Research Information System
22nd Federation of European Societies for Surgery of the Hand's Congress, Budapest, Hungary, 21 - 24 June 2017, pp.127-128
Objective: The aim of this study is to investigate correlation between disease activity, quality of life, level of disability, and scapular dyskinesis (SD) among patients with rheumatoid arthritis (RA).
Methods: Fifty-six patients with RA were evaluated for the study, and they were divided equally into two groups with the following criteria: Patient has SD or patient do not has SD. Demographic information of them recorded and following tests applied to every patients: Disabilities of Arm, Shoulder and Hand questionnaire (DASH), Shoulder Pain and Disability Index (SPADI), Rheumatoid Arthritis specific Quality of Life questionnaire (RAQoL), Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5), and Visual Analog Scale (VAS). Range of Motion (ROM) of shoulder’s flexion, extension, abduction, external, and internal rotation was evaluated with goniometer. Moreover, patient’s muscles strength, such as shoulder flexion, abduction, internal and external rotation, elbow flexion, and suprasipinatus, muscle was assessed using the manual muscle test. Lateral Scapular Slide Test (LSST) and observational methods were used to identify presence of SD.
Results: Both groups are similar in terms of body age, mass index, duration of shoulder pain, and course of RA. Results of the patient with SD (Group 2) is significantly worse than those of the patient without SD (Group 1) in DASH ( p = .001), SPADI (p < .001), RADAI-5 (p < .001), RAQoL (p < .001), VAS right shoulder (p = .002) and left shoulder (p = .001). In terms of ROM, we did not find any significant differences between groups. Moreover, when looking at ROM scores, no significant difference was found between all patients’ left and right shoulders. In Group 2, the side (left or right shoulder) with SD has less external rotation muscle strength compared to the other shoulder (p = .046). However, there not is significantly difference in Group 1 patients’ muscle strength such as shoulder flexion, abduction, internal and external rotation, elbow flexion and suprasipinatus. Moreover, although the difference for pain between right and left shoulders of Group 2 is bigger than Group 1; this is not a significant difference.
Conclusions: SD can exacerbate quality of life and functional capacity of patient with RA. In conclusion, when studying with 56 patients with RA, we found the patients with SD had worse clinical results than the patients with no SD. In RA, shoulder involvement can trigger SD. In RA, inflammatory process that affects joints is also risk for shoulder. By looking at the results, we believe disease activity and level of pain contribute to SD. Overall, we do recommend patients with RA getting scapula evaluated regularly.