Predictors of changes in observed dexterity during one year in patients with rheumatoid arthritis

OBJECTIVE: To determine which disease-related variables predict loss of dexterity in patients with rheumatoid arthritis (RA). METHODS: A random sample of 94 RA patients was measured twice 1 yr apart. Dexterity, or hand-related disability, was measured with the Sequential Occupational Dexterity Assessment (SODA). The SODA measures dexterity in activities of daily life based on the observation of standardized tasks. Impairment of the hands, disease activity, pain and self-reported functioning were additionally assessed. RESULTS: After 1 yr, observed dexterity was significantly decreased. Change in dexterity was predicted by impairment of the hands at baseline. Changes in dexterity were related to changes in grip strength, disease activity indicators, self-care, depressive mood and cheerful mood. An increase in the number of swollen joints was most strongly correlated with a decrease in dexterity, even after controlling for impairment at baseline. CONCLUSION: It was concluded that even in patients with longer disease duration, observed dexterity declines gradually.