550 Thursday, 04 June 2020 Scientific Abstracts from wide uptake of this publication (including Cochrane, OMERACT, IDEOM, RADS, and the GRADE Working Group). Musculoskeletal Statistics Unit, The Parker Institute is grateful for the fnancial support received from public and private foundations, companies and private individuals over the years. The Parker Institute is supported by a core grant from the Oak Foundation; The Oak Foundation is a group of philanthropic organiza- tions that, since its establishment in 1983, has given grants to not-for-proft organ- izations around the world. DOI: 10.1136/annrheumdis-2020-eular.809 THU0615-HPR FORCE-TIME CURVE ANALYSIS OF HANDGRIP STRENGTH IN PATIENTS WITH FIBROMYALGIA: COMPARISON WITH HEALTHY SUBJECTS S. Farah 1 , M. DI Carlo 1 , F. Salaffi 1 . 1 Hospital “Carlo Urbani”, Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Jesi, Italy Background: Factors associated with handgrip strength (HGs), in female with fbromyalgia (FM), use of force-time (FeT) curve to assess peak force, area under the curve (AUC), and variability of the time to reach maximum plateau of the curves (Fig.1) (1) to identify the impact of FM patients versus healthy controls have not been extensively studied. Figure 1. Force–time (FeT) curve showing the method of calculation of the various force attributes. Objectives: The aim of the study was to compare the HGs of FM with healthy subjects and to evaluate the relationship between curve characteristics and FM disease severity (2,3). Methods: One hundred and ten women (mean age 53.8±12.4 years; range 18 to 80) were included and compared with 111, age and BMI matched, female healthy controls. HGs was measured with an electronic device, while demographic and clinical characteristics of the subjects were obtained by the Revised version of the Fibromyalgia impact questionnaire (FIQR) and Fibromyalgia Activity Score (FAS). The patient opinion of their symptoms state (PASS) was evaluated as external criterion. The HGs threshold that best discriminates between the pres- ence and absence of FM, as well as between moderate and severe FM, was determined using the receiver operating characteristic (ROC) curves analyses. Multivariate regression procedure was used in order to assess the relative contri- bution of the covariates on the HGs. Results: HGs-AUC and peak force levels were lower in patients with FM than healthy women (median 342.7 vs 496.5; and in Kg median was 13.9 vs 19.9, respectively; both at signifcant level of p<0.001) and in women with severe FM compared with those with mild-moderate FM (p<0.0001). The time to reach max- imum plateau of the curves was signifcantly higher in patients with FM than healthy women (15.5 vs 11.8 sec; p>0.001). ROC analyses revealed that the HGs peak force threshold that best discriminated between the presence and absence of FM was 14.2 kg (AUC 0.801; p<0.001), whereas the HGs peak force threshold that best discriminate between PASS was 16.3 kg (AUC 0.834; p<0.001). A neg- ative correlation was found between FIQR and FAS scores and peak force, AUC in patients with FM (all at p< 0.001). Furthermore, a correlation was observed between widespread pain index (WPI) and peak force, AUC (both at p<0.0001), and of the time to reach maximum plateau of the curves (P=0.04) in patients with FM. Factors signifcantly associated with HGs-AUC in multivariate analysis were WPI and FIQR (both at p<0.001). Conclusion: HGs is reduced in woman FM patients and is inversely related to FM severity and symptomatology. The FeT curve gave more information about grip in the FM and could be used as a complementary tool in the assessment and monitoring of FM. Further research on male FM patients is needed to con- frm or contrast these fndings. Table 6. Correlations between HGs curve characteristics and question- naires studied through the Spearman’s rho correlation coefficients (rho). FIQR FAS HGs peak force levels Time to reach maximum plateau of the curves HGs-AUC WPI 0.732 <0.0001 0.823 <0.0001 -0.612 <0.0001 -0.195 0.0415 -0.615 <0.0001 FIQR 0.761 <0.0001 -0.576 <0.0001 -0.054 0.5768 -0.592 <0.0001 FAS -0.577 <0.0001 -0.167 0.0813 -0.588 <0.0001 HGs peak force levels -0.151 0.0249 0.991 <0.0001 Time to reach maximum plateau of the curves -0.135 0.0456 References: [1] Dias, J.J., Singh, H.P., Taub, N. & Thompson, J. Grip strength characteristics using force-time curves in rheumatoid hands. J Hand Surg Eur Vol. 38, 170- 177 (2013). [2] Salaffi, F., Di Carlo, M., Arcà, S. & Galeazzi, M. Categorisation of disease severity states in fbromyalgia: a frst step to support decision-making in health care policy. Clin Exp Rheumatol. 36, 1074-1081 (2018). [3] Aparicio, V.A., Ortega, F.B., Heredia, J.M., Carbonell-Baeza, A., Sjöström, M. & Delgado-Fernandez, M. Handgrip strength test as a complementary tool in the assessment of fbromyalgia severity in women. Arch Phys Med Rehabil. 92, 83-98 (2011). Disclosure of Interests: None declared DOI: 10.1136/annrheumdis-2020-eular.4197 THU0616-HPR EXPIRATORY FLOW ACCELERATOR (EFA) IN SYSTEMIC SCLEROSIS PATIENTS WITH MUCUS HYPERSECRETION, PRODUCTIVE COUGH AND DYSPNOEA: PRELIMINARY RESULTS FROM A HOME- BASED AIRWAY CLEARANCE TECHNIQUE DAILY PROGRAM S. Faverzani 1 , A. Becciolini 1 , E. Crisafulli 2 , F. Nocera 1 , E. DI Donato 3 , F. Mozzani 1 , M. Riva 3 , D. Santilli 1 , L. Monica 1 , A. Barbieri 3 , L. Barone 3 , M. Marvisi 4 , V. Alferi 1 , A. Frizzelli 1 , A. Chetta 1 , A. Ariani 1 . 1 Azienda Ospedaliero Universitaria of Parma, Parma, Italy; 2 Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy; 3 Azienda Ospedaliero Universitaria of Parma, Parma, Italy; 4 Casa di Cura Figlie di San Camillo, Cremona, Italy Background: Systemic sclerosis (SSc) is a chronic disease with frequent lung involvement. As mucociliary clearance is impaired, mucus retention and frequent pulmonary infections, increase morbidity and mortality (1). Airway clearance techniques (ACT) enhance removal of mucus from the airways. Expiratory fow accelerator (EFA) is a new technology that promotes deep and gentle drainage of the bronchial secretions, through the Venturi effect. No res- piratory effort is required and no negative pressure is generated, avoiding risk of bronchial collapse (2). Objectives: The aim of this study was to describe the effectiveness of EFA in improving pulmonary symptoms in SSc patients. Methods: SSc patients with daily productive cough, frequent pulmonary exac- erbations, exertional dyspnea and/or reduced physical activity were selected. All of them underwent a home-based ACT program with EFA. A Respiratory Physi- otherapist (RT) trained each patient to use the device 3 times a day, 15 minutes each session. Every subject compiled the Saint George’s Respiratory Question- naire (SGRQ) and scleroderma Health Assessment Questionnaire (SHAQ) at baseline, 30, 90 and 180 days from the beginning. Statistical analysis has been carried out with General linear model for repeated measures. A value of p<0.05 was considered statistically signifcant. Results: 8 patients were enrolled (M:F=1:7), median age 54 (IC95% 46-69) years. Interstitial lung disease affected the majority of them (7/8). SGRQ total score and SHAQ domain for respiratory symptoms decreased over time on February 23, 2022 by guest. Protected by copyright. http://ard.bmj.com/ Ann Rheum Dis: first published as 10.1136/annrheumdis-2020-eular.2434 on 2 June 2020. Downloaded from