Skip to main content
2024 BMES Annual Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Biomechanics

Biomechanics - Poster Session E

Poster P13 - Exploring the Intersection of Hand Pain and Activities of Daily Living Across Demographics

Saturday, October 26, 2024
10:00 AM - 11:00 AM EST
Location: Exhibit Hall E, F & G

Introduction:  The human hand is crucial for carrying out activities of daily living (ADLs), ranging from high-force activities, like opening a jar, to precision tasks, like picking up a coin. The ability to perform ADLs is often assessed by patient-reported outcome measures (PROMs),1 such as the Michigan Hand Questionnaire (MHQ).2
An important outcome variable to measure when assessing ADLs is pain. Pain is a unique somatosensory perception that can significantly impair daily function and life. Research suggests that pain varies based on several factors, including age, sex, and ethnicity/race. For example, women experience higher pain prevalence and process pain differently than men3, and Non-Hispanic Blacks experience more movement-evoked pain than Non-Hispanic Whites.4 However, the relationship between demographic variables, pain, and ADLs is not fully understood because of the complex interactions across demographic variables.
Despite a growing body of research examining pain across demographics, most studies overlook hand pain and/or hand function. Much like other critical body parts, such as the spine or knees, the hand is integral for mobility and function. The hand's extensive use makes it particularly susceptible to various pain conditions. Thus, an integrated understanding of pain, function, and demographics is essential for informing personalized treatments for the hand.
This study aimed to explore how hand pain relates to difficulty performing ADLs across three demographic variables: age, sex, and ethnicity/race. We hypothesized that (1) Black and Hispanic, (2) female, and (3) elderly female participants would have statistically significant relationships between pain and function, as opposed to other possible combinations.

Materials and

Methods:  This study is a secondary analysis of a hand function dataset in adults without hand pathology. The full dataset includes demographic data, anthropometric data, and clinical outcome data via grip and pinch strength, as well as the results of the Michigan Hand Questionnaire (MHQ) for the participant's dominant hand.
Data from 292 participants (167 females, 125 males) was examined. Participants were stratified by sex, age, and ethnic/racial background. Sex was stratified into male and female. Age was stratified into three groups: young (18-39 years), middle-aged (40-63 years), and older (64-95 years) adults. Ethnic/Racial background was stratified into Black, White, Hispanic, and Asian. White, Black, and Asian cohorts were all Non-Hispanic.
The MHQ, a patient-reported outcome measure focused on the hand, specifically asks participants about their difficulty with 12 ADLs. A participant’s difficulty with each ADL is measured using a 5-point Likert scale ranging from “not at all difficult” to “very difficult”. Self-reported hand pain ratings were reported on a scale from 0 to 100, with 0 indicating no pain and 100 indicating the worst pain imaginable.
Statistical analyses were performed to evaluate the relationship between the pain scores, difficulty performing ADLs, and demographic variables. Briefly, t-tests compared means with two levels, while ANOVAs were utilized for interactions with three or more levels, followed by Tukey's Honestly Significant Difference (HSD) tests.

Results, Conclusions, and Discussions: This study highlights significant differences in hand pain related to difficulty performing ADLs based on age, sex, and race/ethnicity (Table 1). Multi-comparison testing confirmed a significant association between ADLs and pain. For example, White participants reporting no difficulty holding a frying pan experienced significantly less pain than those reporting difficulty (p < 0.01).
For both middle-aged and older adults, there was a statistically significant relationship between pain and difficulty performing ADLs for most tasks. Young participants also had a significant relationship between pain and ADLs, indicating that pain-related limitations affect hand function across all age groups.
The sex analysis indicates pain affects females more than males. Interestingly, when examining the interaction between sex and age, young males showed no significant relationship between pain and ADLs for all tasks, except shoelace tying. In contrast, females across all age groups reported pain impacting ADLs. The sex difference may be influenced by biological differences, social roles, or health-seeking behaviors.
The analysis of racial/ethnic differences highlighted that White participants have a significant relationship between pain and ADLs for all tasks, but this is true for less than 60% of tasks for Black, Hispanic, and Asian participants. Further research is needed to understand whether these differences arise from variations in pain perception due to genetic, cultural, and/or lifestyle factors.
Across analyses of each demographic factor (Table 1) and interactions between demographic factors (data not shown), a consistent conclusion is that to what extent pain affects ADLs is task-specific. For Asian males and Asian females, there was no significant relationship between pain and difficulty performing jar opening or doorknob turning, but for shoelace tying, a significant relationship existed. In contrast, there was no significant relationship between pain and ADLs for Black males and Hispanic males, while significant relationships existed for over 33% of tasks for Black females and Hispanic females.
This study examines the complex interplay between age, sex, and race in the experience of hand pain related to ADLs. Recognizing the hand's crucial role and pain susceptibility can lead to strategies that preserve ADL performance and enhance quality of life while considering these demographic factors.

Acknowledgements (Optional):  Funding from the National Institutes of Health is gratefully acknowledged (NIH NIAMS R01 AR078817 and NIH NIBIB R21 EB030068).