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Objective Hand Mobility in Scleroderma (HAMIS) is a hand function test used to determine the degree of dysfunction of hand movements. The Modified Hand Mobility in Scleroderma (mHAMIS), on the other hand, was developed later and consists of 4 items. The aim of this study was to determine the reliability and validity of mHAMIS. Methods This study included a total of 39 patients with systemic sclerosis (SSc) who were assessed with mHAMIS. The Cronbach's alpha coefficient, Kappa concordance, and intraclass correlation were respectively used to assess the internal consistency, intra- and inter-observer agreement, and inter-observer reliability of the test. The correlation between the Health Assessment Questionnaire (HAQ), the Duruoz Hand Index (DHI), and the Turkish version of mHAMIS were evaluated. Results The internal consistency of the test items was between .912 and .939. The total internal consistency of the test was excellent, with a Cronbach's alpha value of .954. The intra- and inter-observer agreement were good, with Kappa values of 0.954 (95% CI 0.89-1.6) and 0.965 (95% CI 0.82-1.4), respectively. The inter-observer reliability was 0.966 (95% CI 0.936-0.982; P

Background The Hand Mobility in Scleroderma (HAMIS) test was created to measure the degree of dysfunction of hand movements imposed by systemic sclerosis (SSc). The modified version (mHAMIS), with 4 of the 9 original items, was developed later. The goal of the present study was to translate and validate HAMIS and mHAMIS into Brazilian Portuguese and culture. Methods After direct and reverse translation and comprehension test in 10 SSc patients, HAMIS-Br was applied to another 32 patients with SSc. To evaluate internal consistency, intraobserver and interobserver agreement, and intraobserver and interobserver reliability, we used respectively the Cronbach’s α coefficient, kappa concordance and intraclass correlation (ICC). The correlation between HAMIS-Br and mHAMIS-Br was evaluated and a factorial analysis was performed. Results HAMIS-Br showed excellent internal consistency (Cronbach’s α = 0.997), good intraobserver agreement (kappa between 0.78 [95%CI =0.57–0.99] and 1) and intraobserver and interobserver reliability (ICC = 0.993, 95% CI = 0.973–0.993 and ICC = 0.994, 95% CI = 0.987–0.997, respectively). The mHAMIS-Br presented similar results and excellent correlation with HAMIS-Br (r = 0.923). The factorial analysis extracted three groups of questions that explain 84.4% of the total variance, and that can be understood through the influence of certain movements in the interpretation of others: [1] questions whose interpretation is influenced by the extension of the fingers, [2] questions whose interpretation is influenced by flexion of the fingers, [3] volar flexion of the fingers, with similar correlation with both other factors. Conclusions HAMIS-Br and mHAMIS-Br showed good agreement, intraobserver and interobserver reliability, and internal validity. It is necessary to be attentive to the influence of certain limitations of movements in the interpretation of others.

Introduction Systemic sclerosis is a connective tissue disease associated with significantly impaired hand mobility, which may hamper activities of daily living. The aim of the present study was to investigate the effect on hand mobility and health status of patients with systemic sclerosis of warming up hands with paraffin compared with warming up hands in lukewarm water prior to hand exercises. Methods Patients were allocated to receive either warm-up treatment with water or paraffin prior to hand exercises for a period of six months. Primary outcome was Hand Mobility in Scleroderma (HAMIS), while secondary outcomes included SF-36 and measurements of fingertips to proximal and distal palmar crease. Follow-up assessments were conducted 3, 6 and 12 months post baseline. Results Ninety patients were enrolled in the study and 56 patients completed. No statistically significant differences were observed between groups regarding hand mobility post intervention. Within both groups, hand mobility improved on the HAMIS six months post baseline with −2.6 points (95% CI: −4.4; −0.8) in the paraffin group and −3.3 points (95% CI: −5.2; −1.5) in the water group. Improvements were maintained at 12-month follow-up. Conclusions Our findings suggested that warm-up with paraffin compared to lukewarm water prior to hand exercises in patients with systemic sclerosis had no additional effect on hand mobility. Results may have been affected by the high dropout rate and statistical errors underestimating a possible effect.