Major Finding: When asked, 211 Norwegians with hand osteoarthritis listed 311 tasks their OA made difficult.
Data Source: Survey conducted using the Australian/Canadian Hand Osteoarthritis Index.
Disclosures: The study was paid for by the Norwegian Occupational Therapy Association and the Oslo Rheumatism Association. Dr. Fernandes said she has no disclosures.
SAN DIEGO – Hand osteoarthritis causes a wide range of problems, but popular functional assessment questionnaires may miss many of them, Norwegian researchers have found.
In response to a survey question, 211 Norwegians with hand osteoarthritis (OA) listed 311 tasks their OA made more challenging. Wringing out cloths and opening jars was a struggle for more than half. A third or more cited buttoning and unbuttoning clothes, as well as carrying suitcases and other heavy objects. More than 20% reported having a hard time peeling raw vegetables.
Those items are among the nine tasks listed on the widely used Australian/Canadian (AUSCAN) Hand Osteoarthritis Index questionnaire, said lead investigator Linda Fernandes, Ph.D., a physiotherapist at Diakonhjemmet Hospital in Oslo.
But more than half of the Norwegian sample had a hard time opening bottles, too.
About a third said writing by hand and slicing bread were tough. About 20% or more said knitting, putting on socks, vacuuming, carrying shopping bags, zipping pants, and wiping down floors, among other chores, were problems, and some patients listed those items as priorities. None are on the AUSCAN, she said at the congress, sponsored by the Osteoarthritis Research Society International.
Patients did not mention problems with opening doors and turning on faucets, likely because doors in Scandinavia have turning handles, not doorknobs, and most sinks have a single lever to control hot and cold water. These items are on the AUSCAN, Dr. Fernandes said.
“The outcome measures we have today,” which also include Dreiser's Functional Index, “are all expert opinion–based questionnaires. They haven't really asked the patients themselves” about their struggles, she said.
She and her colleagues said they hope to develop a more comprehensive questionnaire.
Meanwhile, they said, physicians should go beyond current questionnaires to learn more about the challenges their patients face. Lid handles to open jars, as well as grip-strength and range of motion exercises, especially for the thumb, may also help patients, Dr. Fernandes said.
The study involved 201 women and 10 men, average age 63 years, recruited consecutively as they presented to rheumatology clinics in Oslo and Trondheim.
They had a mean disease duration of 12.5 years and 8.6 affected joints; 64% had a comorbidity, 49% were employed.