The use of the health assessment questionnaire (HAQ) to determine physical disability in systemic sclerosis

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Abstract
The health assessment questionnaire (HAQ), a self administered instrument to determine physical disability, was completed by 211 patients with systemic sclerosis who subsequently received scleroderma examinations. The mean HAQ disability index for the entire group was 0.92. Patients with high skin scores had significantly higher disability indices as compared to patients with low skin scores (p < 0.001). Higher disability indices were found for patients with joint pain, tendon rubs, and contractures. However, the presence of ulcers on the digital tip did not interfere with patients' abilities to function as measured by this scale. Intensive hand evaluations were performed on a subset of these 211 patients with systemic sclerosis (n = 80). Grip strength, thumb abduction, wrist extension, and motion of the index and middle fingers significantly correlated with the HAQ scores (p < 0.01). The findings from this study suggest that patients with systemic sclerosis have significant physical disability. Furthermore, the HAQ appears to be useful in assisting health professionals in quantitating this disability.