Hand functional capacity in women with systemic sclerosis using the Glittre-ADL-Shelf test: Relationship with demographics, body composition, hand function, physical function, digital dexterity, muscle strength and lung function

Abstract

Objective: Hand functionality in systemic sclerosis is assessed using patient-reported measures. However, the Glittre-ADL test (TGlittre) provides an objective assessment of functional capacity using activities of daily living, including the hand shelf task. The aim of this study was to assess hand functional capacity in women with systemic sclerosis using the TGlittre-Shelf and to correlate it with demographics, body composition, hand function, physical function, digital dexterity, muscle strength, and lung function.

Methods: This was a cross-sectional study in which 41 women with systemic sclerosis and 41 healthy controls underwent the TGlittre-S. They also underwent the following assessments: Cochin Hand Functional Scale, modified Rodnan skin score, Health Assessment Questionnaire Disability Index, 9-hole peg test, handgrip strength, and pulmonary function tests.

Results: The mean age was 51.9 ± 13.7 and 45.9 ± 9.3 years in women with systemic sclerosis and healthy controls, respectively (p = 0.09). Body mass index was 24.4 ± 4.9 and 29.4 ± 5.3 kg/m² in women with systemic sclerosis and healthy controls, respectively (p < 0.0001). TGlittre-S time was higher in women with systemic sclerosis than in healthy controls [60 (55-74) vs 44 (41-49) sec, p < 0.0001]. In addition, 9-hole peg test was higher in women with systemic sclerosis than in healthy controls [24 (22-26) vs 20 (18-22) sec, p < 0.0001]. Similarly, Cochin Hand Functional Scale was higher in women with systemic sclerosis than in healthy controls [6 (0.5-25) vs 0 (0-0) points, p < 0.0001]. In women with systemic sclerosis, TGlittre-S time was significantly correlated with the following variables: handgrip strength (r_s = -0.511, p = 0.0006), Health Assessment Questionnaire Disability Index (r_s = 0.510, p = 0.0006), 9-hole peg test (r_s = 0.398, p = 0.009), and Cochin Hand Functional Scale (r_s = 0.351, p = 0.024).

Conclusion: In women with systemic sclerosis, there is a deterioration in impaired hand functional capacity as measured by TGlittre-S. In these patients, the longer the TGlittre-S time, the worse the handgrip strength, digital dexterity, and physical function. As TGlittre-S is easy to perform and does not require much space, its incorporation into clinical practice is promising and may be considered as an outcome measure for future studies in systemic sclerosis.

Keywords: Systemic sclerosis; exercise; functional capacity; hand; pulmonary function.

Figure 1.

Schematic representation of the Glittre-ADL-Shelf test. The participant moved three objects of 1 kg each from an upper shelf (shoulder height) to a lower shelf (pelvic height), one at a time. The participant then moved the three objects from the lower shelf to the upper shelf. This was done five times. Participants performed the test with a 2.5 kg backpack, as recommended in the original test description, as this weight approximates the weight of supplemental oxygen equipment that may be added in the future without altering the test. Participants were previously instructed to move the objects as quickly as possible.

Figure 2.

Relationship between the Glittre-ADL-Shelf test time (TGlittre-S) and handgrip strength (HGS) in women with systemic sclerosis (wwSSc) (r_s = −0.511, p = 0.0006) and healthy controls (r_s = −0.359, p = 0.021).