WRIST JOINT POSITION SENSE AND MANUAL DEXTERITY IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Background: Joint position sense is a marker of proprioception and is defined as being aware of the body position and individual body parts in the space. Position sense in the wrist joint is especially important for the manual dexterity. A possible damage due to arthritis may lead a decrease in joint position sense. However, the status of joint position sense was not investigated in children with juvenile idiopathic arthritis (JIA).Objectives: To compare the wrist position sense and a motor performance test related to manual dexterity among children with JIA with wrist arthritis history (JIAWrist+), children with JIA without wrist arthritis history (JIAWrist-), and healthy controls.Methods: A total of sixty children (20 children for each group) were included in the study. Wrist joint position sense was evaluated by measuring joint re-position error. The wrist was passively placed in a pre-determined position (30o for flexion, 30o for extension, 10o for radial deviation, and 15o for ulnar deviation). Then passively was returned to baseline position. The patient was asked to reposition their wrist into the target degree actively. The absolute error in degrees between each position and reposition was calculated. Manual dexterity was evaluated by using Purdue Pegboard Test. The test was repeated three times and the average number of the correctly placed pines was used in the analysis.Results: Joint position sense (in all directions except radial deviation) and manual dexterity (except assembly) was found negatively affected in JIAWrist+ patients compared to healthy controls. No differences (except radial deviation) were observed between JIAWrist- patients and healthy controls.Conclusion: Joint position sense and related manual dexterity is diminished in JIA patients with wrist involvement. The results of this study suggested that children with wrist arthritis should be followed with special attention focusing on manual abilities. Hand therapy programs might help improving joint position sense acuity.