Are Illness Perceptions, Depression, and Anxiety Associated with Hand Dexterity for People with Rheumatoid Arthritis?

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disease where a reduction in hand dexterity affects fine finger movements, extending the time it takes to perform tasks while increasing the difficulty of completing daily activities. The primary aim of this study was to examine the relationship between illness perceptions, anxiety and depression and the dexterous automated fine motor task of handwriting in people with RA. Secondarily, this study set out to investigate the relationship that age, disease duration, disease activity, functional disability and grip strength have with hand dexterity. Fifty-seven participants with RA (M = 61yrs, range 32-81) were tested using accelerometers placed on the thumb and index finger to ascertain two forms of dexterity, one measure being acceleration of hand movement over time (MT); the other being mean squared jerk (MSJ), with higher MSJ equating to less fine finger movement. Grip strength was measured using a dynamometer while the accelerometers were attached to the participant’s hand before and after the handwriting task. On the completion of the task participants completed a self-report questionnaire including measures of depression, anxiety and illness perceptions. Older age was related to less disease activity (p = 0.04), lower anxiety (p = 0.01) and lower depression (p = 0.02), while longer RA duration was associated with weaker grip strength (p = 0.01). Lastly, older age (p = 0.02) and higher depression scores (p = 0.01) were associated with longer MT. However, analysis of one item with the measure of depression (“I feel as if I am slowed down”) was not solely related to a reduction in MT alone. Overall, the results provide insight into how aging and depression are associated with some components of hand dexterity in RA. Taken together the results indicate the relationship between mental health, age and RA duration. Although the results from this thesis regarding the use of accelerometers to measure MSJ are limited, their use may be beneficial in accurately recording MT and may profit from further investigation as their use in the RA population is limited.