Novi parametri stiska šake u bolesnika s reumatoidnim artritisom temeljeni na elektrodinamičkim mjerenjima – pilot evaluacijska studija

Ines Doko Vajdić, Amir Dubravić, Ivan Michieli Branka, Medved Rogina, Simeon Grazio

Introduction: In rheumatoid arthritis, inflammation and damage lead to functional impairment. As the hand is a typical site of involvement, lower grip strength is often found in patients with rheumatoid arthritis. In these patients it is necessary to evaluate the hand grip impairment in a more detailed way. The aim of this study was to analyze a new method for measuring hand grip. Methods: An expert electronic measuring system for obtaining dynamic time series of hand grip force was developed. We tested it in a sample of 24 participants, 12 patients with rheumatoid arthritis and 12 age- and sex- matched healthy controls. The main dynamometric parameters obtained were: maximum grip force, fatigue, grip velocity, and functional potential. These were measured at the baseline and at 60, 120, and 180 days. Results: Compared to the control group, at baseline the patients with rheumatoid arthritis had a significantly lower maximum grip force (68.2 vs. 97.3), earlier occurrence of fatigue (22.4 vs. 24.9), as well as lower grip velocity (14.8 vs. 22.2) and functional potential (808.2 vs. 1876.3). A significant improvement in all measured variables was observed during the follow-up period. Conclusion: In our pilot study we tested a newly developed electrodynamometer measuring system and found that
it can provide an objective and detailed description of the hand condition. This system has the potential to be used as a relevant indicator of hand function in patients with rheumatoid arthritis as well as to help tailor their rehabilitation.

Uvod: U reumatoidnom artritisu upala i oštećenje dovode do funkcionalne nesposobnosti. Uobičajeno mjesto zahvaćenosti jest šaka i zato ovi bolesnici često imaju slabiju snagu stiska. U bolesnika s reumatoidnim artritisom potrebno je provesti detaljniju evaluaciju oštećenja šake. Cilj ove studije bila je analiza nove metode mjerenja snage stiska šake. Metode: Razvijen je ekspertni elektronički mjerni sustav za dobivanje dinamičkih vremenskih serija sile stiska šake. Testirali smo ga na uzorku od 24 sudionika: 12 bolesnika s reumatoidnim artritisom i 12 zdravih kontrolnih ispitanika koji se podudaraju po dobi i spolu. Glavni dobiveni dinamometrijski parametri bili su: maksimalna sila stiska šake, zamor šake, brzina stiska te funkcionalni potencijal. Navedeni parametri izmjereni su pri početnomu mjerenju i nakon 60, 120 i 180 dana. Rezultati: U usporedbi s kontrolnom skupinom bolesnici s reumatoidnim artritisom imali su znatno manju maksimalnu silu stiska šake (68,2 prema 97,3), raniju pojavu zamora šake (22,4 prema 24,9), manju brzinu stiska (14,8 prema 22,2) i manji funkcionalni potencijal (808,2 prema 1876,3) pri početnomu mjerenju. Tijekom praćenja primijećeno je znatno poboljšanje svih izmjerenih varijabla. Zaključak: U našoj pilot studiji testirali smo novorazvijeni elektrodinamometrijski sustav mjerenja te smo utvrdili da se njegovom uporabom može objektivno i detaljno opisati stanje šake. Taj se sustav može upotrijebiti kao relevantan pokazatelj funkcije šake u bolesnika s reumatoidnim artritisom i može pomoći u prilagodbi njihove rehabilitacije.