FRI0552 Hand Grip Strength as Simple Predictor of Disease Activity and Disability in Patients with Juvenile Idiopathic Arthritis

Background Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease resulting in joints arthritis and deformities in the hands and fingers. This leads to decrease of joint mobility and strength of the hands which can lead to physical and functional hand disability (1) and subsequent reduction in daily living activities (2). Despite the presence of indices to assess the hand function, grip strength assessment remains the strong predictor of both hand and upper limb function (3). Hand grip strength (HGS) can be measured quantitatively using a hand dynamometer (4). Although the role of HGS in evaluating hand function in JIA has been studied (5), the use of HGS as a predictor of disease activity and disability in JIA has not been explored. Objectives The aim of the study was to evaluate the HGS in JIA patients using electronic hand dynamometer and to assess its relationship with JIA disease activity, disability and quality of life. Methods Twenty-three patients with JIA (14 girls and 9 boys) diagnosed according to International League of Associations for Rheumatology (ILAR) classification criteria and 59 healthy children were enrolled in the study. The disease activity was assessed using Juvenile Disease Activity Score (JDAS-27). Juvenile Arthritis Functionality Scale (JAFS) and Pediatric QOL Inventory (PedsQL) were used to assess physical function and quality of life respectively. HGS was tested 3 times in each hand of every patient and control using electronic hand dynamometer and the mean value was considered. Results Patients with JIA showed low HGS in one or both hands compared with healthy children ( p =0.001). Grip strength showed a significant inverse correlation with JDAS-27 ( p =0.003, r value = -0.591) and with JAFS (total and after exclusion of hand component) ( p =0.001 and 0.002, r value = -0.650 and -0.608 respectively). Significant correlations were observed between HGS and PedsQL ( p =0.036). Conclusions Patients with JIA have reduced HGS when compared to healthy children. HGS may be considered as a non invasive predictor of JIA disease activity and disability. Pediatric quality of life is adversely affected with decrease in HGS. HGS testing might be used a simple screening for disease activity in patients with JIA. References 1. Filocamo G, Sztajnbok F, Cespedes-Cruz A, Magni-Manzoni S, Pistorio A, Viola S, Ruperto N, Buoncompagni A, Loy A, Martini A, Ravelli A (2007) Development and validation of a new short and simple measure of physical function for juvenile idiopathic arthritis. Arthritis Rheum 57 (6) Article: 913-20 2. Varni JW, Seid M, Kurtin PS (2001) PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 39 (8) Article: 800-12 3. Dunn W (1993) Grip strength of children aged 3 to 7 years using a modified sphygmomanometer: comparison of typical children and children with rheumatic disorders. Am J Occup Ther 47 (5) Article: 421-8 4. Sheehy C, Gaffney K, Mukhtyar C (2013) Standardized grip strength as an outcome measure in early rheumatoid arthritis. Scand J Rheumatol 5. Lindehammar H (2003) Hand strength in juvenile chronic arthritis: a two-year follow-up. Acta Paediatr 92 (11) Article: 1291-6 Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.1858