Functional index for hand osteoarthritis (FIHOA) is associated with pain, muscle strength, and EQ-5D in hand osteoarthritis

Kim, Seong-Kyu; Jung, Ui Hong; Choe, Jung-Yoon

doi:10.1186/s42358-021-00177-5

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Sumário

Research • Adv. rheumatol. 61 • 2021 • https://doi.org/10.1186/s42358-021-00177-5 copy

Functional index for hand osteoarthritis (FIHOA) is associated with pain, muscle strength, and EQ-5D in hand osteoarthritis

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background:

This study identified whether Functional Index for Hand Osteoarthritis (FIHOA) is associated with pain, hand muscle strength, health-related quality of life, and radiographic severity in hand osteoarthritis (OA).

Methods:

We consecutively recruited 95 patients with hand OA. The FIHOA was used to assess questionnaire-based physical function in hand OA. Health-related quality of life was evaluated using EuroQol-5 dimension (EQ-5D). Radiographic changes of hand joints were measured by Kellgren-Lawrence (K-L) grade, which was determined based on total radiographic severity score and number of affected joints. Other measures included patient's visual analogue scale (VAS) score for pain and performance-based function indexes such as grip and pinch strength. Statistical analysis was performed using Mann-Whitney U test, Spearman's correlation analysis, and multivariate logistic regression analysis.

Results:

FIHOA score was negatively associated with grip and pinch hand strength and EQ-5D and positively correlated to VAS pain (p < 0.05 for all). There were significant differences of grip and pinch strength, VAS pain, EQ-5D index, and EQ-VAS between two FIHOA groups (≤ 4 vs. > 4) (p < 0.05 for all). Multivariate logistic regression analysis showed that higher FIHOA score (FIHOA > 4) was related with increased VAS pain and with lower EQ-5D index (p = 0.008 and p = 0.013, respectively). There was no association between FIHOA score and measures of total radiographic severity score and number of affected joints.

Conclusion:

This study observes that FIHOA score is associated with patient-reported VAS pain, hand muscle strength indexes, and EQ-5D but not radiographic severity in hand OA.

Keywords:
Osteoarthritis; Hand; FIHOA; EQ-5D; VAS; Kellgren-Lawrence grade

Variables		Results
Age (year)		60.0 (54.0–66.0)
Sex, female (n, %)		90 (94.7)
Symptom duration (month)		6.0 (1.0–73.0)
BMI (kg/m²)		23.4 (21.5–24.9)
SBP (mmHg)		127.0 (115.0–135.0)
DBP (mmHg)		74.0 (69.0–80.0)
ESR (mm/hr)		14.0 (9.0–32.0)
CRP (mg/L)		0.6 (0.6–0.8)
Past history
	Hypertension (n, %)	24 (25.3)
	Diabetes mellitus (n, %)	10 (10.5)
Grip strength
	Mean^a a Average value of the sum of right and left hand scores	20.0 (16.5–24.5)
	Right	20.0 (16.0–25.0)
	Left	22.0 (16.0–25.0)
Pinch strength
	Mean^a a Average value of the sum of right and left hand scores	5.7 (4.8–6.5)
	Right	6.0 (5.0–6.8)
	Left	5.5 (4.8–6.5)
VAS pain		34.0 (20.0–52.0)
FIHOA		65.0 (50.0–80.0)
EQ-5D index		0.82 (0.77–0.87)
EQ-VAS		65.0 (50.0–80.0)
Total radiographic severity scores (0–80) ^b b Based on Kellgren-Lawrence grade		6.0 (2.0–18.0)
Number of affected joints (0–20) ^b b Based on Kellgren-Lawrence grade		5.0 (2.0–9.0)

		FIHOA ≤4(n = 49)	FIHOA >4 (n = 46)	p values
Age (year)		61.0 (54.6–67.5)	59.0 (54.0–63.3)	0.367
Sex, female (n, %)		46 (93.9)	44 (95.7)	0.530
Symptom duration (month)		24.0 (1.0–96.0)	4.0 (1.0–30.0)	0.120
BMI (kg/m²)		23.4 (21.3–24.0)	23.8 (21.5–25.9)	0.295
SBP (mmHg)		126.0 (114.0–135.0)	127.5 (119.5–135.5)	0.690
DBP (mmHg)		74.0 (69.0–80.0)	75.5 (69.5–80.3)	0.463
ESR (mm/hr)		14.0 (9.0–27.3)	14.0 (8.0–20.5)	0.376
CRP (mg/L)		0.6 (0.6–0.8)	0.6 (0.6–1.3)	0.295
Grip strength
	Mean^a a Average value of the sum of right and left hand scores	23.0 (19.3–25.0)	18.0 (13.9–22.3)	< 0.001
	Right	22.0 (18.0–27.5)	18.0 (14.0–22.5)	0.004
	Left	23.0 (10.0–26.0)	17.5 (12.8–23.0)	< 0.001
Pinch strength
	Mean^a a Average value of the sum of right and left hand scores	6.3 (5.3–7.1)	5.4 (4.0–6.4)	< 0.001
	Right	6.3 (5.1–7.3)	5.5 (3.5–6.5)	0.001
	Left	6.0 (5.0–7.0)	5.5 (3.9–6.0)	0.002
VAS pain		22.0 (10.0–36.5)	48.5 (34.0–71.0)	< 0.001
EQ-5D index		0.87 (0.82–0.91)	0.82 (0.7–0.86)	< 0.001
EQ-VAS		70.0 (57.5–80.0)	50.0 (49.5–70.0)	< 0.001
Total radiographic severity scores^b b Based on Kellgren-Lawrence grade		6.0 (2.5–21.0)	8.5 (2.0–17.3)	1.000
Number of affected joints^b b Based on Kellgren-Lawrence grade		5.0 (2.0–12.0)	5.5 (2.0–9.0)	0.917

	Univariate regression			Multivariate regression
Variables	OR	95% CI	p values	OR	95% CI	p values
Age (year)	0.978	0.934–1.025	0.362	0.940	0.864–1.022	0.149
Sex, female (n, %)	0.697	0.111–4.372	0.700	1.919	0.128–28.793	0.637
Symptom duration (month)	0.995	0.988–1.001	0.111	0.988	0.976–1.001	0.078
BMI (kg/m²)	1.060	0.900–1.226	0.535
ESR (mm/hr)	0.974	0.939–1.009	0.146
CRP (mg/L)	1.137	0.856–1.512	0.375
Mean grip strength	0.871	0.803–0.945	0.001	0.907	0.794–1.037	0.152
Mean pinch strength	0.525	0.368–0.748	< 0.001	0.803	0.445–1.448	0.466
Patient VAS	1.066	1.038–1.096	< 0.001	1.044	1.011–1.079	0.008
EQ-5D index	0.000	0.000–0.001	< 0.001	0.000	0.000–0.069	0.013
EQ-VAS	0.947	0.921–0.974	< 0.001	0.970	0.931–1.011	0.149
Total radiographic severity scores	0.996	0.963–1.030	0.815
Number of affected joints	0.988	0.913–1.070	0.773

Sociedade Brasileira de Reumatologia Av. Brigadeiro Luís Antônio, 2466, Jardim Paulista, 01402-000 - São Paulo, SP, Tel.: +551132897165 - São Paulo - SP - Brazil
E-mail: rbreumatol@terra.com.br

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[1] * Correspondence: kimsk714@cu.ac.kr