SAT0105 HAND DISABILITY IN RHEUMATOID ARTHRITIS: AN ENGINEERED GLOVE FOR THE COMPUTERISED QUANTIFICATION OF THE DAMAGE
Authors: Massimo Patanè, Luca Carmisciano, Emanuele Gotelli, Veronica Tomatis, Federica Goegan, Elisa Alessandri, Massimo Ghio, Alessio Signori, Maurizio Cutolo
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Tenderness, swelling and loss of motility of the joints are the main determinants of the disability function (DF) of Rheumatoid Arthritis (RA) patients (RApts)<sup>1</sup>. The evaluation of DF is performed by Patient Reported Outcomes (PROs), like Health Assessment Questionnaire (HAQ)<sup>2</sup>. The lack of objective evaluation of DF is one of the most important "unmet needs" in RA. The Hand Test System (HTS, ETT) is an engineered glove, nowadays applied for neuroscience studies to evaluate hands motility with interesting perspectives of use in other clinical research fields<sup>3-4</sup>. <h3>Objectives:</h3> To quantify the DF of RApts by the analysis of speed and right execution of fingers opposition movement in both hands, evaluated by HTS. To verify the correspondence with the HAQ. <h3>Methods:</h3> In this pilot study 14 consecutives RApts (3 males, 11 females, age 61 ± 11,5 years, mean duration of disease 11,21 ± 5,07 years), classified according to 2010 ACR/EULAR criteria<sup>5</sup>, and 13 healthy controls (HC – 7 males, 6 females, age 50 ± 15 years) were enrolled from the RA clinic. After consent, all participants undergone HTS test that recognizes the touches between the finger tips during the opposition movements of the hands in standard sequences of movements, after dressed the glove. A multiple finger evaluation (MFE) and a single finger evaluation (SFE) were performed using a dedicated software that provided the physician the following quantitative parameters: Touch Duration (TD), Inter Tapping Interval (ITI) and Movement Rate (MR). Average time for hand 2 minutes. RApts compiled the HAQ and a tender and swollen joint count of the hands was performed. Continue variables were summarized as mean and standard deviation (SD) or median and interquartile range (IQR), discrete variables were summarized with count and percentage. Variables with skewed distribution was converted to natural logarithm. T-test was used to compare log glove parameters between groups. Pearson's r and p value were used to report the correlation between log-converted glove parameters and HAQ score. <h3>Results:</h3> In MFE, glove parameters TD and ITI were significantly higher in RApts (TD 257.34 ± 123.93 ms, ITI 377.8 ± 211.35 ms) than HC (TD 172.25 ± 59.36 ms, ITI 177.98 ± 78.53 ms) (p = 0.004 and p &lt; 0.001) and MR was significantly lower in RApts (1.51 ± 0.47 Hz) compared to HC (2.87 ± 0.9 Hz) (p &lt;0.001). TD of RApts had a significant correlation with the total score of the HAQ (Pearson r = 0.79, p = 0.001). In SFE non-active fingers (NAF, not swollen and not tender) of RApts seemed to perform slightly better than a clinically active finger (AF) but significantly worse than average HC finger (ANOVA, p &lt; 0.001). <h3>Conclusion:</h3> HTS is a new easy and totally safe tool that seems to quantify in an objective manner the hand DF in RApts. The significant correlation found with HAQ underlines the value and veracity of self-assessment tools in clinical practice. Further studies are ongoing with larger number of RApts to validate its application to monitor the improvement or the worsening of RA in order to optimize pharmacological treatments. The study is now extended in other Rheumatic and Musculoskeletal Diseases. <h3>Reference</h3> [1] Hakkinen A, et al. Ann Rheum Dis. 2005; 64:59–63. 2 Fries J, et al. Arthritis Rheum. 1980; 23:137–45. 3 Bonzano L, et al. Eur J Neurol. 2019;26(1):162-167. 4 Signori A, et al. PLoS One. 2017 Oct 18;12(10): e0186524. 5 Aletaha D, et al. Ann Rheum Dis. 2010;69(9):1580-8. <h3>Disclosure of Interests:</h3> None declared