POS1479-HPR INVESTIGATING THE RELIABILITY OF THE SOLLERMAN HAND FUNCTION TEST AND THE ASSOCIATIONS WITH DISEASE- AND HAND-RELATED PARAMETERS IN PATIENTS WITH SYSTEMIC SCLEROSIS

Abstract

BackgroundAlthough the hand involvement is one of the first manifestations in the disease course of Systemic Sclerosis (SSc), hand functions are generally inquired by using patient-reported tools. Sollerman Hand Function Test (SHFT) is developed to evaluate the performance-based hand functions.ObjectivesThe aim of this study was to investigate the reliability of the SHFT and the associations with disease- and hand-related parameters in patients with SSc.MethodsThirty-six patients (30 females) were included in the study. SHFT includes 20 different hand functions which are scored between 0 (unable to perform) and 4 (performed within 20 seconds with normal quality) (1). In the present study, item 12 ‘put on Tubigrip stocking on the other hand’ was not evaluated, thus, the SHFT was scored over a total score of 76. Inter-rater reliability was investigated by comparing the scores of two different investigators, and test-retest reliability was investigated by assessing the scores obtained at 2-hour intervals. Modified Hand Mobility in Scleroderma Test (mHAMIS), modified Rodnan skin score (mRSS), grip and pinch strengths were measured to evaluate hand-related physical characteristics. Duruoz Hand Index, Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), and Scleroderma Health Assessment Questionnaire (SHAQ) were used as patient-reported outcomes.Table 1.Associations between the Sollerman Hand Function Test scores and disease- and hand-related parametersn= 36Median (IQR 25/75)rhopmHAMIS (score 0-4)0 (0/0)-0.3660.072mRSS-Fingers (score 0-3)2.5 (2/3)-0.0700.684mRSS-Hands (score 0-3)1.5 (1/2)-0.0560.747mRSS-Forearms (score 0-3)1 (0/2)-0.0320.855mRSS-Upper Arms (score 0-3)0 (0/1)0.0080.962mRSS-Total (0-51)10 (6/27.5)-0.1580.356Hand Grip Strength (kg)19.9 (12.0/24.9)0.612<0.001*Tip to Tip Pinch Strength (kg)3.1 (2.3/3.9)0.5170.001*Three Jaw Pinch Strength (kg)2.7 (1.9/3.4)0.554<0.001*Lateral Pinch Strength (kg)3.9 (3.3/5.3)0.4610.005*Duruoz Hand Index (score 0-90)5.5 (0/17)-0.751<0.001*DASH (score 30-150)61.5 (47/84)-0.645<0.001*HAQ (score 0-3)0.3 (0.1/0.9)-0.632<0.001*SHAQ-Raynaud’s Phenomenon (score 0-3)0.9 (0.1/1.4)-0.2460.161SHAQ-Digital Ulcers (score 0-3)0.1 (0/1.2)-0.3720.030*SHAQ-Gastrointestinal (score 0-3)0.2 (0/1.5)-0.1770.315SHAQ-Pulmonary (score 0-3)0.6 (0.1/1.5)-0.2700.123SHAQ-Patient Global Assessment (score 0-3)1.4 (0.1/2.1)-0.5470.001*p<0.05, rho: Spearman correlation coefficient, mHAMIS: modified Hand Mobility in Scleroderma Test, mRSS: modified Rodnan skin score, lcSSc: limited cutaneous Systemic Sclerosis, dcSSc: diffuse cutaneous Systemic Sclerosis, DASH: Disability of Arm, Shoulder, and Hand Questionnaire; HAQ: Health Assessment Questionnaire; SHAQ: Scleroderma Health Assessment QuestionnaireResultsSHFT demonstrated excellent inter-rater reliability (75 (72/76) vs. 75 (72/76), ICC: 0.987) and moderate test-retest reliability (75 (72/76) vs. 76 (75/76), ICC: 0.645). SHFT scores correlated significantly with grip and pinch strengths, Duruoz Hand Index scores, HAQ scores, SHAQ-Patient Global Assessment scores, and SHAQ-Digital Ulcer Scores (p<0.05). No significant correlations were observed between other parameters and SHFT (p>0.05). The hardest task was determined as ‘do up buttons’ which cannot be completed within 20 seconds by the half of the patients. All the patients completed ‘put key into Yale lock, turn 90o’, ‘lift iron over edge 5 cm in height’, and ‘lift telephone receiver, put to ear’ tasks within 20 seconds with normal quality.ConclusionThe results of the present study suggest that SHFT is a reliable tool to evaluate hand functions in patients with SSc.