is to evaluate hand function in patients with rheumatoid arthritis as a result of physical therapy using the Sollerman test.
 Materials and methods. The research was conducted on the basis of the rheumatology department and the department of rehabilitation treatment using traditional and alternative methods of the Municipal Enterprise “Rivne Regional Clinical Hospital named after Yuriy Semeniuk” in Rivne. The results of the research were accumulated as patients were admitted for inpatient treatment. A total of 188 patients with rheumatoid arthritis were examined, with an average age of 44.9±7.6 years. All patients were randomly assigned to the control (n=92) and main (n=96) groups. Patients of the control group underwent rehabilitation in accordance with the recommendations of the regulatory document of the Ministry of Health of Ukraine. Patients in the main group were treated according to the proposed physical therapy technology, which included the following elements: therapeutic exercises, therapeutic massage, physiotherapy, hydrotherapy, orthotics, kinesiotaping of the upper extremities, mechanotherapy and psychological support. A physical therapy programme was developed for each patient for a long-term period of 6 months. To determine the function of the arm, the Sollerman test was used. The obtained digital material was processed statistically using the Statistica 10 statistical analysis package (Serial Number: STA999K347150-W).
 Results. The initial examination revealed the presence of disorders of the basic functions of the hand and deviations from the norm, as well as impaired fine motor skills and various types of hand grip according to the Solleraman test. We analysed the quality of different types of grasping in patients with rheumatoid arthritis, in particular, the greatest difficulties were in performing spherical and cylindrical grasping – in 82.9% of patients and 89.3% of cases, respectively. Forceps grasping was also difficult in 76.5% of patients. During the repeated examination after 3 and 6 months, patients in both groups showed positive dynamics in the performance of individual test tasks. Thus, in patients of the main group, after 3 months, the average Sollerman test scores increased to 65.1±5.3 points, in the control group this figure was significantly lower than 61.8±3.6 points (x ±S) (p<0.05). In 6 months after hospitalisation, the mean values of the Sollerman test in the main group of patients with rheumatoid arthritis increased significantly and were close to normal values. In patients of the control group, the average values of this test also increased, but they were significantly lower than those of the main group. Accordingly, the mean Sollerman test score in patients of the main group increased from 65.1±5.3 points to 70.2±6.3 points, which is significantly higher than in patients of the control group – from 61.8±3.6 points to 65.1±3.8 points (x±S) (p<0.05). The results of the Sollerman test in the main group are significantly higher than those of the control group, which indicates the effectiveness of the developed rehabilitation technology for patients in the main group.
 Conclusions. The increase in the functional capacity of the upper extremities of patients in the main group with rheumatoid arthritis confirms the effectiveness of the implemented physical therapy technology.