Background/Purpose: Hand Osteoarthritis (HOA) is a highly prevalent disease with important impact on the patient´s daily activity performance and quality of life. Dreiser et al. developed the Functional Index for Hand Osteoarthritis (FIHOA), a questionnaire (either physician or self-patient administered) designed to assess the functional impact of HOA on daily living activities, and it is expected to change with the progression of the disease or under the effect of treatment. To translate FIHOA into Spanish and to validate the Spanish version in patients with HOA.

Methods: Prospective, analytical, cross-sectional observational study. The English version of FIHOA was translated into Spanish according to the Beaton et al. guidelines. Patients 18 years of age and older with diagnosis of HOA (ACR1990) were included. Those with secondary OA or any condition affecting upper limbs were excluded. All patients completed the questionnaire, along with other subjective measures: Pain and patient global assessment of the disease using a visual analogue scale (Pain and PtGA VAS), and Health Assessment Questionnaire (HAQ-A). For a patient subgroup, an occupational therapist performed an evaluation of hand function, using the Sequential Occupational Dexterity Assessment (SODA-A) and the Jebsen Hand Function Test (JHFT). To assess reproducibility, a subgroup of patients with similar clinical and therapeutic conditions to their first evaluation completed the questionnaire again one week later. Statistical analysis: Demographic and clinical characteristics were described. Construct validity was analyzed through the correlation of FIHOA with HAQ-A, SODA-A test and JHFT using the Spearman coefficient. Internal consistency was assessed using Cronbach’s α coefficient and inter-item correlation. Reproducibility was estimated using test-retest reliability. A multiple regression model was constructed with FIHOA as the outcome variable and those variables that proved significant on bivariate analysis.

Results: Eighty-seven patients were included (93% women), mean age 67.8 years (SD 9.3). Educational mean level was 8 years (SD 3.7). Mean Pain VAS score was 4.57 (SD 2.54) and mean PtGA 4 (SD 2.63). Median TJC was 5 (IQR 3-8) and median SJC was 0 (IQR 0-1). We observed a good correlation between FIHOA and HAQ-A (r=0.69). FIHOA also showed a positive correlation with Pain VAS score (r=0.57), TJC (r=0.70), SODA-A (r=0.47) and the activities with small objects performed with the non-dominant hand in JHFT (r=0.50). FIHOA demonstrated good internal consistency (Cronbach´s α=0.85) and reproducibility (0.76). A multiple lineal regression adjusted by age, gender and Pain VAS showed TJC as the main determinant of FIHOA. Median time to complete the test was 70 seconds (IQR 50-100). FIHOA showed good acceptance.

Conclusion: The Spanish version of the FIHOA questionnaire proved to be a valid, reliable, and reproducible assessment of functional capacity in patients with HOA, providing a valuable tool for the evaluation of our patients.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/validation-of-a-spanish-version-of-the-functional-index-for-hand-osteoarthritis-fihoa/