ASSESSMENTS OF DISABILITY IN WOMEN WITH RHEUMATOID-ARTHRITIS IN RELATION TO GRIP FORCE AND PAIN

The aim of this study was to assess disability with the Health Assessm ent Questionnaire (HAQ) and to evaluate the relationships between grip force, pain and difficulty in daily activities. Twenty women with rhe umatoid arthritis were assessed with measurements of grip force and pa in before and after grip test. Both the original HAQ version and an al ternative rating model, not taking the use of assistive devices into a ccount, were used. All patients reported pain which significantly incr eased after grip test and with a significant inverse correlation to gr ip force. All patients had assistive devices, on average 15 devices (r ange 1-27). Ninety-one per cent of the patient's devices were in conti nued use, most frequently in the categories; Eating, Grip and Hygiene. Disability was significantly correlated to pain, grip force and use o f assistive devices. When using the alternative ratings of 20 question s in HAQ, 8 of the 20 questions showed significantly (p = 0.0003-0.033 9) lower scoring, and the number of questions with significant correla tions between grip force and disability increasing from 9 (r = 0.48-0. 74, p = 0.039-0.001) to 14 questions (r = 0.47-0.74, p = 0.047-0.001). Difference between intrinsic disability (without assistive devices) a nd actual disability (with such assistance) is not reflected in origin al HAQ. The present study indicates that assessment of actual disabili ty by the alternative rating model is more often correlated to impairm ent (grip force) than disability assessed by original HAQ and can be c onsidered to give a better assessment of actual disability than the or iginal HAQ model.