Effect Of Scapular Dıskınesis On Dısease Actıvıty, Qualıty Of Lıfe, Level Of Dısabılıty In Patıent Wıth Rheumatoıd Arhtrıtıs


Thesis Type: Postgraduate

Institution Of The Thesis: Gazi Üniversitesi, Sağlık Bilimleri Enstitüsü, Turkey

Approval Date: 2016

Student: MEHMET DELEN

Supervisor: DERAN OSKAY

Abstract:

Rheumatoid arthritis (RA), which affects 1 % general population in the world, is a chronic and an autoimmune disease. Synovial inflammation process in RA is extra risk for shoulder. Activity limitations of patients with RA is related to their functuions. The aim of this study is to investigate effects of scapular dyskinesis on disease activity, quality of life, level of disability among patients with RA. 52 patients with RA were evaluated for the study, and they were divided equally into two groups with the following criteria: patient has SD or patient do not has SD. Demographic information of them recorded and following tests applied to every patients: Disabilities of Arm, Shoulder and Hand questionnaire (DASH), Shoulder Pain and Disability Index (SPADI), Rheumatoid Arthritis specific Quality of Life questionnaire (RAQoL), Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5), Visual Analog Scale (VAS). Range of Motion (ROM) of shoulder s flexion, extension, abduction, external and internal rotation was evaluated with goniometer. Moreover, patient s muscles strength were assessed by using the manual muscle test. Lateral Scapular Slide Test (LSST) and observational methods were used to identify the presence of SD. Both groups are similar in terms of age, body mass index, duration of shoulder pain and course of RA. Results of the patient with SD (Group 2) is significantly worse than those of the patient without SD (Group 1) in DASH (p=0,001), SPADI (p<0,001), RADAI-5 (p<0,001), RAQoL (p<0,001), VAS right shoulder (p=0,002) and left shoulder (p=0,001). In terms of ROM, any significant differences were not found between groups. In addition, when looking at ROM scores, no difference was found between all patients left and right shoulders. In Group 2, the side shoulder with SD has less external rotation muscle strength compared to the other shoulder (p=0,046). However, there is not difference in Group 2 patients' other muscles strength and in Group 1 patients all muscle strength. In terms of difference for pain between right and left shoulders, this was not a difference between two groups. In conclusion, clinical results of patients with RA and SD are worse than those of patient with RA and no SD.