Abstract：
BACKGROUND: Reports on hand dysfunction and rehabilitation in SSc are quite scarce in the literature and mainly focus on functional assessment tools, such as the Duruoz Hand Index and the HAMIS test for evaluating hand mobility by simulating specific grasps with nine different objects.
OBJECTIVE: This study aimed to provide an adequate assessment methodology for hand grasp dysfunctions in patients suffering from systemic sclerosis (SSc) through the 16-grasp test.
METHODS: Case-control study.
METHODS: Ninety-seven consecutive SSc patients were recruited at our Scleroderma Unit, where a 16-grasp test was performed by all patients and supervised by an experienced hand therapist. Sixteen different patterns of grasp have been divided into power grasps and precision pinch and two more modalities: static and dynamic prehension evaluation on scale from 0 to 4. We also compared previous evaluations on 19 of patients recruited.
RESULTS: The majority of SSc patients (84 females and 13 males; mean age 56.0±12.0 years; mean disease duration 8.0±6.0 years) displayed grasp dysfunctions; in particular 48% and 54% reported slight difficulty in the right and left grasps respectively, 6% medium difficulty in both hands, and only 3% and 1% experienced severe difficulty respectively, while 31.5% had no issues in either hand. Our results showed that the limited cutaneous subset (lcSSc) scored a lower deficit for either grasp compared to diffuse form (dcSSc). No statistically significant differences in total grasp deficit had been noticed when comparing patients having a disease duration < 5 years or longer. In the retrospective study on 19 of these patients, 8 out of 10 lcSSc patients showed no significant changes, while in 2 out of 10, slight improvements were observed in both hands. However, in the dcSSc group, 4 out of 9 worsened bilaterally while the grasp scores for 5 of them remained unchanged.
CONCLUSIONS: Our study reported hand involvement in both lcSSc and dcSSc forms, more significantly in dcSSc patients. This test is intended to be a more objective means of assessing grasp alterations linked to scleroderma hand deformities. Furthermore, thanks to its intuitiveness, the test may be useful for engineers designing personalized ergonomic assistive devices.
OBJECTIVE: This study aimed to provide an adequate assessment methodology for hand grasp dysfunctions in patients suffering from systemic sclerosis (SSc) through the 16-grasp test.
METHODS: Case-control study.
METHODS: Ninety-seven consecutive SSc patients were recruited at our Scleroderma Unit, where a 16-grasp test was performed by all patients and supervised by an experienced hand therapist. Sixteen different patterns of grasp have been divided into power grasps and precision pinch and two more modalities: static and dynamic prehension evaluation on scale from 0 to 4. We also compared previous evaluations on 19 of patients recruited.
RESULTS: The majority of SSc patients (84 females and 13 males; mean age 56.0±12.0 years; mean disease duration 8.0±6.0 years) displayed grasp dysfunctions; in particular 48% and 54% reported slight difficulty in the right and left grasps respectively, 6% medium difficulty in both hands, and only 3% and 1% experienced severe difficulty respectively, while 31.5% had no issues in either hand. Our results showed that the limited cutaneous subset (lcSSc) scored a lower deficit for either grasp compared to diffuse form (dcSSc). No statistically significant differences in total grasp deficit had been noticed when comparing patients having a disease duration < 5 years or longer. In the retrospective study on 19 of these patients, 8 out of 10 lcSSc patients showed no significant changes, while in 2 out of 10, slight improvements were observed in both hands. However, in the dcSSc group, 4 out of 9 worsened bilaterally while the grasp scores for 5 of them remained unchanged.
CONCLUSIONS: Our study reported hand involvement in both lcSSc and dcSSc forms, more significantly in dcSSc patients. This test is intended to be a more objective means of assessing grasp alterations linked to scleroderma hand deformities. Furthermore, thanks to its intuitiveness, the test may be useful for engineers designing personalized ergonomic assistive devices.
摘要：
背景：关于SSc中手部功能障碍和康复的报告在文献中相当稀缺，主要集中在功能评估工具上，例如Duruoz手指数和HAMIS测试，用于通过模拟九种不同物体的特定抓握来评估手的移动性。
目的：本研究旨在通过16抓握测试为患有系统性硬化症（SSc）的患者的手抓握功能障碍提供适当的评估方法。
方法：病例对照研究。
方法：在我们的硬皮病单位招募了97名连续的SSc患者，所有患者都进行了16次抓握测试，并由经验丰富的手治疗师监督。16种不同的抓握模式已分为力量抓握和精确捏合以及另外两种模式：从0到4的静态和动态抓握评估。我们还比较了19名招募患者的先前评估。
结果：大多数SSc患者（84名女性和13名男性；平均年龄56.0±12.0岁；平均病程8.0±6.0年）表现出抓握功能障碍；特别是48％和54％分别报告了左右抓握的轻微困难，6％双手中等难度，分别只有3%和1%的人经历了严重困难，而31.5%的人没有任何问题。我们的结果表明，与弥漫性形式（dcSSc）相比，有限的皮肤子集（lcSSc）在任一抓握方面的得分均较低。当比较疾病持续时间<5年或更长的患者时，没有发现总抓握缺陷的统计学显着差异。在对其中19例患者的回顾性研究中，10例lcSSc患者中有8例没有明显变化，而在10个中的2个中，观察到双手略有改善。然而,在dcSSc组中，9个中的4个双边恶化，而其中5个的把握得分保持不变。
结论：我们的研究报告了lcSSc和dcSSc形式的手受累，在dcSSc患者中更显著。该测试旨在成为评估与硬皮病手畸形相关的抓握改变的更客观的方法。此外，多亏了它的直觉,该测试对于设计个性化人体工程学辅助设备的工程师可能很有用。
目的：本研究旨在通过16抓握测试为患有系统性硬化症（SSc）的患者的手抓握功能障碍提供适当的评估方法。
方法：病例对照研究。
方法：在我们的硬皮病单位招募了97名连续的SSc患者，所有患者都进行了16次抓握测试，并由经验丰富的手治疗师监督。16种不同的抓握模式已分为力量抓握和精确捏合以及另外两种模式：从0到4的静态和动态抓握评估。我们还比较了19名招募患者的先前评估。
结果：大多数SSc患者（84名女性和13名男性；平均年龄56.0±12.0岁；平均病程8.0±6.0年）表现出抓握功能障碍；特别是48％和54％分别报告了左右抓握的轻微困难，6％双手中等难度，分别只有3%和1%的人经历了严重困难，而31.5%的人没有任何问题。我们的结果表明，与弥漫性形式（dcSSc）相比，有限的皮肤子集（lcSSc）在任一抓握方面的得分均较低。当比较疾病持续时间<5年或更长的患者时，没有发现总抓握缺陷的统计学显着差异。在对其中19例患者的回顾性研究中，10例lcSSc患者中有8例没有明显变化，而在10个中的2个中，观察到双手略有改善。然而,在dcSSc组中，9个中的4个双边恶化，而其中5个的把握得分保持不变。
结论：我们的研究报告了lcSSc和dcSSc形式的手受累，在dcSSc患者中更显著。该测试旨在成为评估与硬皮病手畸形相关的抓握改变的更客观的方法。此外，多亏了它的直觉,该测试对于设计个性化人体工程学辅助设备的工程师可能很有用。
