An Engineered Glove for the Computerised Quantification of Hand Disability in Rheumatoid Arthritis

Massimo Patane' ¹, Luca Carmisciano ², Emanuele Gotelli ³, Veronica Tomatis ⁴, Francesco Cattelan ⁵, Elisa Alessandri ⁶, Alessio Signori ², Massimo Ghio ⁷, Vanessa Smith ⁸ and Maurizio Cutolo⁹, ¹Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, ²Biostatistics Unit, Department of Health Sciences, University of Genoa, Genoa, Italy, ³Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genova, Italy., Genoa, Italy, ⁴Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genova, Italy, Genoa, Italy, ⁵Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, IRCCS Polyclinic Hospital San Martino, University of Genoa, Genoa, Italy, ⁶Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genova, ⁷Research Laboratory and Academic Division of the Clinical Rheumatology Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, ⁸Department of Rheumatology, Ghent University Hospital; Department of Internal Medicine, Ghent University; Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium, ⁹Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Genoa, Italy

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Disability, Hand function, rheumatoid arthritis (RA) and outcome measures

Session Information

Date: Monday, November 11, 2019

Title: RA – Diagnosis, Manifestations, & Outcomes Poster II: Treatments, Outcomes, & Measures

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Background Rheumatoid arthritis (RA) is a long-term, progressive, and disabling autoimmune disease. The disease activity can be quantified by the Disease Activity Score 28-joint count C reactive protein (DAS28-CRP) but the evaluation of disability function (DF) is actually mainly performed only by subjective Patient Reported Outcomes (PROs) like Health Assessment Questionnaire (HAQ). Hence there are no objective and affordable tests to quantify the DF. The Hand Test System (HTS, ETT) is an engineered glove that can evaluate hands motility¹, nowadays applied for neuroscience studies

Purpose: To quantify by HTS the DF of RA patients (RApts) by the analysis of speed and right execution of fingers opposition movement in both hands, evaluated. To verify the correspondence with the HAQ and DAS28(CRP)

Methods: In this pilot study 14 consecutives RApts (3 males, 11 females, age 61±11,5 years, mean duration of disease 11,21±5,07 years), classified according to 2010 ACR/EULAR criteria⁶, and 13 healthy controls (HC – 7 males, 6 females, age 50±15 years) were enrolled. After consent, all participants undergone HTS test; a multiple finger evaluation (MFE) and a single finger evaluation (SFE) were performed analyzing the touches between the finger tips during the opposition movements of the hands in standard sequences of movements. A dedicated software provided the physician these quantitative parameters: Touch Duration (TD), Inter Tapping Interval (ITI) and Movement Rate (MR). RApts compiled the HAQ and a DAS28-CRP was performed. Continue variables were summarized as mean and standard deviation or median and interquartile range, discrete variables were summarized with count and percentage. Variables with skewed distribution was converted to natural logarithm. T-test was used to compare log glove parameters between groups. Pearson’s r and p value were used to report the correlation between log-converted glove parameters and HAQ score

Results: In MFE, glove parameters TD and ITI were found significantly higher in RApts (TD 257.34 ± 123.93 ms, ITI 377.8 ± 211.35 ms) than HC (TD 172.25 ± 59.36 ms, ITI 177.98 ± 78.53 ms) (p = 0.004 and p < 0.001) and MR was significantly lower in RApts (1.51 ± 0.47 Hz) compared to HC (2.87 ± 0.9 Hz) (p < 0.001). There was a trend of increased TD at the increasing of DAS28-CRP (P=0.178). TD of RApts had a significant correlation with the total score of the HAQ (Pearson r = 0.79, p = 0.001). In SFE not swollen and not tender fingers of RApts performed slightly better than a clinically active finger (AF) but significantly worse than average HC finger (ANOVA, p < 0.001)

Conclusion: HTS is a totally safe and promising tool to quantify in an objective manner the DF of the hands in RApts. The significant correlation found with HAQ highlights the loss of motility of the hands as one of the main determinant of DF. The non-significative result with DAS28-CRP is likely due to the low number of subjects enrolled. Further studies are ongoing with larger number of RApts to validate its application to monitor the improving or the worsening of RA in order to optimize pharmacological treatments. The study is now extended to the hands in other Rheumatic and Musculoskeletal Diseases

1Signori et al PLoS One 2017.18;12:e0186524

Disclosure: M. Patane', None; L. Carmisciano, None; E. Gotelli, None; V. Tomatis, None; F. Cattelan, None; E. Alessandri, None; A. Signori, None; M. Ghio, None; V. Smith, None; M. Cutolo, Boehringer, Actelion, Celgene, Bristol-Mayer Squibb, 2.

To cite this abstract in AMA style:

Patane' M, Carmisciano L, Gotelli E, Tomatis V, Cattelan F, Alessandri E, Signori A, Ghio M, Smith V, Cutolo M. An Engineered Glove for the Computerised Quantification of Hand Disability in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/an-engineered-glove-for-the-computerised-quantification-of-hand-disability-in-rheumatoid-arthritis/. Accessed .

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