Balneotherapy in Hand Osteoarthritis

VAS which is easy to understand, apply and interpret, and provides valid and reliable data in a short time, is the most commonly used method in clinics. With a 100 mm visual linear scale, the patient is told that there is no pain at point 0, and that the most severe pain they have ever felt at point 100, and the patient is asked to put a mark on the point corresponding to their pain.

Palm-to-finger distance Used to assess hand joint mobility. Obtained by measuring the distance (in millimeters) between the fingertip of the second to fifth finger and the distal palmar crease while making a full fist and adding the distances (higher scores indicate greater limitations).

It was developed specifically for use in hand osteoarthritis. It is recommended for use in clinical studies by OMERACT (Outcome Measures in Rheumatology Clinical Trials Group). It evaluates hand functions, pain and stiffness in patients with hand osteoarthritis. It consists of three subscales: Hand pain (5 items), hand stiffness (1 item), hand function (9 items). A 5-point Likert scale (0=none, 4=severe) LK 3.0 is used. Its validity and reliability have been demonstrated in osteoarthritis.

It is a 10-question questionnaire. Answers are scored on a 4-point scale: 0 = Possible without difficulty; 1 = Possible with some difficulty; 2 = Possible with great difficulty; 3 = Impossible. The total score for the questionnaire ranges from 0 to 30. A higher score indicates a more severe functional limitation. Validity and reliability in Turkish have been demonstrated.

Measurements will be made by sitting with the shoulder adducted and neutrally rotated, adjacent to the body, elbow 90 degrees flexed, wrist 0-30 degrees dorsiflexed and 0-15 degrees ulnar deviation, thumb up. Measurements will be repeated three times with 5-second intervals on the affected hand and the average of the three measurements will be recorded in kilograms. Finger grip strength will be assessed with the 'Jamar digital pinchmeter'. Patients will be placed in a sitting position with the wrist 90° flexed and the forearm in a neutral position. Measurements will be made bilaterally in three different positions as lateral, palmar and fingertip grips. Patients will be asked to squeeze with maximum force and each measurement will be taken three times and the average will be recorded in kg.

This test measures manual dexterity based on performance (seconds). A wooden board with nine holes on it, 9 short wooden sticks and a box in which the wooden sticks can be placed are placed in front of the patient. The patient is asked to place the wooden sticks in the box into the holes on the board as quickly as possible using the hand to be evaluated, then is asked to put the sticks back into the box one by one. The test completion time is determined by a stopwatch

Test items are turning cards, picking up small objects and throwing them into a tin can, stacking backgammon tiles, writing, jumping 5 light tin cans across, jumping 5 heavy tin cans across, collecting 5 dried kidney beans using a dessert spoon The test materials include detailed instructions for use in the test manual. In order to ensure a standard arrangement of the objects used, a scaled board and a stopwatch are included in the test materials to measure the time the activities are performed. Before the test is administered, the person is shown how to do it. Explaining that the test is performed against time is necessary for the patient's motivation. The patient starts with the start command and the stopwatch is stopped when the activity is completed.

HAQ was developed for the assessment of patients with rheumatic diseases. It consists of 20 questions related to eight activities (items); dressing, getting up, eating, walking, hygiene, grasping and activities of daily living are questioned. HAQ reflects the functional status of patients and this questionnaire has been shown to correlate with disease activity markers. Each item or question is rated on a scale of 0 to 3, with 0 (normal/no difficulty), 1 (some difficulty), 2 (much difficulty), and 3 (unable to do). The 8 category scores are averaged, which represent an overall score from 0 (no disability) to 3 (completely disabled).

Scores 0-1 indicates mild to moderate disability, 1-2 indicates moderate to severe disability, and 2-3 indicates severe to very severe disability.

SF-36 is a generic quality of life scale. It is evaluated between 0-100 points. It was created to evaluate health status. It contains a total of 36 items. Higher scores indicate better health status, and a mean score of 50 has been articulated as a normative value for all scales.There is a Turkish validity and reliability study.