The impact of Chikungunya chronic arthralgia on women’s upper limbs motor function: a cross-sectional study

Machado, Germano Luís Rocha; Castro, Rayane Quintão; Forechi, Ludimila; Souza, Heloísa da Costa; Fonseca, Diogo Simões; Garcia, Marco Antonio Cavalcanti

doi:10.1590/1809-2950/22011229042022EN

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ORIGINAL RESEARCH • Fisioter. Pesqui. 29 (4) • Oct-Dec 2022 • https://doi.org/10.1590/1809-2950/22011229042022EN copy

The impact of Chikungunya chronic arthralgia on women’s upper limbs motor function: a cross-sectional study

O impacto da artralgia crônica pós-Chikungunya na função motora dos membros superiores de mulheres: um estudo transversal

El impacto de la artralgia crónica poschikunguña en la función motora del miembro superior de mujeres: un estudio transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Post-Chikungunya chronic arthralgia (PCCA) may lead to musculoskeletal repercussions and functional loss. The objective was to assess the upper limb physical disability and symptoms during daily, work, and leisure activities of women presenting PCCA compared to healthy controls (HC). This was a cross-sectional study conducted with 52 women. The participants were divided into PCCA (37) and HC (15) groups. Handgrip strength, range of motion, level of pain (numerical rating scale), and participants’ physical disability and symptoms (Disabilities of the Arm, Shoulder, and Hand Questionnaire - DASH) were evaluated. Differences between groups were evaluated using the Students t-test and Pearson’s correlations. The chi-square test was applied for categorical variables. The significance was set at α=0.05. The disease duration was 19.5±13.1 months. We found no differences between groups for peak force (PCAA:23.6±7.4kgf; HC: 24.5±6.2kgf; p=0.676). The results showed a significant difference between groups regarding range of motion (PCCA: 63.5±17.3^o; HC: 77.2±9.6^o), level of hand pain (PCCA: 5.8±2.2; HC: 0.4±1.5), and upper limbs functional levels (PCCA: 44.5±17.4; HC: 16.2±20.5). Participants related severe difficulty or inability to perform tasks such as opening a jar (78.4%), placing objects above head height (48.7%), doing heavy household chores (56.8%), and gardening (51.4%). Impairment in the upper limb physical function in daily, work, and leisure activities shows the higher prevalence in the long-term.

Keywords:
Chikungunya Virus; Arthralgia; Upper Extremities; Functional Status

Characteristic		CG (n=15)	PCCA (n=37)	p-value
Age (mean±SD)		54.5±9.24	53.45±7.32	0.666
Schooling years				0.454
	≤9 years	3 (20)	14 (37.8)
	10-12 years	9 (60)	15 (40.5)
	>12 years	3 (20)	8 (21.6)
Skin-color				0.854
	Black	4 (26.7)	9 (24.3)
	Mixed-race	8 (53.3)	17 (46)
	White	2 (13.3)	9 (24.3)
	Other	1 (6.7)	2 (5.4)
Self-related health status				0.005
	Good and very good	12 (80)	12 (32.4)
	Fair, poor, and very poor	3 (20)	24 (64.9)
	Not answered	0 (0)	1 (2.7)
Employment status				0.297
	Active and formal	7 (46.7)	10 (27.0)
	Active and informal	3 (20)	13 (35.1)
	Inactive with income	4 (26.7)	6 (16.2)
	Inactive without income	1 (6.7)	8 (21.6)
Absence from work				0.021
	<15 days	2 (13.3)	17 (45.9)
	>15 days	0 (0)	6 (16.2)
	Without absence	13 (86.7)	14 (37.8)
Body mass index (mean±SD)		28.1±3.5	29.6±5.6	0.671
Disease duration (months) (mean±SD)		-	19.5±13.1	-

Parameter	CG (n=15)	PCCA (n=37)	p-value
Dominant peak force (kgf)	24.5±6.2	23.6±7.4	0.676
Dominant average force (kgf)	16.6±10.0	17.9±9.2	0.824
Range of motion wrist flexion (°)	77.2±9.6	63.5±17.3	0.005
Pain	0.4±1.5	5.8±2.2	<0.001
DASH score	16.2±20.5	44.5±17.4	<0.001
Work module DASH score	43.7±27.3	84.1±22.6	<0.001

DASH ITEMS	CG (n=15)			PCCA (n=37)			p
DIFFICULTY	NO AND MILD N (%)	MODERATE N (%)	SEVERE AND UNABLE N (%)	NO AND MILD N (%)	MODERATE N (%)	SEVERE AND UNABLE N (%)
1. Open a tight or new jar	12 (80)	1 (6.7)	2 (13.3)	3 (8.1)	5 (13.5)	29 (78.4)	0.001
2. Write	14 (93.3)	1 (6.7)	0 (0)	20 (54.1)	10 (27)	7 (18.9)	0.021
3. Turn a key	15 (100)	0 (0)	0 (0)	26 (70.3)	7 (18.9)	4 (10.8)	0.049
4. Prepare a meal	13 (86.7)	1 (6.7)	1 (6.7)	23 (62.2)	10 (27)	4 (10.8)	0.235
5. Push open a heavy door	10 (66.7)	2 (13.3)	3 (20)	15 (40.6)	13 (35.1)	9 (24.3)	0.244
6. Place an object on a shelf above your head	11 (73.3)	3 (20)	1 (6.7)	14 (37.8)	5 (13.5)	18 (48.7)	0.020
7. Do heavy household chores	10 (66.7)	3 (20)	2 (13.3)	11 (29.7)	5 (13.5)	21 (56.8)	0.017
8. Garden or do yard work	10 (66.7)	3 (20)	2 (13.3)	13 (35.1)	5 (13.5)	19 (51.4)	0.043
9. Make a bed	12 (80)	1 (6.7)	2 (13.3)	23 (62.2)	10 (27)	4 (10.8)	0.288
10. Carry a shopping bag or briefcase	11 (73.3)	3 (20)	1 (6.7)	10 (27)	11 (29.7)	16 (43.2)	0.006
11. Carry a heavy object (over 10 lbs.)	11 (73.3)	2 (13.3)	2 (13.3)	11 (29.7)	9 (24.3)	17 (46)	0.014
12. Change a lightbulb overhead	9 (60)	2 (13.3)	4 (26.7)	10 (27)	9 (24.3)	18 (48.7)	0.095
13. Wash or blow dry your hair	10 (66.7)	3 (20)	2 (13.3)	14 (37.8)	9 (24.3)	14 (37.8)	0.142
14. Wash your back	12 (80)	2 (13.3)	1 (6.7)	21 (56.8)	4 (10.8)	12 (32.5)	0.148
15. Put on a pullover sweater	12 (80)	1 (6.7)	2 (13.3)	23 (62.2)	6 (16.2)	8 (21.6)	0.464
16. Use a knife to cut food	12 (80)	2 (13.3)	1 (6.7)	22 (59.5)	9 (24.3)	6 (16.2)	0.376
17. Recreational activities which require little effort	13 (86.7)	1 (6.7)	1 (6.7)	16 (43.2)	7 (18.9)	14 (37.8)	0.017
18. Recreational activities in which you take some force or impact through your arm, shoulder, or hand	9 (60)	1 (6.7)	5 (33.3)	9 (24.3)	10 (27)	18 (48.7)	0.034
19. Recreational activities in which you move your arm freely	11 (73.3)	1 (6.7)	3 (20)	10 (27)	10 (27)	17 (46)	0.004
20. Manage transportation needs	12 (80)	1 (6.7)	2 (13.3)	21 (56.8)	9 (24.3)	7 (18.9)	0.273
21. Sexual activities	12 (80)	1 (6.7)	2 (13.3)	23 (62.2)	6 (16.2)	8 (21.6)	0.493
INTERFERENCE IN SOCIAL ACTIVITIES	NOT AT ALL AND SLIGHTLY N (%)	MODERATELY N (%)	QUITE A BIT AND EXTREMELY N (%)	NOT AT ALL AND SLIGHTLY N (%)	MODERATELY N (%)	QUITE A BIT AND EXTREMELY N (%)
22. During the past week, to what extent has your arm, shoulder, or hand problem interfered with your normal social activities with family, friends, neighbors, or groups?	13 (86.7)	2 (13.3)	0 (0)	18 (48.7)	9 (24.3)	10 (27)	0.032
WORK AND DAILY ACTIVITIES LIMITATIONS	NOT AT ALL AND SLIGHTLY N (%)	MODERATELY N (%)	VERY AND UNABLE N (%)	NOT AT ALL AND SLIGHTLY N (%)	MODERATELY N (%)	VERY AND UNABLE N (%)
23. During the past week, were you limited in your work or other regular daily activities as a result of your arm, shoulder or hand problem?	13 (86.7)	1 (6.7)	1 (6.7)	16 (43.2)	8 (21.6)	13 (35.1)	0.014
SYMPTOMS SEVERITY IN THE LAST WEEK	NONE AND MILD N (%)	MODERATE N (%)	SEVERE AND EXTREME N (%)	NONE AND MILD N (%)	MODERATE N (%)	SEVERE AND EXTREME N (%)
24. Arm, shoulder, or hand pain	13 (86.7)	2 (13.3)	0 (0)	6 (16.2)	12 (32.5)	17 (46)	0.001
25. Arm, shoulder, or hand pain when you performed any specific activity	11 (73.3)	3 (20)	1 (6.7)	9 (24.3)	15 (40.5)	11 (29.7)	0.003
26. Tingling (pins and needles) in your arm, shoulder, or hand	13 (86.7)	0 (0)	2 (13.3)	18 (48.7)	6 (16.2)	10 (27)	0.037
27. Weakness in your arm, shoulder, or hand	14 (93.3)	1 (6.7)	0 (0)	12 (32.5)	13 (35.1)	10 (27)	0.001
28. Stiffness in your arm, shoulder, or hand	12 (80)	1 (6.7)	2 (13.3)	11 (29.7)	12 (32.5)	12 (32.5)	0.008
SLEEP DIFFICULTY	NO AND MILD N (%)	MODERATE N (%)	SEVERE AND SO MUCH THAT I CAN’T SLEEP N (%)	NO AND MILD N (%)	MODERATE N (%)	SEVERE AND SO MUCH THAT I CAN’T SLEEP N (%)
29. During the past week, how much difficulty have you had sleeping because of the pain in your arm, shoulder, or hand?	12 (80)	1 (6.7)	2 (13.3)	15 (40.5)	6 (16.2)	14 (37.8)	0.069
SELF-PERCEPTION OF HEALTH STATE	STRONGLY DISAGREE AND DISAGREE N (%)	NEITHER AGREE NOR DISAGREE N (%)	AGREE AND STRONGLY AGREE N (%)	STRONGLY DISAGREE AND DISAGREE N (%)	NEITHER AGREE NOR DISAGREE N (%)	AGREE AND STRONGLY AGREE N (%)
30. I feel less capable, less confident, or less useful because of my arm, shoulder, or hand problem	12 (80)	0 (0)	3 (20)	14 (37.8)	4 (10.8)	17 (45.9)	0.016
WORK MODULE DIFFICULTY DURING WORK ACTIVITIES	NO AND MILD N (%)	MODERATE N (%)	SEVERE AND UNABLE N (%)	NO AND MILD N (%)	MODERATE N (%)	SEVERE AND UNABLE N (%)
1. Using your usual technique for your work?	11 (73.3)	3 (20)	1 (6.7)	8 (21.6)	15 (40.5)	14 (37.8)	0.005
2. Doing your usual work because of arm, shoulder, or hand pain?	11 (73.3)	2 (13.3)	2 (13.3)	8 (21.6)	12 (32.4)	17 (46)	0.006
3. Doing your work as well as you would like?	11 (73.3)	3 (20)	1 (6.7)	5 (13.5)	14 (37.8)	18 (48.7)	0.001
4. Spending your usual amount of time doing your work?	10 (66.7)	1 (6.7)	4 (26.7)	5 (13.5)	13 (35.1)	19 (51.4)	0.001

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