Reliability, validity, and responsiveness of the modified Kapandji index for assessment of functional mobility of the rheumatoid hand. The limited value of the Health Assessment Questionnaire as an outcome measure in short term exercise trials. A comparative study of patient-reported functional outcomes in acute rheumatoid arthritis. Feeling good rather than feeling better matters more to patients. Feasibility and efficacy of a robotic device for hand rehabilitation in hemiplegic stroke patients: a randomized pilot controlled study Evaluation of a structured goal planning and tailored follow-up programme in rehabilitation for patients with rheumatic diseases: protocol for a pragmatic, stepped-wedge cluster randomized trial Randomized comparison of a multidisciplinary job-retention vocational rehabilitation program with usual outpatient care in patients with chronic arthritis at risk for job loss. A comparison of health-related quality-of-life measures for rheumatoid arthritis research. The Auranofin Cooperating Group. Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review Comparison of performance-based and patient-reported measures of function in anterior-cruciate-ligament-deficient individuals. Revalidation of the original Cedars-Sinai health-related quality of life in rheumatoid arthritis questionnaire. Integrative rehabilitation of residents chronic post-stroke in skilled nursing facilities: the design and evaluation of the BrightArm Duo Responsiveness and validity of three dexterous function measures in stroke rehabilitation. Utility of the PedsQL Rheumatology Module as an Outcome Measure in Juvenile Fibromyalgia Evaluation of joint mobility in rheumatoid arthritis trials: the value of the EPM-range of motion scale. Early occupational therapy programme increases hand grip strength at 3 months: results from a randomised, blind, controlled study in early rheumatoid arthritis The use of kinesiology taping method in patients with rheumatoid hand--pilot study.
OBJECTIVE To determine the reliability , validity , and responsiveness of the modified Kap and ji index ( MKI ) . DESIGN Prospect i ve study . A cohort of patients planned for surgery of the wrist and /or fingers was evaluated within 48 hours before surgery and at least 6 months after surgery . SETTING Patients were in hospitalized or private care in France . PARTICIPANTS Patients with rheumatoid arthritis according to criteria of the American College of Rheumatology . Forty-two patients ( 36 women ; mean age , 57.5y ; range , 22 - 80y ) were included in the reliability study . Fifty patients ( 42 women ; mean age , 54.18y ; range , 19 - 77y ) were included in the validity study . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Clinical outcome measures included the MKI , the overall mobility score of the wrist and fingers , the finger mobility score , a visual analog scale ( VAS ) of pain in the h and s and wrists , morning stiffness duration , total score of tenderness , total score of swelling , grip and pinch strength , the H and Functional Index ( HFI ) , and the Cochin rheumatoid h and disability scale . Reliability was studied with the intraclass correlation coefficient ( ICC ) and the Bl and and Altman method . Convergent and divergent validity were assessed with the Spearman correlation coefficient . Responsiveness was assessed by the paired t test , the effect size , and the st and ardized response mean ( SRM ) . RESULTS Interobserver reliability was good with an ICC of.90 , and the Bl and and Altman analysis showed homogeneous distribution of the differences , with no systematic trend . The MKI correlated well with the other mobility measures ( HFI , the finger mobility score measured with the finger goniometer ) , indicating a good convergent validity , and the expected divergent validity with the other outcome measures ( grip and pinch strength , total score of swelling , total score of Ritchie Articular Index , Cochin scale , VAS of pain ) was observed . The 50 patients in the validity study were evaluated twice , before and after surgery , at a mean interval + /- st and ard deviation of 7.16+/-2.10 months ( range , 6 - 15mo ) . Thirty-six patients ( 72 % ) were very satisfied or satisfied with the results of surgery , 7 ( 14 % ) were not satisfied or dissatisfied , and 7 ( 14 % ) were dissatisfied or very dissatisfied . The SRM and effect size values of the MKI were -.19 and -.10 , respectively . Individual changes in the score had the best correlation ( r(s)=.51 ) with overall patient satisfaction . CONCLUSIONS The MKI has excellent validity and reliability . Individual changes in the score are clinical ly relevant . This index can be used in clinical practice and in therapeutic trials ; it needs further study concerning its use for h and surgery OBJECTIVE To examine the value of the  Health Assessment Question naire ( HAQ ) as an outcome measure in short term exercise trials . We studied the association of the objectives of exercise , namely joint mobility , muscle strength , and physical condition , with the HAQ . METHODS Data for 100 patients with rheumatoid arthritis ( RA ) included in a study to examine the effect of exercise therapy were used for secondary analysis . Disease activity was determined by the disease activity score ( DAS3 ) , pain was scored on a visual analog scale ( VAS ) , and depression was measured by the Dutch Arthritis Impact Measurement Scale . Aerobic capacity ( VO2max ) estimated from a submaximal ergometer test , grip strength ( kPa ) ,  isokinetic muscle strength of the knee  ( Nm/kg ) , and the  Escola Paulista de Medicina range of motion ( EPM-ROM ) score , a measure of general flexibility , were used as indicators for physical impairments . All variables were entered in a forward multiple regression analysis with the HAQ as dependent variable . RESULTS The HAQ was significantly correlated with the DAS3 score ( r = 0.53 ) , pain ( r = 0.51 ) , depression ( r = 0.40 ) , joint mobility ( r = 0.27 ) , quadriceps strength ( r = -0.35 ) , and grip strength ( r = -0.50 ) , but not with physical condition . The DAS3 score was first entered in the multiple regression analysis model , followed by pain , quadriceps strength , and grip strength ( R2 = 0.45 ) . After 12 weeks of exercise therapy changes in the HAQ were significantly correlated with changes in pain ( r = 0.41 ) , in depression ( r = 0.33 ) , and in quadriceps strength ( r = -0.25 ) , but not with changes in joint mobility or physical condition . CONCLUSION Physical impairments are weakly associated with the HAQ .  The HAQ is not an appropriate instrument to detect changes in physical impairments due to short term exercise therapy OBJECTIVE To assess the performance of the Barthel Index ( BI ) in patients with rheumatoid arthritis ( RA ) in the acute care hospital , as compared to the Stanford Health Assessment Question naire ( HAQ ) and the Hannover Functional Question naire ( Funktionsfragebogen Hannover , FFbH ) . METHODS A prospect i ve study of 97 patients with RA admitted to an acute rheumatology hospital with new onset or acute flare of RA . Patients were required to self-complete the BI , the HAQ , and the FFbH.  Disease activity was measured using the Disease Activity Score ( DAS28 ) . RESULTS Seventy-eight percent of patients were female , average age was 61.5 ( SD 12.5 ) years , and 72.2 % were rheumatoid factor-positive . The median HAQ was 1.29 ( range 0 - 3 ) , median FFbH was 50 % ( 6 - 100 % ) , and median BI was 95 ( 0 - 100 ) , and distribution was highly skewed . All measures of physical functioning were significantly correlated with each other and with the DAS28 ; however , the BI discriminated poorly between low and high disease activity . CONCLUSION The BI is not a useful instrument to assess physical functioning in patients with acute symptoms of RA , but may have a role in assessing patients with comorbidities and in assessing nursing care needs in the acute care hospital OBJECTIVE To determine the most appropriate means to assess the response to treatment in terms of  pain and functional impairment in a chronic rheumatic condition ( knee osteoarthritis [ OA ] ) and an acute rheumatic condition ( rotator cuff syndrome [ RCS ] ) . METHODS Two prospect i ve studies were conducted consisting of 1,019 out patients with knee OA and 271 patients with acute RCS . The minimal clinical ly important improvement and the patient acceptable symptom state were determined for knee OA pain using a visual analog scale , and for knee OA function using the Western Ontario and McMaster Universities Osteoarthritis Index function subscale ; for acute RCS pain , a numeral rating scale was used , and the Neer function subscale was used for RCS function . RESULTS The minimal clinical ly important improvement was shown to be the change required to achieve the patient acceptable symptom state , whatever the baseline level of symptom , the outcome ( pain or function ) , or type of condition ( chronic or acute ) . This acceptable state for pain was higher for chronic ( 27.0 - 36.4 across the baseline score ) than acute ( 16.7 - 24.1 ) conditions . The level of functional impairment considered satisfactory by patients with knee OA was higher for more disabled patients ( 43.1 ) than for less disabled patients ( 20.4 ) . CONCLUSION Patients consider that they experienced an important improvement only if this improvement allowed them to achieve a state they consider satisfactory . The most appropriate means to assess the response to therapy seems to be to assess whether patients feel good ( i.e. , achieve the patient acceptable symptom state ) Objective : The purpose of the study was to evaluate the feasibility and efficacy of robot-assisted h and rehabilitation in improving arm function abilities in sub-acute hemiplegic patients . Design : R and omized controlled pilot study . Setting : Inpatient rehabilitation centers . Participants : Thirty hemiplegic stroke patients ( Ashworth spasticity index <3 ) were recruited and r and omly divided into a Treatment group ( TG ) and Control group ( CG ) . Interventions : Patients in the TG received intensive h and training with Gloreha , a h and rehabilitation glove that provides computer-controlled , repetitive , passive mobilization of the fingers , with multisensory feedback . Patients in the CG received the same amount of time in terms of conventional h and rehabilitation . Main outcome measures : H and motor function ( Motricity Index , MI ) , fine manual dexterity ( Nine Hole Peg Test , NHPT ) and strength ( Grip and Pinch test ) were measured at baseline and after rehabilitation , and the differences , ( Δ ) mean(st and ard deviation ) , compared between groups . Results Twenty-seven patients concluded the program : 14 in the TG and 13 in the CG . None of the patients refused the device and only one adverse event of rheumatoid arthritis reactivation was reported . Baseline data did not differ significantly between the two groups . In TG , ΔMI 23(16.4 ) , ΔNHPT 0.16(0.16 ) , ΔGRIP 0.27(0.23 ) and ΔPINCH 0.07(0.07 ) were significantly greater than in CG , ΔMI 5.2(9.2 ) , ΔNHPT 0.02(0.07 ) , ΔGRIP 0.03(0.06 ) and ΔPINCH 0.02(0.03 ) ] ( p=0.002 , p=0.009 , p=0.003 and p=0.038 , respectively ) . Conclusions : Gloreha Professional is feasible and effective in recovering fine manual dexterity and strength and reducing arm disability in sub-acute hemiplegic patients Background Comprehensive rehabilitation , involving health professionals from various disciplines , is widely used as an adjunct to pharmacological and surgical treatment in people with rheumatic diseases . However , the evidence for the clinical - and cost-effectiveness of such interventions is limited , and the majority of those who receive rehabilitation are back to their initial health status six to 12 months after discharge . Methods / design To evaluate the goal attainment , health effects and cost-effectiveness of a new rehabilitation programme compared to current traditional rehabilitation programmes for people with rheumatic diseases , a stepped-wedge cluster r and omized trial will be performed . Patients admitted for rehabilitation at six centres in the south-eastern part of Norway will be invited to participate . In the trial , six participating centres will switch from a control ( current rehabilitation programme ) to an intervention phase ( the new rehabilitation programme ) in a r and omized order . Supported by recent research , the new programme will be a supplement to the existing programme at each centre , and will comprise four elements design ed to enhance and support lifestyle changes introduced in the rehabilitation period : structured goal -planning , motivational interviewing , a self-help booklet and four follow-up telephone calls during the first five months following discharge . The primary outcome will be health-related quality of life and goal attainment , as measured by the Patient Generated Index directly before and after the rehabilitation stay , as well as after six and 12 months . Secondary outcomes will include self-reported pain , fatigue , a global assessment of disease activity and motivation for change ( measured on 11-point numeric ratings scales ) , health-related quality of life as measured by the Short Form 36 Health Survey ( SF-36 ) and utility assessed by the SF6D utility index . The main analysis will be on an intention to treat basis and will assess the clinical - and cost-effectiveness of the structured goal planning and tailored follow-up rehabilitation programme for patients with rheumatic diseases . Discussion The findings will constitute an important contribution to more cost-effective- and evidence -based rehabilitation services for people with rheumatic diseases . Trial registration IS RCT N91433175 OBJECTIVE Work disability is a major consequence of inflammatory rheumatic conditions . Evidence regarding the effectiveness of interventions aim ed at the prevention or reduction of work disability in rheumatic diseases is limited . We conducted a r and omized controlled trial to investigate the effectiveness of a multidisciplinary job-retention vocational rehabilitation ( VR ) program in patients with a rheumatic condition who were at risk for job loss . METHODS A total of 140 patients with a chronic rheumatic condition were r and omly assigned to either a multidisciplinary job-retention VR program ( n = 74 ) or usual outpatient care ( UC ) ( n = 66 ) . Patients in the VR group were assessed and guided by a multidisciplinary team , whereas patients in the UC group received care as initiated by their rheumatologist , supplemented with written information . The main outcome measure was the occurrence of job loss ( complete work disability or unemployment ) ; additional outcome measures included job satisfaction , pain , functional status , emotional status , and quality of life . RESULTS There was no difference between the 2 groups regarding the proportion of patients having lost their job at any time point , with 24 % and 23 % of the patients in the VR and UC groups , respectively , having lost their job after 24 months . Over the total period of 24 months , patients in the VR group had a significantly greater improvement of the fatigue visual analog scale and of emotional status ( all P values < 0.05 ) . CONCLUSION A job-retention VR program did not reduce the risk of job loss but improved fatigue and mental health in patients with chronic rheumatic diseases at risk for job loss Twenty-eight instruments measuring pain , clinical , functional , and global characteristics  were administered to 303 patients in a six-month r and omized clinical trial of auranofin and placebo in the treatment of patients with rheumatoid arthritis . The instruments were compared with respect to their responsiveness in detecting a treatment effect , the time involved in administering the instrument , the need for the presence of an interviewer , and ease of administration . The instruments ' ability to detect a treatment effect was the deciding characteristic in the clinical , pain , and global categories in choosing the preferred instrument . The counts of tender and swollen joints were found to be the most responsive clinical measures , the 10-cm pain line was the most responsive and the fastest to administer of the pain instruments , and the categorical self- assessment of arthritis was the most responsive global measure . In the functional ability category , the Health Assessment Question naire ( HAQ ) , the Keitel Functional Assessment , and the Quality of Well-Being ( QWB ) Question naire were equally responsive . The HAQ was the shortest and the only self-administered question naire . The QWB has had the most extensive validation work but was a complex instrument requiring intensive interviewer training . The Keitel was the most time-consuming instrument , but had the advantage of high interobserver agreement . The design of future trials can be guided by the information obtained in this study on their relative efficiencies and ease of use Background . This paper aim ed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer- review ed evidence supporting their reliability , validity , and responsiveness to change . Methods . A systematic review of r and omised controlled trials among people with wrist osteoarthritis was undertaken . Studies reporting reliability , validity , or responsiveness were identified using a systematic reverse citation trail audit procedure . Psychometric properties of the instruments were examined against predefined criteria and summarised . Results . Thirteen clinical trials met inclusion criteria . The most common patient-reported outcome was the disabilities of the arm , shoulder , and h and question naire ( DASH ) . The DASH , the  Michigan H and Outcomes Question naire ( MHQ ) , the  Patient Evaluation Measure ( PEM ) , and the  Patient-Reported Wrist Evaluation ( PRWE ) had evidence supporting their reliability , validity , and responsiveness . A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis H and Index as another suitable instrument that had favourable reliability , validity , and responsiveness . Conclusions . The DASH , MHQ , and AUSCAN Osteoarthritis H and Index instruments were supported by the most favourable empirical evidence for validity , reliability , and responsiveness . The PEM and PRWE also had favourable empirical evidence reported for these elements . Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted There is a dearth of reliable and valid instrumentation that measures disability following injury and /or surgery of the knee joint that is responsive to clinical ly significant changes over time . The purpose of this investigation was to determine whether  performance-based or patient-reported measures of function  are more effective in estimating disability in individuals with an anterior-cruciate-ligament (ACL)-deficient knee .  Subjective rating of knee function was used as the criterion measure for disability , and selected performance-based and patient-reported measures were used as estimation variables . Twenty-nine individuals with an ACL-deficient knee participated in this investigation . Step-wise regression analysis revealed that the Cincinnati Knee Scale , Lysholm Knee Scale , and hop index were the most effective estimates of disability . The results demonstrate that patient-reported measures are more related to the patient 's level of disability in individuals with an ACL-deficient knee . More research is necessary to substantiate these findings OBJECTIVE To assess the psychometric characteristics of the original 33-item Cedars-Sinai Health-Related Quality of Life in Rheumatoid Arthritis Question naire ( O-CSHQ-RA ) and 11-item CSHQ-RA Short Form ( SF ) using a representative population of patients with rheumatoid arthritis ( RA ) from 55 sites across the United States . METHODS Data were from a 24-week multicenter , open-label , single-arm study of 312 RA patients receiving anakinra .  Cronbach 's alpha coefficient was used to indicate the internal consistency . Test-retest reliability was assessed by establishing the intraclass correlation coefficient ( ICC ) for screening and baseline visit responses . Convergent validity was tested with the Pearson correlation coefficient . Analysis of variance was performed to determine discriminant validity . A Wilcoxon signed-rank test and analysis of covariance were used to assess the responsiveness . A discriminant function was generated to determine the clinical ly meaningful change . RESULTS Test-retest reliability was demonstrated for both versions of the CSHQ-RA , with ICC ranging from 0.82 to 0.94 . Cronbach 's alpha coefficients were > or = 0.9 , indicating good internal consistency . Pearson correlations between health-related quality of life instruments and CSHQ-RA measures ranged from -0.33 to -0.73 and 0.39 to 0.76 , demonstrating good convergent validity . Scores on both versions of the CSHQ-RA differed significantly ( p < 0.0001 ) for patients with different levels of physical disability as measured by the Stanford Health Assessment Question naire . Both instruments were responsive to differences in patient health as measured by the general health question ( p < 0.0001 ) . Clinical ly meaningful changes were calculated for all 5 domains of the O-CSHQ-RA ( 6.9 - 14.0 ) and the overall O-CSHQ-RA SF ( 12.7 ) . CONCLUSION These results support the validity and reliability of both the original CSHQ-RA and the 11-item CSHQ-RA SF when tested in a representative patient population Abstract Purpose : To describe the novel BrightArm Duo bimanual upper extremity ( UE ) rehabilitation system ; to determine its technology acceptance and clinical benefit for older hemiplegic participants . Methods : The system table tilted to adjust arm gravity loading . Participants wore arm supports that sensed grasp strength and wrist position on the table . Wrist weights further increased shoulder exertion . Games were design ed to improve UE strength , motor function , cognition and emotive state and adapted automatically to each participant . The system underwent feasibility trials spanning 8 weeks in two skilled nursing facilities ( SNFs ) . Participants were evaluated pre-therapy and post-therapy using st and ardized clinical measures . Computerized measures of supported arm reach , table tilt and number of arm repetitions were stored on a remote server . Outcomes : Seven participants had significant improvements in their active range of shoulder movement , supported arm reach , shoulder strength , grasp strength and their ability to focus . The group demonstrated higher arm function measured with FMA ( p = 0.01 ) and CAHAI ( p = 0.05 ) , and had an improvement in depression ( Becks Depression Inventory , II ) .  BrightArm Duo technology was well accepted by participants with a rating of 4.4 out of 5 points . Conclusions : Given these findings , it will be beneficial to evaluate the BrightArm Duo application in SNF maintenance programs . Implication s for Rehabilitation Integrative rehabilitation that addresses both physical and cognitive domains is promising for post-stroke maintenance in skilled nursing facilities . Simultaneous bilateral arm exercise may improve arm function in older hemiplegic patients several years after stroke . Virtual reality games that adapt to the patient can increase attention and working memory while decreasing depression in elderly In this study , we compared the responsiveness and validity of the Box and Block Test ( BBT ) , the Nine-Hole Peg Test ( NHPT ) , and the Action Research Arm Test ( ARAT ) .  We r and omized 59 patients with stroke into one of three rehabilitation treatments for 3 weeks . We administered six outcome measures  ( BBT , NHPT , ARAT , Fugl-Meyer Assessment [ FMA ] , Motor Activity Log [ MAL ] , and Stroke Impact Scale [ SIS ] h and function domain ) pretreatment and posttreatment . We used the st and ardized response mean ( SRM ) to examine responsiveness and the Spearman rank correlation coefficient ( rho ) to examine concurrent validity . The BBT , NHPT , and ARAT were moderately responsive to change and not significantly different ( SRM = 0.64 - 0.79 ) . The correlations within the BBT , NHPT , and ARAT were moderate to good at pretreatment ( rho = -0.55 to -0.80 ) and posttreatment ( rho = -0.57 to -0.71 ) . The BBT and ARAT showed fair to moderate correlations with the FMA , MAL , and SIS h and function domain at pretreatment and posttreatment ( rho = 0.31 - 0.59 ) , whereas the NHPT demonstrated low to fair correlations with the FMA and MAL ( rho = -0.16 to -0.33 ) and moderate correlations with the SIS h and function domain ( rho = -0.58 to -0.66 ) . Our results indicate that the BBT , NHPT , and ARAT are suitable to detect changes over time . While simultaneously considering the responsiveness and validity attributes , the BBT and ARAT can be considered more appropriate for evaluating dexterous function than the NHPT . Further studies with larger sample s are needed to vali date these findings The PedsQL rheumatology module is currently the only available measure of disease‐specific quality of life for children and adolescents with juvenile fibromyalgia ( FM ) , but limited information has been published about the psychometric properties of the instrument , specifically in juvenile FM . The objective of this study was to assess the reliability , validity , and sensitivity to change of the 5 scales ( pain and hurt , daily activities , treatment , worry , and communication ) of the patient and parent proxy versions of the PedsQL rheumatology module in the context of a r and omized controlled trial in juvenile FM OBJECTIVE Evaluation of joint range of motion ( ROM )  is important in the therapeutic approach to patients with rheumatoid arthritis ( RA ) . The reliability , construct validity and sensitivity to change of the Escola Paulista de Medicina (EPM)--range of motion scale that measures 10 distinct movements of small and large joints were examined . METHODS Fifty patients with active RA who were participating in an inpatient multidisciplinary treatment program were examined by 2 investigators . Twenty-five of the patients were examined both at admission and at discharge from the hospital . RESULTS The mean EPM-ROM score at study entry was 11.52 ( SD + /- 3.80 ) . The intra and inter-observer reliability of the EPM-ROM scale was high , with correlations of r = 0.91 and r = 0.85 , respectively . There was a good correlation between the EPM-ROM scale and measures of functional ability . Correlations with measures of disease activity were poor . After a mean duration of the treatment program of 4.2 weeks , patients generally improved in variables of functional status and disease activity . The improvement of the EPM-ROM score ( mean difference 1.58 , 95 % CI 0.84 - 2.32 ) was generally larger than improvement in other variables of functional status . CONCLUSION The EPM-ROM scale is a reliable instrument , and according to its correlation with measures of functional status , relevant to the performance of activities of daily living . It showed a good response to improvement of functional status and disease activity and was more sensitive to changes than other variables of functional status Aim : The goal of occupational therapy ( OT ) is to facilitate adjustments to lifestyle and to prevent function loss . This study evaluated the effects of an early OT programme in early rheumatoid arthritis ( RA ) . Methods : We conducted a r and omised , blind , controlled trial enrolling 60 patients with early RA , divided into 2 groups . At baseline , group 1 received the full information programme and group 2 received no information . In an extension phase , patients in group 2 received the full information programme at 3 months and were assessed at 6 months . The main outcomes were grip strength of h and s ( as objective assessment ) and Health Assessment Question naire ( HAQ ) score ( as subjective assessment ) . Results : At 3 months , grip strength of the dominant and non-dominant h and s increased more in group 1 than in group 2 ( p = 0.021 and 0.047 respectively ) . HAQ score decreased more in group 1 than in group 2 ( p<0.001 ) . In the extension phase , changes in grip strength and HAQ score in group 2 were similar to those seen in group 1 between baseline and 3 months . Conclusions : This study comparing two schedules of OT programme showed that an early extended information programme improved h and function in patients with early RA BACKGROUND Rheumatoid arthritis ( RA ) most frequently affects smaller joints in the h and s and feet . Among the most common deformations result ing from the progression of the disease are ulnar deviation , Boutonniere deformity , swan neck deformity , contractures and limited range of movement in the h and and wrist joints , muscular atrophy of long and short muscles . The topic of this article is the influence of using Kinesiology Taping method on the functioning of the h and of the patient suffering from rheumatoid arthritis . MATERIAL AND METHODS The research involved 20 patients suffering from rheumatoid arthritis ( 16 women , 4 men ) , treated in the Hospital in Kup . Average age of patients was 62.2 . Research subjects , apart from pharmacological treatment in the hospital ward , received  st and ard physiotherapy . In case of 10 patients additional K-Active Tape applications were used to correct ulnar positioning of the h and and improve h and functioning . Prior to physiotherapy , all patients were given a h and functioning test and a dynamometer measurement was made . The tests were repeated after the 2-week rehabilitation process has been completed . The results were subjected to statistical analysis with the use of the Wilcoxon test and the U Mann-Whitney test . The assessment of the correlation between analysed parameters was made with the use of linear correlation test . RESULT In the group where Kinesiology Tape applications were used , h and muscle strength increased significantly ( p<0.05 ) in comparison with the group treated with st and ard physiotherapy .  H and muscle strength increase correlated with the tempo of carrying out the h and functioning test ( r>0.8 ) . CONCLUSION Results suggest Kinesiology Taping method useful for physiotherapy of rheumatoid h and
Only a limited number of the identified instruments for the assessment of impairments is both reliable and valid .
The objective of this study is to provide a critical overview of available instruments to assess impairments in patients with rheumatic disorders , and to recommend reliable and valid instruments for use in allied health care and rehabilitation medicine .