The impact of Chikungunya chronic arthralgia on women’s upper limbs motor function: a crosssectional study
DOI:
https://doi.org/10.1590/1809-2950/22011229042022ENKeywords:
Chikungunya Virus, Arthralgia, Upper Extremities, Functional StatusAbstract
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±17.3o
; HC: 77.2±9.6o
), 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
Downloads
References
Brighton SW, Prozesky OW, De La Harpe AL. Chikungunya
virus infection. A retrospective study of 107 cases. S Afr Med J.
;63(9):313-5.
Mathew AJ, Ganapati A, Kabeerdoss J, Nair A, Gupta N,
et al. Chikungunya infection: a global public health menace.
Curr Allergy Asthma Rep. 2017;17(2):13. doi: 10.1007/
s11882-017-0680-7.
Pathak H, Mohan MC, Ravindran V. Chikungunya arthritis. Clin
Med (London). 2019;19(5):381-5. doi: 10.7861/clinmed.2019-0035.
Brasil. Ministério da Saúde. Monitoramento dos casos de
arboviroses urbanas transmitidas pelo Aedes (dengue,
chikungunya e Zika) até a Semana Epidemiológica 12 de 2019.
Boletim Epidemiológico. 2019;50:1-13.
Tritsch SR, Encinales L, Pacheco N, Cadena A, Cure C, et al.
Chronic joint pain 3 years after Chikungunya virus infection
largely characterized by relapsing-remitting symptoms. J
Rheumatol. 2020;47(8):1267-74. doi: 10.3899/jrheum.190162.
Marques CDL, Duarte ALBP, Ranzolin A, Dantas AT,
Cavalcanti NG, et al. Recommendations of the Brazilian Society
of Rheumatology for diagnosis and treatment of Chikungunya
fever. Part 1 – Diagnosis and special situations. Rev Bras
Reumatol. 2017;57(S2):421-37. doi: 10.1016/j.rbre.2017.05.006.
Chopra A, Anuradha V, Ghorpade R, Saluja M. Acute
Chikungunya and persistent musculoskeletal pain following the
Indian epidemic: a 2-year prospective rural community
study. Epidemiol Infect. 2012;140(5):842-50. doi: 10.1017/
S0950268811001300.
Simon F, Javelle E, Cabie A, Bouquillard E, Troisgros O, et al.
French guidelines for the management of chikungunya (acute
and persistent presentations). November 2014. Med Mal Infect.
;45(7):243-63. doi: 10.1016/j.medmal.2015.05.007.
Murillo-Zamora E, Mendoza-Cano O, Trujillo-Hernández B,
Guzmán-Esquivel J, Higareda-Almaraz E, et al. Persistent
arthralgia and related risks factors: a cohort study at 12 months
from laboratory-confirmed Chikungunya infection. Arch Med
Res. 2018;49(1):65-73. doi: 10.1016/j.arcmed.2018.04.008.
Almeida PHTQ, Pontes TB, Matheus JPC, Muniz LF,
Mota LMH. Occupational therapy in rheumatoid arthritis:
what rheumatologists need to know? Rev Bras Reumatol.
;55(3):272-80. doi: 10.1016/j.rbr.2014.07.008.
Nyffeler RW, Werner CML, Gerber C. Biomechanical relevance
of glenoid component positioning in the reverse Delta III total
shoulder prosthesis. J Shoulder Elbow Surg. 2005;14(5):524-8.
doi: 10.1016/j.jse.2004.09.010.
Silva TSS, Massa LDB. A utilização de órteses de membro
superior em pacientes com artrite reumatoide: uma revisão
de literatura no campo da terapia ocupacional. Cad Ter Ocup
UFSCar. 2015;23(3):647-59. doi: 10.4322/0104-4931.ctoAR0522.
Forechi L, Silveira-Nunes G, Barbosa MA, Barbosa EG, Santos DL,
et al. Pain, balance, grip strength and gait parameters of older
adults with and without post-chikungunya chronic arthralgia.
Trop Med Int Health. 2018;23(12):1394-400. doi: 10.1111/tmi.13154.
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O MiniExame do Estado Mental em uma população geral: impacto da
escolaridade. Arq Neuropsiquiatr. 1994;52(1):1-7. doi: 10.1590/
S0004-282X1994000100001.
Oldfield RC. The assessment and analysis of handedness:
the Edinburgh inventory. Neuropsychologia. 1971;9(1):97-113.
doi: 10.1016/0028-3932(71)90067-4.
MacDermid J, Solomon G, Valdes K, editors. Clinical assessment
recommendations: Impairment-based conditions. 3rd ed. Mount
Laurel: American Society of Hand Therapists; 2015.
Nugraha B, Gutenbrunner C, Barke A, Karst M, Schiller J, et al.
The IASP classification of chronic pain for ICD-11: functioning
properties of chronic pain. Pain. 2019;160(1):88-94. doi: 10.1097/j.
pain.0000000000001433.
Orfale AG, Araújo PMP, Ferraz MB, Natour J. Translation into
Brazilian Portuguese, cultural adaptation and evaluation of
the reliability of the Disabilities of the Arm, Shoulder and
Hand Questionnaire. Braz J Med Biol Res. 2005;38(2):293-302.
doi: 10.1590/S0100-879X2005000200018.
Silva GS, Lourenço MA, Assis MR. Hand strength in patients
with RA correlates strongly with function but not with
activity of disease. Adv Rheumatol. 2018;58:20. doi: 10.1186/
s42358-018-0020-1.
Schlüssel MM, Anjos LA, Vasconcellos MTL, Kac G. Reference
values of handgrip dynamometry of healthy adults:
a population-based study. Clin Nutr. 2008;27(4):601-7.
doi: 10.1016/j.clnu.2008.04.004.
Li ZM, Kuxhaus L, Fisk JA, Christophel TH. Coupling between
wrist flexion-extension and radial-ulnar deviation. Clin
Biomech (Bristol, Avon). 2005;20(2):177-83. doi: 10.1016/j.
clinbiomech.2004.10.002.
Neumann IL, Oliveira DA, Barros EL, Santos GS, Oliveira LS,
et al. Resistance exercises improve physical function in chronic
Chikungunya fever patients: a randomized controlled trial. Eur
J Phys Rehabil Med. 2021;57(4):620-9.
Franko OI, Zurakowski D, Day CS. Functional disability of the
wrist: direct correlation with decreased wrist motion. J Hand
Surg Am. 2008;33(4):485.E1-9. doi: 10.1016/j.jhsa.2008.01.005.
Rainbow MJ, Wolff AL, Crisco JJ, Wolfe SW. Functional
kinematics of the wrist. J Hand Surg Eur Vol. 2016;41(1):7-21.
doi: 10.1177/1753193415616939.
Burt FJ, Chen W, Miner JJ, Lenschow DJ, Merits A, et al.
Chikungunya virus: an update on the biology and pathogenesis
of this emerging pathogen. Lancet Infect Dis. 2017;17(4):E107-17.
doi: 10.1016/S1473-3099(16)30385-1.
Watson H, Tritsch SR, Encinales L, Cadena A, Cure C, et al.
Stiffness, pain, and joint counts in chronic chikungunya disease:
relevance to disability and quality of life. Clin Rheumatol.
;39(5):1679-86. doi: 10.1007/s10067-019-04919-1.
Paixão ES, Rodrigues LC, Costa MCN, Itaparica M, Barreto F,
et al. Chikungunya chronic disease: a systematic review and
meta-analysis. Trans R Soc Trop Med Hyg. 2018;112(7):301-16.
doi: 10.1093/trstmh/try063.
Soumahoro MK, Gérardin P, Boëlle PY, Perrau J, Fianu A,
et al. Impact of Chikungunya virus infection on health status
and quality of life: a retrospective cohort study. PLoS One.
;4(11):e7800. doi: 10.1371/journal.pone.0007800.
Bastos MLA, Abreu FS, Silva Junior GB. Inability to work due to
Chikungunya virus infection: impact on public service during
the first epidemic in the State of Ceará northeastern Brazil. Braz
J Infect Dis. 2018;22(3):248-9. doi: 10.1016/j.bjid.2018.05.002.
Amaral JK, Bilsborrow JB, Schoen RT. Chronic Chikungunya
arthritis and rheumatoid arthritis: what they have in common.
Am J Med. 2020;133(3):E91-7. doi: 10.1016/j.amjmed.2019.10.005.
Xavier RM, Zerbini CAF, Pollak DF, Morales-Torres JLA,
Chalem P, et al. Burden of rheumatoid arthritis on patients’
work productivity and quality of life. Adv Rheumatol. 2019;59:47.
doi: 10.1186/s42358-019-0090-8.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Germano Luís Rocha Machado, Rayane Quintão Castro, Ludimila Forechi, Heloísa da Costa Souza, Diogo Simões Fonseca
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
