The Effects of Early Rheumatoid Arthritis on Dominant and Non-dominant Hand Impairment and Function

Abstract

Rheumatoid arthritis (RA) is defined as a symmetrical disease yet there is evidence that hand joint damage sustained in RA is related to use, and hand dominance could affect the degree of structural impairment evident in the wrist and hand. This exploratory research aimed to examine the relationship of dominant and non-dominant wrist and hand joint impairment and function in an early rheumatoid population. A multi-centre cohort study was conducted, recruiting consenting patients with early rheumatoid arthritis from eight outpatient occupational therapy departments. Wrist and hand joint impairment and function were assessed by measuring joint pain and swelling, range of motion and joint deviation, handgrip and hand dexterity. The results demonstrated that the non-dominant hand showed less pathological structural and functional involvement than the dominant hand in all but one outcome measure. These differences reached statistical significance between dominant and non-dominant hands on active range of motion in the wrist and some digits. Dominant hand structural impairment and dysfunction in this early RA sample was consistently greater than the non-dominant hand and bilateral handgrip ratio did not reflect healthy values for norms. Individuals with early RA showed a greater level of impairment in their dominant hands.