THU0734-HPR Novel experience equipment for rheumatoid hand-fingers
Authors: M. Kusumoto, S. Tsuji, M. Toshiharu, Y. Kushimoto, N. Ise, N. Yoshida, S. Kawai, T. Kyrosawa, E. Oguro, Y. Okita, K. Kuzuya, H. Matsuoka, S. Teshigawara, M. Yoshimura, Y. Harada, T. Noguchi, M. Matsushita, K. Hagio, S. Tsuji, S. Akita, S. Ohshima, J. Hashimoto, Y. Saeki
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> RA patients are prone to ulnar deviation and swan-neck deformity even early after onset of the disease. Limitation of finger joint range of motion due to hand-finger deformation brings restriction to ADL in the workplace as well as in the home. Patients and caretakers of patients are often burdened by these limitations; however, RA hand-finger deformation experience equipment have not been developed to experience these limitations. We have developed a novel RA hand-finger deformation experience equipment with opened fingertips (RSE; RA hand/finger simulation equipment). <h3>Objectives</h3> To assess the utilisation of RSE in healthy volunteers (HV) to experience RA hand-finger dysfunction using DASH (Disabilities of the Arm, Shoulder and Hand), STEF (Simple Test for Evaluating Hand Function), and Purdue Pegboard. <h3>Methods</h3> We developed the following equipment: Type U to imitate extension limitation of metacarpophalangeal (MCP) joints seen in ulnar deviation; Type B which imitates flexion deformity of the distal interphalangeal (DIP) joints by seen in boutonniere deformity; and Type S which imitates flexion limitation of proximal interphalangeal (PIP) and interphalangeal (IP) joints by reversing the upper and lower ends of the Oval-8 Finger Splint (Fukui Co. Ltd, Japan). Types U and S were fitted on HV (index to pinky). RSE was evaluated using DASH, STEF and Purdue Pegboard in hand-finger function evaluation. Twenty-four RA patients with hand-finger deformation and Forty-one HV were included in this study to evaluate the equipment. <h3>Results</h3> Mean ±SD ages for RA patients was 67.4±8.0 years (95.8% female) and 38.2±17.7 for HV (63.4% female), respectively. Total hand-finger deformities for RA patients were 23 hands for ulnar deviation, 66 fingers for swan-neck deformity, and 33 fingers for boutonniere deformity. Randomization for RA patients was as follows: 13 DASH, 5 (10 hands) STEF, and 6 Purdue Pegboard. 10 HV were assigned to DASH, 10 to Purdue Pegboard, and 14 (28 hands) to STEF. HV were evaluated with RSE and without RSE. For DASH, STEF, and Purdue Pegboard, RA patients showed significant functional loss compared to HV. Significant function loss in RA patients was also observed with the RSE. However, no differences were seen between the RA group and the HV with RSE group (figure 1). <h3>Conclusions</h3> We developed the RSE, which allows for one to experience the decrease in function with RA hand-finger deformity. Our study showed that RSE use can indeed allow this experience. By using RSE, health care workers, patient caretakers and early RA patients can experience joint limitation of RA for educational purposes, personalised rehab programs, and development of self-help tools. <h3>Disclosure of Interest</h3> None declared