Rheumatoid Arthritis
Rheumatoid Arthritis

Dr. Sanjay Agrawal

Leading Pharmaceutical consultant and editor-in chief of IJMToday

Rheumatoid Arthritis is the most common chronic autoimmune systemic inflammatory arthritis, characterized by symmetrical joint synovitis and pain, commonly affecting the wrist and smaller joints of the hand, in about 0.5-1% of the general population.

The hand is the principle means by which an individual interacts with people and objects in the external environment. The Grip Ability Test is an Activity of Daily Living specific tool to evaluate hand function in patients with Rheumatoid Arthritis. The GAT hand function test has three tasks which evaluate 4 grips: lateral pinch, 5 finger pinch, pulp pinch and transverse voter grip.

The International Classification of Functioning, Disability and Health (ICE) give a classification of health and health related domains, describing changes in body function and structure. It gives a Biopsychosocial model which is an interaction of the medical and social models.

The WHO defines disability as an umbrella term covering impairments, activity limitations and participation restrictions. Disability is a consequence of pain, active synovitis and joint damage and ultimately affects the quality of life (QOL) which can be assessed by self –reported questionnaire: the Health Assessment Questionnaire Disability Index (HAQ-DT).

Functionally, patients with RA can also be categorized as per revised criteria for Classification of Functional Status as given by the American College of Rheumatology. The 30 item Disabilities of Arm, Shoulder and Hand questionnaire (DASH) Outcome Measure is a self –reported questionnaire designed to measure physical function and symptoms in patients with musculoskeletal disorders of the upper limb.

Despite pain and deformities, individuals with RA continue to function, causing secondary consequences on the overall functioning of the individual. Hence, we need to evaluate the correlation between a bimanual dexterity hand function task and upper limb function and to find the association between hand function and disability. This can provide valuable insight on the impact of hand dysfunction on disability in RA. Hence, there is a need for exploring the relationship between hand function and its effect on Upper limb function and Quality of Life in an Indian population diagnosed with RA.

Aims and Objectives

The aim of the study was to observe the correlation between the Functional Ability of the Hand with Upper Limb function and Quality of Life in patients with RA.

The objectives of the study were to assess and correlate the functional ability of the hand with upper limb function, the functional ability of the with quality life and upper limb function with quality of life in patients with RA.


In our study, we conclude that in patients with RA, there is a moderate positive correlation between the functional ability of the hand and upper limb function, a moderate positive correlation between the functional ability of the hand and quality of life and a strong positive correlation between the upper limb function and quality of life.

The impact of hand dysfunction on the functioning of an RA patient can lead to grave disabilities. Hand function disability poses as one of the greatest obstacles to independent living, thus leading to the need of incorporating newer technique and approaches to assessment and treatment for enhancing functioning of the upper extremity. Assessment using the GAT , DASH and HAQ-DI can provide us a quick and early insight on the debilitating effects of RA on functioning and disability .Early intervention can then be initiated which will help limit joint damage and thereby improve functional outcomes.

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