Development of a Modified Hand Mobility in Scleroderma (HAMIS) Test and its Potential as an Outcome Measure in Systemic Sclerosis

Sandqvist, Gunnel; Nilsson, Jan‐Åke; Wuttge, Dirk M.; Hesselstrand, Roger

doi:10.3899/jrheum.140286

Cited by 23 publications

(24 citation statements)

References 24 publications

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“…The Hand Mobility in Scleroderma (HAMIS) test has shown significant correlations with skin involvement of hands and ADL, and it has been shown to be sensitive to change and useful as an outcome measure [10]. The HAMIS test is a 9 item performance based measure of impairment using different grips and movements to assess finger and wrist mobility.…”

Section: Arthralgias and Inflammatory Arthritismentioning

confidence: 99%

“…The HAMIS test is a 9 item performance based measure of impairment using different grips and movements to assess finger and wrist mobility. A modified HAMIS using 4 items is currently being evaluated as well [10]. Health assessment questionnaire-disability index (HAQ-DI) and Scleroderma HAQ (SHAQ), which has 5 additional SSc-specific visual analog scales (VAS) compared to HAQ-DI, are measures of disability that assess difficulties with ADL and have been validated in SSc.…”

Section: Arthralgias and Inflammatory Arthritismentioning

confidence: 99%

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Hand Impairment in Systemic Sclerosis: Various Manifestations and Currently Available Treatment

Young

Namas

Dodge

et al. 2016

Curr Treat Options in Rheum

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OPINION STATEMENT Systemic sclerosis (SSc) is an autoimmune disease initially recognized by hand involvement due to characteristic Raynaud's phenomenon (RP), puffy hands, skin thickening, and contractures resembling claw deformities. SSc contributes to hand impairment through inflammatory arthritis, joint contractures, tendon friction rubs (TFRs), RP, digital ulcers (DU), puffy hands, skin sclerosis, acro-osteolysis, and calcinosis. These manifestations, which often co-exist, can contribute to difficulty with occupational activities and activities of daily living (ADL), which can result in impaired quality of life. However, despite this knowledge, most diagnostic and treatment principles in SSc are focused on visceral manifestations due to known associations with morbidity and mortality. Treatment of inflammatory arthritis is symptom based and involves corticosteroids ≤10mg daily, methotrexate, tumor necrosis factor inhibitors, tocilizumab, and abatacept. Small joint contractures are managed by principles of occupational hand therapy and rarely surgical procedures. TFRs may be treated similar to inflammatory arthritis with corticosteroids. All patients with RP and DU should keep digits covered and warm and avoid vasoconstrictive agents. Pharmacologic management of RP begins with use of calcium channel blockers, but additional agents that may be considered are fluoxetine and phosphodiesterase 5 (PDE5) inhibitors. DU management also involves vasodilators including calcium channel blockers and PDE5 inhibitors; bosentan has also been shown to prevent DU. In patients with severe RP and active DU, intravenous epoprostenol or iloprost can be used and surgical procedures, such as botulinum injections and digital sympathectomies, may be considered. For those with early diffuse cutaneous SSc needing immunosuppression for skin sclerosis, methotrexate or mycophenolate mofetil can be used, but the agent of choice depends on co-existing manifestations, such as inflammatory arthritis and/or lung involvement. Various pharmacologic agents for calcinosis have been considered but are generally ineffective; however, surgical options, including excision of areas of calcinosis, can be considered. Overall management of hand impairment for all patients with SSc should include occupational hand therapy techniques such as range of motion exercises, paraffin wax, and devices to assist in ADL. Thus, treatment options for the various manifestations contributing to hand impairment in SSc are limited and often modestly efficacious at best. Robust studies are needed to address the manifestations of SSc that contribute to hand impairment.

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Section: Arthralgias and Inflammatory Arthritismentioning

confidence: 99%

Section: Arthralgias and Inflammatory Arthritismentioning

confidence: 99%

Hand Impairment in Systemic Sclerosis: Various Manifestations and Currently Available Treatment

Young

Namas

Dodge

et al. 2016

Curr Treat Options in Rheum

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“…Modified hand mobility in scleroderma was developed by Sandqvist et al in 2014 to evaluate hand mobility in patients with SSc. This test was finalized by modifying the 9‐item HAMIS test developed by the same researchers in 2000 and reducing it to 4 items . mHAMIS provides assessment of flexion, extension and abduction of the 2nd to 5th fingers and wrist extension of individuals with SSc by occupational therapists, physicians and physiotherapists.…”

Section: Methodsmentioning

confidence: 99%

“…The test is performed while the patient is in a sitting position in a chair with his/her back supported. While no material is required to evaluate the abduction of the fingers and extension of the wrist, a pencil with a diameter of 5 mm, a fork, knife or spoon handle with a diameter of 15 mm, a handlebar with a diameter of 30 mm and a table are required to evaluate the flexion and extension of the fingers . In the test, flexion and extension of 2nd to 5th fingers are evaluated, while there is no substance that evaluates thumb movements.…”

Section: Methodsmentioning

confidence: 99%

“…The equipment used for this test is selected from materials that are easily accessible to everyone. mHAMIS is a short, inexpensive and practical test developed to evaluate the hand mobility of patients with SSc . Because of these advantages, it is frequently used in clinical studies including hand‐related evaluations in individuals with SSc …”

Section: Introductionmentioning

confidence: 99%

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Inter‐rater reliability of modified hand mobility in scleroderma test

et al. 2019

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Aim Systemic sclerosis (SSc) is a chronic autoimmune disease of unknown etiology characterized by excessive collagen production, endothelial cell injury, microvascular obliteration, cutaneous fibrosis and progressive visceral disease. The hands are frequently involved during the progression of the disease, with symmetrical skin thickening as a prominent feature. Modified hand mobility in scleroderma (mHAMIS) test is a measurement method to assess hand mobility in patients with SSc. Knowing the inter‐rater reliability of the instrument is important in order for the results from different examiners to be accurately interpreted. The aim of this study was to test inter‐rater reliability of the mHAMIS test. Method Hand mobility for both hands was assessed in 25 female patients with SSc by 2 physiotherapists who have different years of experience. Patients who had flexion contracture in at least 1 finger and undergone hand surgery in the last year due to any injuries, were excluded from the study since hand mobility was prevented. Inter‐rater reliability was determined using intra‐class correlation coefficients (ICCs). Result The ICCs were excellent between raters for dominant and non‐dominant hands. The values were 0.92 and 0.93, respectively. Conclusion The inter‐rater reliability of the mHAMIS was found to be excellent. This research contributes to the literature by proving that the test can be used without causing bias in clinical trials.

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An Update of Outcome Measures in Systemic Sclerosis

Chang

Pope

2020

Arthritis Care & Research

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Development of a Modified Hand Mobility in Scleroderma (HAMIS) Test and its Potential as an Outcome Measure in Systemic Sclerosis

Abstract: The mHAMIS involves 4 easily measurable items and has the potential to be a relevant clinical measure of outcome in the evaluation of fibrotic skin involvement in SSc.

Cited by 23 publications

References 24 publications

Hand Impairment in Systemic Sclerosis: Various Manifestations and Currently Available Treatment

Hand Impairment in Systemic Sclerosis: Various Manifestations and Currently Available Treatment

Inter‐rater reliability of modified hand mobility in scleroderma test

An Update of Outcome Measures in Systemic Sclerosis

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