Hand functional capacity in women with systemic sclerosis using the Glittre-ADL-Shelf test: Relationship with demographics, body composition, hand function, physical function, digital dexterity, muscle strength and lung function.

Abstract

Objective: Hand functionality in systemic sclerosis is assessed using patient-reported measures. However, the Glittre-ADL test (TGlittre) provides an objective assessment of functional capacity using activities of daily living, including the hand shelf task. The aim of this study was to assess hand functional capacity in women with systemic sclerosis using the TGlittre-Shelf and to correlate it with demographics, body composition, hand function, physical function, digital dexterity, muscle strength, and lung function.

Methods: This was a cross-sectional study in which 41 women with systemic sclerosis and 41 healthy controls underwent the TGlittre-S. They also underwent the following assessments: Cochin Hand Functional Scale, modified Rodnan skin score, Health Assessment Questionnaire Disability Index, 9-hole peg test, handgrip strength, and pulmonary function tests.

Results: The mean age was 51.9 ± 13.7 and 45.9 ± 9.3 years in women with systemic sclerosis and healthy controls, respectively (p = 0.09). Body mass index was 24.4 ± 4.9 and 29.4 ± 5.3 kg/m² in women with systemic sclerosis and healthy controls, respectively (p < 0.0001). TGlittre-S time was higher in women with systemic sclerosis than in healthy controls [60 (55-74) vs 44 (41-49) sec, p < 0.0001]. In addition, 9-hole peg test was higher in women with systemic sclerosis than in healthy controls [24 (22-26) vs 20 (18-22) sec, p < 0.0001]. Similarly, Cochin Hand Functional Scale was higher in women with systemic sclerosis than in healthy controls [6 (0.5-25) vs 0 (0-0) points, p < 0.0001]. In women with systemic sclerosis, TGlittre-S time was significantly correlated with the following variables: handgrip strength (r_s  = -0.511, p = 0.0006), Health Assessment Questionnaire Disability Index (r_s  = 0.510, p = 0.0006), 9-hole peg test (r_s  = 0.398, p = 0.009), and Cochin Hand Functional Scale (r_s  = 0.351, p = 0.024).

Conclusion: In women with systemic sclerosis, there is a deterioration in impaired hand functional capacity as measured by TGlittre-S. In these patients, the longer the TGlittre-S time, the worse the handgrip strength, digital dexterity, and physical function. As TGlittre-S is easy to perform and does not require much space, its incorporation into clinical practice is promising and may be considered as an outcome measure for future studies in systemic sclerosis.