Hand Performance Assessed by Functional Dexterity Test Correlates With Clinical Disease Activity but Remains Altered in Rheumatoid Arthritis Patients Achieving Treatment Goals: A Cross-Sectional Cohort Study.

Abstract

Objectives: Direct hand function is not commonly evaluated in patients with rheumatoid arthritis (RA). The Functional Dexterity Test (FDT) assesses a patient's ability to use the hand for daily tasks and is an accepted quantitative assessment tool in occupational medicine. This pilot study aimed to examine the correlations of FDT-measured hand performance with disease activity status in a cohort of RA patients.

Methods: Forty-eight patients with established RA performed the FDT during their regular follow-up visits. The dominant and non-dominant hands were assessed separately. FDT results were compared among patients with active RA and Clinical Disease Activity Index (CDAI) > 10, RA patients achieving controlled disease activity state (CDAI ≤ 10), and 20 volunteers with no rheumatic disease.

Results: Mean FDT for the dominant hand was 43 s in active RA, 35 s in controlled RA, and 25 s in persons without arthritis. Corresponding FDT results for the non-dominant hand were 50, 38, and 29 s, respectively. FDT significantly correlated with CDAI in the entire cohort of RA patients and the subgroup with CDAI > 10. Patients with controlled disease, CDAI ≤ 10, still demonstrated significantly reduced hand performance compared with non-rheumatic controls.

Conclusions: FDT is a sensitive tool for assessing rheumatoid hand function. Reduced hand performance by FDT in many RA patients who have already achieved existing treatment goals speaks to the question of the suitability of direct hand performance assessment as an RA outcome measure.