Julianna Ethridge, Georgia Parnell, Madison Holloman, Nicholas Murray. East Carolina University, Greenville, NC.

ABSTRACT BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease that often leads to joint damage due to the breakdown of the synovial membrane (Smolen, Aletaha, Koeller, & Emery, 2007). Though RA affects the whole body, patients generally lose the most function in the wrists and fingers. Due to decreased hand strength and dexterity, RA patients typically adopt abnormal movement patterns to complete activities of daily living (ADLs) (Palamar, 2017). The purpose of this study was to observe the differences in neuromotor control and joint patterns of the upper extremities between RA patients and healthy individuals. In preliminary trials, RA patients were more inclined to rotate and overuse their shoulders to compensate for a loss of functioning in their hands; however, a healthy individual completes the marble task primarily using their elbow joint (Pierce, 2021). In addition, this study explored the relationship between intrinsic motivation and level of independence as RA symptoms progress. METHODS: To assess the difference in movement patterns, the participant used tweezers to manipulate marbles of different sizes. Using an electroencephalogram (EEG), neuromotor processes and cognitive workload were analyzed immediately before and following the participants’ manipulation of the marbles. Vicon Nexus’ motion capture software and upper limb model were used to track and analyze fine motor movements. Additionally, the participants’ level of motivation and its subsequent effect on neuromotor processing was assessed using a survey based on the Self-Determination Theory of Motivation. RESULTS: Individuals with RA are more likely to utilize their shoulder joints during tasks involving the hands and wrists. The changes in movement patterns generally resulted in greater processing within the frontal cortex both before and throughout trial completion. Lastly, most of the individuals who were able to complete the tasks reported higher levels of intrinsic motivation and independence in completing activities of daily living. CONCLUSION: Due to changes in movement patterns, individuals with RA typically experience more shoulder pain than their healthy counterparts, and their movements are less accurate. Additionally, differences in intrinsic motivation prior to their initial diagnosis tends to affect how independent an individual is as their RA progresses.

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