Upper limb function impairment is independently associated with all Lupus Quality of Life (LupusQoL) domains in systemic lupus erythematosus.

Abstract

Patients with systemic lupus erythematosus (SLE) experience poor health-related quality of life (HRQoL) that is associated with disease characteristics, comorbidities and reduced physical activity. We aimed to investigate the relationship between upper limb function and HRQoL in patients with SLE. A total of 240 patients with SLE and 122 age-/sex-matched healthy controls were assessed for upper limb function using grip and pinch strength, as well as the Purdue pegboard test for dexterity. Disability in activities of daily living (ADLs) was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. HRQoL was evaluated with the LupusQoL questionnaire. Associations of upper limb function and DASH scores with all LupusQoL domains were examined using linear regression analyses. Patients with SLE demonstrated significant impairment in grip strength, pinch strength and dexterity compared with healthy controls (all P < 0.05). In univariate analysis, lower grip strength, pinch strength and Purdue pegboard scores, as well as higher DASH scores, were significantly associated with diminished LupusQoL across all domains (all P < 0.05). In multivariate models, all upper limb function parameters were independently associated with all LupusQoL domains (P < 0.05) after adjustments for disease activity, disease damage, medications, fibromyalgia and visual analogue score, except the body image domain in relation to the Purdue test. DASH scores were inversely related to all LupusQoL domain scores (all P < 0.001). Impaired upper limb function and ADL performance are independently associated with poor LupusQoL across all domains in SLE, highlighting the importance of incorporating upper limb function assessment and management into clinical practice.