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| Nico Magni PhD Student, Auckland University of Technology, Auckland, NZ Sensorimotor Performance and Function in People with Osteoarthritis of the Hand: A Case-Control Comparison N E Magni*, P J McNair*, D A Rice* **
* Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, NZ
** Waitemata Pain Service, North Shore Hospital, Waitemata DHB, Auckland, NZ
Introduction: Hand osteoarthritis (OA) is a common cause of pain and disability, affecting 20% of adults over age 70.1 Classically this pathology has been attributed solely to impairments of peripheral structures (e.g. joint and surrounding tissues). However, recent evidence has shown that changes in the central nervous system may contribute to the maintenance of pain and disability.2 To date no evidence has focused on brain related sensorimotor impairments in hand OA, highlighting the need for further studies on this topic. We hypothesised that patients with hand OA would present with evidence of sensorimotor impairments and that these changes would be correlated to hand function.
Aims: To determine whether motor imagery (MI), tactile acuity, and body perception, are disrupted in people with hand OA. To verify if a correlation exists between these measures and hand function in people with hand OA.
Methods: Twenty patients with symptomatic hand OA and 19 healthy pain-free controls undertook MI (hand left/right judgments), a brain speed processing task (controls left/right judgments), two-point discrimination (TPD) threshold testing, a neglect-like symptoms questionnaire (assessing body perception) and hand performance tests.
Results: People with hand OA were slower and less accurate in the MI task (P < 0.05) when compared to healthy controls, with no brain processing differences between groups. No difference was found between groups for two-point discrimination measures. Patients with hand OA presented with higher (P < 0.05) scores on the neglect-like questionnaire. Interestingly, people with left hand pain demonstrated enhanced neglect-like symptoms (P < 0.05) compared to those with right-sided hand pain. A correlation between TPD thresholds and measures of hand performance was identified, however no relation was found between MI and hand function.
Conclusion: Patients with hand OA demonstrate brain related sensorimotor deficits. Additionally, the side of the pain appears to influence body perception, probably due to differences in right and left hemispheric functions. Sensorimotor measures partially correlate to function, specifically tactile acuity is moderately related to hand function.
References:
1. Zhang, Y., Niu, J., Kelly-Hayes, M., Chaisson, C. E., Aliabadi, P., & Felson, D. T. (2002). Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: The Framingham study. American Journal of Epidemiology, 156(11), 1021-1027. doi:10.1093/aje/kwf141
2. Arendt-Nielsen, L., Nie, H., Laursen, M. B., Laursen, B. S., Madeleine, P., Simonsen, O. H., & Graven-Nielsen, T. (2010). Sensitization in patients with painful knee osteoarthritis. Pain, 149(3), 573-581. doi:10.1016/j.pain.2010.04.003
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